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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400367
Report Date: 03/28/2023
Date Signed: 03/28/2023 04:03:03 PM

Document Has Been Signed on 03/28/2023 04:03 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:FLEWELEN FAMILY CHILD CAREFACILITY NUMBER:
198400367
ADMINISTRATOR:FLEWELEN, EMANIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 710-2277
CITY:LOS ANGELESSTATE: CAZIP CODE:
90011
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
03/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:06 PM
MET WITH:Emani Flewelen, LicenseeTIME COMPLETED:
04:20 PM
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On Tuesday, March 28, 2023 at 1:06 p.m., Licensing Program Analyst (LPA) Mayra Rivera conducted an unannounced annual inspection met with Licensee Emani Flewelen who guided LPA Rivera on a tour of the facility.

During the inspection, 2 children were present LPA Rivera observed the children napping in the living room. Family members residing in the home has been discussed with licensee and are cleared. Operating hours are Monday to Friday, 7:30 a.m., to 6:00 p.m., and care for children ages 0 to 12 years.

This facility is a one-story home that consists of 2 bedrooms, 2 bathrooms, kitchen, living room, laundry room, front and backyard (fenced and gated). Areas that are accessible to children and identified on the facility sketch were inspected by LPA Rivera; living room, kitchen, bathroom (located in the daycare bedroom) daycare bedroom (located in the front) and front yard.

Areas off limits to children include master’s bedroom, laundry room and backyard.

At approximately 1:15 p.m., LPA Rivera entered the facility to inspect for safety, comfort, cleanliness, ventilation and working phone (cell phone). For ventilation, LPA Rivera observed central AC/heater and vents located on the ceiling walls. LPA observed a cubby storage with children personal belongings and the furniture and children materials to be in good condition and age appropriate.

At approximately 1:24 p.m., LPA Rivera entered the restroom and observed the toilet, hand washing sink, hand washing soap and toilet paper. LPA did not observe bottom cabinets nor hazards in the restroom and observed the restroom to be in good condition.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2023
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: FLEWELEN FAMILY CHILD CARE
FACILITY NUMBER: 198400367
VISIT DATE: 03/28/2023
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At approximately 1:31 p.m., LPA observed cleaning compounds items stored inside the bottom kitchen sink cabinet. LPA observed child proof lock installed making it inaccessible to children to open the bottom sink cabinet. Knives and sharp objects, LPA observed the items inside the kitchen drawer with child proof locks making it inaccessible for children to open the drawers. For drinking water, licensee provides sippy cups and water bottles. During this visit, licensee stated, she currently does not have enrolled children with food allergies or on medication. For ill/isolation area, the bedroom located near the living room is utilized.

LPA Rivera asked if there are any pets, poisons, firearms, weapons or bodies of water. Licensee stated she has a dog and no body of waters, firearms, weapons or poisons. LPA observed one dog and did not observe firearms, weapons, poisons nor bodies of water. Licensee was advised that if any poisons (ex; drano, rat poison or items with skull hazard symbol), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately. Licensee understands that any poisons or firearms must be locked with a key or combination lock.



At approximately1:43 p.m., LPA Rivera observed the required 2A10BC fire extinguisher located in the living room and the valve on the green area indicating fully charged and purchased receipt dated 3/10/2022. LPA reminded licensee that the fire extinguisher needs to be serviced annually or purchase a new one. LPA observed the smoke detector in the bedroom located next to daycare room and carbon monoxide in the living room; tested and heard the smoke detector and observed the green light flashing on the carbon monoxide. The smoke and carbon detectors are operable. LPA observed the emergency drill log with last drill conducted on 3/28/2023.

At approximately 1:56 p.m., LPA Rivera inspected the outdoor area for safety, comfort and cleanliness. Licensee informed LPA Rivera, children are currently not utilizing the backyard due to the backyard is currently under construction. Licensee is currently using the front yard for play time. Licensee stated she has been informed; the project will be completed in a week (April 3, 2023). The backyard is currently off limits. LPA did not observe outdoor play materials. LPA observed the front yard to be fenced and gated. LPA observed the gate door to be closed and self-latched. LPA observed the front yard to be in good condition.

At approximately 2:09 p.m., LPA observed licensee Pediatric First Aid/ CPR certification dated 3/17/2021, 8-hour health and safety on 2/4/2018 and Lead Component on 12/7/2020. Licensee has proof of immunization against Pertussis, MMR and Influenza declination. Licensee has completed the mandated reporter (AB 1207) training on 3/17/22 and was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023
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: FLEWELEN FAMILY CHILD CARE
FACILITY NUMBER: 198400367
VISIT DATE: 03/28/2023
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At approximately 2:16 p.m., LPA reviewed the roster, staff #1 and child #1 and #2 files. LPA observed child #1 file to be missing LIC 627 Medical Consent Form and Child #2 LIC 282 Affidavit Regarding Liability Insurance

At approximately 2:34 p.m., LPA observed LIC 610A Emergency Disaster Plan, Pub 394 Notification of Parents Rights, LIC 999 Facility sketch posted on a bulletin board located in the living room

Safe Sleep: LPA discussed the safe sleep regulations with licensee Emani Flewelen and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee Emani Flewelen of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at also explained to licensee that car seat, stroller are only and only for https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA Rivera also reviewed Sudden Infant Death Syndrome (SIDS), Never Shake A Baby, and Lead Exposure information with licensee. Car seats are only for transportation, highchair is only and only for feeding and stated items cannot be misused. No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, or any other items that falls into this category are not permitted in a family child care facility.


The following was also discussed with licensee:
1. In the absence of the licensee a qualified adult must be present, supervising the children; a qualified adult is an individual who has a valid and current Pediatric first aid/ CPR-adult-child- infant certification and a valid criminal record clearance associated to the facility license.

2. A current roster of children enrolled must be available and maintained for a period of 3 years, even after children are no longer attending the facility.

4. Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the license shall be terminated.

5. The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023
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: FLEWELEN FAMILY CHILD CARE
FACILITY NUMBER: 198400367
VISIT DATE: 03/28/2023
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6. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.

7. Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing (refer to LIC 624B). Mandated reporter requirements were reviewed and explained.

8. Fire and safety drills must be performed every six (6) months and documented for review by the Department.

9. Smoking is prohibited in the family childcare home.

10.Children and staff records must be maintained and updated as needed and be available for review by the Department.

11. Dog(s) and/or pets are recommended to be isolated from children in care.

Medication: 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.htm

Criminal Record Statement: Licensee Emani Flewelen was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023
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: FLEWELEN FAMILY CHILD CARE
FACILITY NUMBER: 198400367
VISIT DATE: 03/28/2023
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Licensee has been given technical violation for missing LIC 282 Affidavit Regarding Liability Insurance for Family Child Care (FCC), LIC 627 Consent for Medical Treatment and technical assistance for fire extinguisher not serviced or purchased within the year (purchased receipt dated 3/10/22).

A notice of site visit was given and posted and must remain posted for 30 days.

Exit interview conducted and report was reviewed along with appeal rights with the licensee Emani Flewelen

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023
LIC809 (FAS) - (06/04)
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