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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400512
Report Date: 04/09/2024
Date Signed: 04/10/2024 08:31:00 AM

Document Has Been Signed on 04/10/2024 08:31 AM - 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:THOMPSON FAMILY CHILD CAREFACILITY NUMBER:
198400512
ADMINISTRATOR/
DIRECTOR:		THOMPSON COURTNEYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(424) 219-8416
CITY:LOS ANGELESSTATE: CAZIP CODE:
90059
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
04/09/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Courtney Thompson, LicenseeTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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Licensing Program Analyst (LPA) Alicia Mooberry conducted a Required Annual Inspection on this date. Upon arrival at 11:00am LPA met with Courtney Thompson, Licensee and explained the purpose of inspection. Also present was Melissa Brumsey, Assistant and Adult 1 observed in off limit back bathroom making home repairs. LPA observed two (2) children present including one (1) infant. LPA inspected rooms/areas on the facility sketch in which child-care services are provided and to which children have access. Per licensee the current hours of operation are Monday-Sunday 7:00 am to 7:00 am. The facility provides overnight care. LPA discussed with licensee Overnight Care regulation and reminded licensee that care provided during the day and overnight combined shall not exceed 24 hours from the time the child entered into care. All adults present that require background clearance have obtained it. Individuals residing in the home were discussed and noted. LPA observed a fire bell and strobe installed over the front entrance, that is lose from the wall, posing a potential risk to the health and safety of children in care. Fire escape on window in living room and bedrooms used by children.

This is a one-story home which consists of 3 bedrooms, 2 bathroom, den, kitchen, laundry room, front and backyard (fenced) and detached garage located in the backyard of the home.

Areas used by children include: Living Room (main daycare area), Bedroom 1 and 2 (by living room), bathroom, kitchen, front and back yard. *The backyard is temporarily off limits due to repairs and equipment is located in the backyard.

Areas off limits include: Bedroom 3 (at rear of home by den) and bathroom, den, laundry room, and detached garage.

The off limit areas are all in the rear of the home, are maintained inaccessible by a safety gate in the kitchen leading to the den. Knives and other sharp utensils are located in overhead cabinet in the kitchen. Cleaning products were located in cabinets locked with safety latches under the sink in kitchen and in the overhead shelves in the laundry room. ----- Page 1 - Report Continues

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE: DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/09/2024
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: THOMPSON FAMILY CHILD CARE
FACILITY NUMBER: 198400512
VISIT DATE: 04/09/2024
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LPA observed the facility license posted at entrance to the facility Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form posted in parent board. Licensee was advised to post the required posted documentation in a location visible to parent/guardians of children in care. LPA reviewed completed LIC 610- Facility Disaster Plan. LPA reminded licensee to maintain updated facility records including LIC 9040- Facility Roster. LPA provided licensing forms LIC 9040.

Smoke and carbon monoxide detectors were tested and are operable. Fire extinguisher indicated fully charged with purchase receipt dated 4/9/24, Licensee was reminded that fire extinguisher needs to be serviced yearly. The home maintains telephone service via cell phone and LAN line. The home is observed to be clean and orderly. There are toys and other age-appropriate material available. LPA observed that cleaning compounds are in kitchen inaccessible to children in care. The bathroom that children use is in the hallway and observed to be clean and free of hazards.


Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, not only inaccessible to children.
Per Licensee there are no firearms or weapons stored in the home. Isolation area for sick children waiting to be picked up is in the daycare room, away from the other children and supervised.

LPA discussed the safe sleep regulations and 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 observed a large trampoline in the backyard with a safety net and in good repair. Per licensee, children age 9 and up are allowed to play in trampoline supervised. LPA provided Trampoline Safety handout from the https://www.cpsc.gov/s3fs-public/085%20Trampoline%20Safety.pdf

Due to construction in the bathroom at rear of home and backyard is used as a holding are for equipment and debri, the backyard is off limits to children in care. The children are using the front yard for outdoor play. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with The facility does not have a pool or similar bodies of water. No pets in the home ----------Page 2 – Report Continues

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024
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: THOMPSON FAMILY CHILD CARE
FACILITY NUMBER: 198400512
VISIT DATE: 04/09/2024
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Children’s records were reviewed: One infant in care is missing Sleep log and immunization records which poses a potential risk to the health and safety of children in care.

Staff records were reviewed Licensee's Pediatric CPR and First Aid expired on 10/2023, Assistant's CPR/First Aid is not EMSA approved.

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/

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

Licensee 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.

Based on the LPA's observations and records review the facility is cited three (3) "B" deficiencies in accordance with California Title 22 Regulations.

During the exit interview, the licensee Courney Thompson, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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

Exit interview conducted and report was reviewed with Licensee Courtney Thompson. Appeal Rights were discussed and a copy provided.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/10/2024 08:31 AM - It Cannot Be Edited


Created By: Alicia Mooberry On 04/09/2024 at 02:07 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: THOMPSON FAMILY CHILD CARE
FACILITY NUMBER: 198400512

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/09/2024

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
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Based on interview and record review, the licensee did not comply with the section cited above in that 2 out of 2 staff do not have completed pediatric CPR/1st Aid which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/23/2024
Plan of Correction
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Per licensee, the Licensee and Staff will complete the required EMSA approved pediatric CPR/1st Aid and send proof of completion to LPA by POC due date.
Type B
Section Cited
CCR
102418(g)
Immunizations
(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that 1 out of 3 children's files did not have immunization record which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/23/2024
Plan of Correction
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Per licensee, the Licensee and Staff will send immunization record to LPA by POC due date.
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:Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:
DATE: 04/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/09/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/10/2024 08:31 AM - It Cannot Be Edited


Created By: Alicia Mooberry On 04/09/2024 at 02:15 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: THOMPSON FAMILY CHILD CARE
FACILITY NUMBER: 198400512

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/09/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above due to fire bell and strobe mounted over the front door has detached from the wall, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/12/2024
Plan of Correction
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Per licensee, the bell and strobe alarm will be secured safely to the wall and a photo will be sent to LPA by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:
DATE: 04/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/09/2024


LIC809 (FAS) - (06/04)
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