198400499-7-28-2023-54-CC-FWHE-CU6QCN-20230728120324

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400499
Report Date: 07/28/2023
Date Signed: 07/28/2023 12:03:34 PM

Document Has Been Signed on 07/28/2023 12:03 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	HAYES FAMILY CHILD CARE		FACILITY NUMBER:	198400499
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 1	DATE:	07/28/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Tierria Hayes		TIME COMPLETED:	12:30 PM

NARRATIVE

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Licensing Program Analyst (LPA) Franchesca White conducted an Unannounced Required Annual inspection to the above facility on 07/28/2023 at 10:00 am. Licensee was not home upon LPA arrival to the home. LPA White called Licensee. She disclosed that she was at the park with one child, and would be home in 10 minutes. Upon arrival, LPA disclosed the purpose of the inspection and met with Licensee, Tierrea Hayes. Licensee was the only adult in the home at the time of inspection, and Licensee's criminal clearance was current. There was one day care child present during today’s inspection. Licensee states she has five children enrolled at this time. Per Licensee, the facility’s hours of operation are 24 hours a day, 7 days a week. Emergency Disaster Plan, License, and Parents’ Rights were posted at the time of inspection. Disaster drill log was also available during today’s inspection, last disaster drill conducted on June 21, 2023.

This is a single story home which consists of two bedrooms, one bathroom, kitchen, living room, dining room. Areas used by the children include the Living Room, Dining Room, and Bathroom 1. Per Licensee, areas off limits to children and parents are the master bedroom, bedroom two, backyard, and kitchen area.

All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. There is a working telephone maintained in the home.

LPA observed Kitchen to be free of clutter. Detergents, cleaning compounds, medications, and other items which can pose a danger to children in care to be inaccessible. LPA observed knives to be kept in kitchen locked drawer with a key and detergents and cleaning compounds to be stored in the kitchen in a locked cabinet, making these items and other hazardous items inaccessible to children in care at time of inspection.

Report Continues 1 of 3 Pages

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023

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

LIC809 (FAS) - (06/04)

Page: 1 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: HAYES FAMILY CHILD CARE	FACILITY NUMBER: 198400499
	VISIT DATE: 07/28/2023

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The Licensee states that there are no poisons in the home. The Licensee does understand that poison must be locked with a key or combination lock. At 10:20 a.m., LPA observed Bathroom 1 to have operable toilet, potty training toilet and sink, bathtub free of shampoos, adequate hand washing supplies, and floor free of hazards at time of inspection.

Per Licensee, the children have access to front yard area for outdoor play. LPA discussed supervision for outdoor play when gate is open with the Licensee. Licensee states that she provides painting activities, and yoga in her front yard for the daycare children. Also, Licensee takes the daycare children to the park that is 10 minutes away from the home for outdoor activities. LPA observed front yard to be maintained and free of hazards at time of inspection.

Per Licensee, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPA observation did not see any bodies of water around the premises or firearms in the home.
Per Licensee, they provide food for children in care.

At 10:35 a.m., LPA observed the valve on the required 2A 10BC fire extinguisher indicates fully charged with service tag. At 10:45 a.m., LPA observed smoke and carbon monoxide detectors are in operable condition at time of inspection. LPA observed First Aid kit is kept in the Living Room (main care space). The Licensee has current Pediatric First Aid and CPR. Proof of immunization against influenza, pertussis, and measles were readily available during today's inspection. The Licensee has a current Mandated Reporter Training certificate. LPA White Reviewed Staff and Child Records and found them to contain all required department documentation at the time of inspection.
__ Mandated Reporter Training valid until: 7/12/2025
—CPR Card valid until: 12/09/2023
—Fire Extinguisher was last serviced on: July 2023
To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.
Report Continues 2 of 3 Pages

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: HAYES FAMILY CHILD CARE	FACILITY NUMBER: 198400499
	VISIT DATE: 07/28/2023

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Licensee Tierria Hayes was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee Tierria Hayes 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 [or facility representative] 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee Tierria Hayes was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Based on observations, interviews, and record review there are no deficiencies sited today under Title 22.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Tierria Hayes.

End of Report 3 of 3 Pages

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023

LIC809 (FAS) - (06/04)

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