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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400116
Report Date: 11/22/2021
Date Signed: 11/22/2021 02:33:17 PM

Document Has Been Signed on 11/22/2021 02:33 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 CAREFACILITY NUMBER:
198400116
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
11/22/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Elexis Longwood, LicenseeTIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Dayna Chambers conducted a case management- licensee initiated inspection today for the purpose of a capacity increase. LPA met with Elexis Longwood, Licensee who guided analyst on a tour of the facility. Also, for today’s inspection was the assistant. The licensee is requesting a large family childcare home. Per licensee, operation hours will be Monday through Friday 5:00am to 6:00pm. Closed Saturday and Sunday. Licensee states that they will care for children 6 weeks to 13 years old. The FCCH roster was reviewed and is current. There are 12 children enrolled and 4 children were present during inspection. There is one infant currently enrolled.

All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a one- story home that consists of two bedrooms (one of the bedrooms will be used for napping infants). The home consists of 1 restroom, kitchen, living room, detached garage, backyard, and front yard.

Per licensee, the children will use the restroom in the hallway. The day care bedroom, living room, and backyard. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service via cell phone and land line. The ventilation and heating are provided by wall heater that is blocked and inaccessible to children. The fireplace is blocked by a gate and is inaccessible to children. Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible and are all kept in high cabinets in the kitchen.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2021
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: 11/22/2021
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Based on the Facility Sketch submitted, areas off limits to children and parents are: Master bedroom, garage, and front yard are off-limits. There are locks in all off- limit areas. The licensees understand that licensing staff may have access to off-limit areas during inspection visit if necessary. LPA toured all areas in the facility sketch including off-limit areas during inspection.
A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Elexis Longwood.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2021
LIC809 (FAS) - (06/04)
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