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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400499
Report Date: 11/19/2024
Date Signed: 11/19/2024 12:46:02 PM

Document Has Been Signed on 11/19/2024 12:46 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:HAYES FAMILY CHILD CAREFACILITY NUMBER:
198400499
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
11/19/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Tierrea Hayes, LicenseeTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Franchesca White arrived at the above facility for the purpose of an Annual inspection and Capacity Increase visit. LPA White announced the purpose of the visit and was granted entry into the facility by Licensee Tierrea Hayes. There are 12 children enrolled, and 0 present at the time of the inspection. Licensee states that she serves children ages infant to 13 yeas of age. Hours of operation are 23 hours / 7 days a week. There are no other adults in the home. Licensee has current criminal background clearance. Upon entry of the home, the parent board was observed to have the following:
  • license, emergency disaster plan, facility sketch, parent's rights, family child care orientation, abuse hotline information and symptoms of illness.
The disaster drill was available at the time of inspection with the last drill being conducted on 10/15/2024.

Licensee Tierrea Hayes applied for a capacity increase on 5/17/2024. Licensee was granted a capacity increase for 14 children on 10/29/2024. Licensee has a landlord consent form on file with the department.

All life saving devices were observed during the inspection. The 2A 10BC fire extinguisher is located behind the front door of the home and has a service tag dated for 7/18/2024. The smoke detector and carbon monoxide detector is located above the front door of the home and was operable at the time of inspection.

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. ...............Report Continues 1 of 3 pages..........................................................
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE: DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/19/2024
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: HAYES FAMILY CHILD CARE
FACILITY NUMBER: 198400499
VISIT DATE: 11/19/2024
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There is a working telephone maintained in the home.

Main care area was observed to have hardwood floors with floor rugs with letters and planets. Cubbies are located to the left upon entry of the home for children's belongings. Playroom rules are posted and visible for young children to see. Bulletin boards with expressions of children's emotions, colors, shapes, numbers, and months of the years line the walls. There is also a flat screen tv mounted to the wall. Licensee states that the library of the home to the right of the front door will be used as a isolation space for sick children waiting to be picked up. LPA observed a baby gate making the off limits areas of the home inaccessible to children in care.



LPA White observed a baby gate to make the kitchen area of the home inaccessible to children in care. 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.

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. 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. The outdoor play area was observed to be in the driveway of the home with a catapillar, three scooters, and an area to play ball in her front yard for the day care children. LPA observed fencing around the perimeter of the home. Also, Licensee takes the day care 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.
............................................................Report Continues 2 of 3 Pages.........................................................
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2024
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: HAYES FAMILY CHILD CARE
FACILITY NUMBER: 198400499
VISIT DATE: 11/19/2024
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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 the following documentation LIC's 700,702,282, 627, 995A, 9150, along with contract.

The following were discussed:
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: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2024
LIC809 (FAS) - (06/04)
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