198400116-8-27-2021-54-CC-DCHS-C6AT32-20210827142136

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400116
Report Date: 08/27/2021
Date Signed: 08/27/2021 02:21:44 PM

Document Has Been Signed on 08/27/2021 02:21 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	LONGWOOD FAMILY CHILD CARE		FACILITY NUMBER:	198400116
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 5	DATE:	08/27/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Elexis Longwood, Licensee		TIME COMPLETED:	03:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Dayna Chambers conducted an unannounced annual inspection to the above facility on 08/27/2021. LPA arrived at the facility at 1:00PM and met with Elexis Longwood, Licensee who guided analyst on a tour of the facility. Also present during this inspection, was Crystal Brown, Licensee’s Assistant. Per Licensee, operation hours are 6:00am – 11:00pm Monday – Friday, Closed Saturday and Sunday. There are 12 children that are currently enrolled. A current children’s roster was available for review. There were 5 children present upon arrival. There are currently 3 infants enrolled. This is a one-story home which consists of 2 bedrooms, 1 bathroom, kitchen, dining room, living room, Laundry Room, front yard and backyard (fenced). The children use the bathroom in the hallway. LPA observed that there is a fireplace in the living room and it is screened. Per Licensee, areas off limits to children and parents include: master bedroom and laundry room. The licensee provides food for children in care. Individuals who reside in the home were noted and discussed. Per Licensee, they currently have one assistant. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed childcare home. Licensee states that there are no firearms stored in the home. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a landline and a cellphone that is used and the cellphone stays at the facility during operation hours. There is ventilation and heating portable air conditioner. LPA observed the wall heater to be screened/barricaded). Safe toys play equipment and materials were observed. Pg 1

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LONGWOOD FAMILY CHILD CARE	FACILITY NUMBER: 198400116
	VISIT DATE: 08/27/2021

NARRATIVE

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Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. Poisons are locked in a cabinet in the laundry room and it is stored in the cupboard. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock. The restroom that children use was observed to be safe and sanitary.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 03/16/2021, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable.

Licensee states that she is currently caring for infants. Licensee states that infants sleep in the living room. Appropriate sleeping arrangements and cribs were observed. (one crib for each infant in care was observed. Cribs or play yard did not hinder the entrance or exit from the sleeping space , mattresses shall be firm and covered with a fitted sheet that overlaps the underside so it cannot be dislodged. Cribs and play yards were observed to be free of loose articles and objects. No objects were observed to be hanging above or attached to the side of the crib. LPA did not observe any infants swaddled while in care. LPA advised the Licensee that infants shall be placed on their backs for sleeping and shall be supervised. Infants shall be checked on every 15 minutes and the time of each 15-minute check shall be documented with child’s name and date.

The LIC 9227 Individual Infant Sleeping Plan shall be completed for each infant up to 12 months of age. A copy of the LIC 9227 was provided to Licensee. a copy of the Provider Information Notice (PIN) 20-24 CCP: Recently Approved Safe Sleep Regulations in Effect.

Currently, children are not using the back yard for outdoor play time. The outdoor play area was observed to be fenced. LPA did not observe any objects that can pose a danger to children on the outdoor yard. Pg 2

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LONGWOOD FAMILY CHILD CARE	FACILITY NUMBER: 198400116
	VISIT DATE: 08/27/2021

NARRATIVE

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The licensee is observed to be operating within the license capacity limitations. LPA did/did not observe any children left in parked vehicles. Car seats shall only be used for transportation. LPA did not observe any children sleeping in car seats.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 03/03/23. There are first aid supplies available. LPA advised that if a child shows signs of illness he/she/they shall be separated from other children.

Children’s records were reviewed, including emergency information and were observed to be complete.

The licensee does/does not have proof of immunization against influenza, pertussis, and measles.

LPA observed that the Licensee and assistant do not have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file.

LPA issued a Confidential Names List (LIC 811) to the licensee which documents staff and children’s files reviewed during this inspection.

All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill documented was conducted on 07/15/2021

There are no pets on the premises.

LPA did not observe any pools, spas, hot tubs, fish ponds, or similar bodies of water during the inspection.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility. Pg 3

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LONGWOOD FAMILY CHILD CARE	FACILITY NUMBER: 198400116
	VISIT DATE: 08/27/2021

NARRATIVE

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Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

LPA provided the licensee with a copy of A Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. LPA also consulted and explained Child Abuse Reporting, Never Shake a Baby, and Safe Sleeping practices.

Incidental Medical Services (IMS):
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htmLPA advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov. LPA also discussed the Provider Information Notices (PINS) on Safe Sleep Awareness: PIN 19-02-CCP, COVID FAQ - PIN 20-11-CCP, Required Lead Testing: PIN 20-01 CCP Effects of Lead Exposure, and Guardian User Account Access - PIN 20-20-CCLD.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

Exit interview was conducted with Elexis Longwood, Licensee, including, but not limited to Appeal Procedures/appeal rights, Site Visit and agency’s consultative role.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

LIC809 (FAS) - (06/04)

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