198400462-2-16-2023-54-CC-SSAZ-CP4VSB-20230216154116

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400462
Report Date: 02/16/2023
Date Signed: 02/16/2023 03:41:42 PM

Document Has Been Signed on 02/16/2023 03:41 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:	IBIZUGBE FAMILY CHILD CARE		FACILITY NUMBER:	198400462
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 2	DATE:	02/16/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:40 AM
MET WITH:	Catina Ibizugbe, Licensee		TIME COMPLETED:	04:00 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 Analysts (LPA) Susann Sanchez conducted an unannounced annual required inspection at the above facility on 2/16/2023 at 11:40AM. LPA met with Catina Ibizugbe, Licensee who guided analysts on a tour of the facility. There were 2 children present when LPA arrived with the Licensee. Also present was Licensee daughter/assistant who is fingerprinted clear. Facility capacity is in compliance for a small Family Child Care Home. Currently hours of operation are Mon-Fri 7:00 AM - 5:30PM. However Licensee stated she is available all hours, 7 days a week if a parents needs. Food is provided by Licensee. Upon arrival LPA observed an adult in an "off limit" area with a infant. Adult and Licensee stated that adult was just using the microwave because they lost power at their home. Adult left within 5 minutes. LPA reminded Licensee that everyone visiting for long periods of time needs to be fingerprinted during operating hours. This is a one-story home which consists of 3 bedrooms, 2 bathrooms, family room, kitchen, living room/ preschool room, garage, backyard and front yard. The children use the bathroom in the hallway, living room/preschool room, and backyard. The children use the family room only as a walkway to go outside. Per licensee, areas off limits to children and parents include: all bedrooms, master bathroom, kitchen, garage, laundry room observed the bedroom doors, garage and outdoor shed door closed and locked, making the areas inaccessible to children. Individuals residing in the home have been discussed and noted. All adults present in the home have obtained a criminal record clearance or exemption. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection:

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023

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: IBIZUGBE FAMILY CHILD CARE	FACILITY NUMBER: 198400462
	VISIT DATE: 02/16/2023

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LPA reviewed required posted documentation for Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. Facility records were reviewed for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster drill log, last drill conducted 09/08/22. Licensee was reminded that another drill needs to be conducted by 03/08/2023.

Smoke and carbon monoxide detectors were and were operable. The home maintains telephone service via cell phone. The home is observed to be clean and orderly. There are toys and other age appropriate material available for children. LPA observed that detergents, cleaning compounds and medication are stored under the kitchen sink and was locked and inaccessible to children. Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, not only inaccessible to children. Isolation area for sick children waiting to be picked up is in living room, away from the other children.

There are weapons, firearms on the premises. LPA observed the firearm to be secured within Title 22 regulations. Licensee has a two big dogs and one small dog. The big dogs are kept in the side outdoor walkway, locked, and away from children.

Infant Care: Currently Licensee does not have infants enrolled and is still unsure if she wants to watch infants in the future. LPA reviewed the following in case Licensee cares for infants in the future: infants mattresses should be firm with tightly fitted sheets and loose object, bumpers, objects hanging, or objects attached to the cribs/play yards. There are currently no infants with pacifiers. LPA reminded licensee of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation. Licensee states the following a sleep supervision plan for infants: current infants in living room room in cots.

Currently, children are using the back yard for outdoor play. The outdoor play area was observed to be fenced. LPA's observed that the outdoor yard has toys and other materials for children to play with. LPA's did not observe any objects that could be hazardous to children in care. There are no pools or spas, or other bodies of water.

Around 12:20pm LPA asked for children's files and Licensee stated she currently has no files for the children that were present during today's inspection. The following was missing: (LIC) 282- Affidavit Regarding Liability Insurance, Immunizations Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights. LPA cited a type B.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023

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: IBIZUGBE FAMILY CHILD CARE	FACILITY NUMBER: 198400462
	VISIT DATE: 02/16/2023

NARRATIVE

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Staff records were reviewed for approved , LIC-501: Personnel Record, LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement of Child and Mandated Reporter Training Certificate expires on 10/13/2024.

During staff file review at around 12:20pm, LPA observed that the current Pediatric First Aid and CPR card did not have the Emergency Medical Services Authority (ESMA) stickers. LPA called and talked to the trainer on the card but was unable to provide proof. LPA also called EMSA and stated that the company on the card is approved (Medic First Aid), but trainer list on card is not authorized to purchase the ESMA stickers and was unable to verify if trainer is ESMA approved. LPA cited a type B.

During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.

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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

Licensee 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: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023

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: IBIZUGBE FAMILY CHILD CARE	FACILITY NUMBER: 198400462
	VISIT DATE: 02/16/2023

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Consult was given regarding the following: Technical Support Program (TSP), change in capacity, and missing documents.

At 1:49pm, Licensee told LPA that she had to leave the facility but will return at 2:30pm. LPA left at 1:55pm to a near by Los Angeles Public Library to finish report.

LPA returned to the facility at 3:00pm to conduct staff interview and finish inspection.

LPA discussed the safe sleep regulations with licensee 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 of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at 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 advised the licensee to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov.

Based on the LPA's observations and records review the following deficiency will be cited today in accordance with California Title 22 Regulations.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee Catina Ibizugbe. Appeal Rights were discussed and a copy provided.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/16/2023 03:41 PM - It Cannot Be Edited

Created By: Susann Sanchez On 02/16/2023 at 02:43 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: IBIZUGBE FAMILY CHILD CARE	FACILITY NUMBER: 198400462
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/16/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102416(c)

Personnel Requirements

(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. Licensee does not have proof of a ESMA provided CPR & 1st Aid training which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/16/2023
	Plan of Correction
1 2 3 4	Per Licensee will retake CPR & First Aid class with an provided ESMA trainer and provide proof via email by POC due date of 03/16/23.

Type B

Section Cited

CCR

102421(b)

Child's Records

(b) The licensee shall maintain, in each child's record, a copy of the emergency information card as required in Section 102417(g)(7). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above. When LPA asked to see the files of the 2 children being care for on the above date, Licensee stated that she currenlty has no children's files which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/02/2023
	Plan of Correction
1 2 3 4	Per Licensee will obtain children's files. Licensee will submitt a photo by POC due date of 03/02/23 via email. LPA will make a referral to TSP where Licensee stated she will like to join.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Valarie Cook

LICENSING EVALUATOR NAME:

Susann Sanchez

LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023

LIC809 (FAS) - (06/04)

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