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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400580
Report Date: 06/09/2022
Date Signed: 06/09/2022 11:58:06 AM

Document Has Been Signed on 06/09/2022 11:58 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:MAJIED FAMILY CHILD CAREFACILITY NUMBER:
198400580
ADMINISTRATOR:LIBERTIE MAJIEDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 991-1242
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/09/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Libertie Majied, ApplicantTIME COMPLETED:
12:00 PM
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On 06/09/22 at 10:10am Licensing Program Analysts (LPAs) Alicia Mooberry and Monique Ayala conducted a pre-licensing inspection with Libertie Majied, Applicant. The applicant is requesting to operate a Large Family Day Care Home (up to 14 children). A fire clearance for a capacity of 14 children was granted on 05/10/22. The operating hours would be Monday through Friday from 7:00 AM to 5:30 PM. The applicant is applying to care for children ages: Infants to 5 years old. Entrance Checklist was provided to the applicant upon arrival. Individuals residing in the home were discussed and noted.

All areas identified on the facility sketch were inspected. This facility is a single family home that consists of three (3) bedrooms, one (2) bathroom, living room, dining room, kitchenette, laundry room (next to kitchen) den and attached garage.

Areas that are accessible to children include: Den (located in the rear of home, 1 bathroom, office and backyard (fenced). Per applicant, the children will utilize the backyard (fenced) for outdoor activity. The den is designated as the main day-care area.

Areas off limits to children include: 3 bedrooms, 1 bathroom, kitchen, living room, laundry area, garage and side yard. LPA observed a safety gate at the entrance to the den to prevent access to areas that are off limit to children. All of the bedroom doors were observed to be closed with safety door handles, and door leading to the garage was closed and locked with door alarm. The applicant was advised that off-limit areas must be made inaccessible during operating hours.

Areas used by children were inspected for safety, comfort, heating, cleanliness and telephone service. LPA observed a floor heater in the hallway in the off limits area where the bedrooms are located, the gate at the entrance to the den making the heater inaccessible to children. Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible in locked kitchen cabinet and overhead locked cabinet in the hallway (off limit area).

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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE: DATE: 06/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/09/2022
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: MAJIED FAMILY CHILD CARE
FACILITY NUMBER: 198400580
VISIT DATE: 06/09/2022
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Applicant disposed of poisons in the home. Applicant was advised that if any poisons are purchased, it is required to be locked with a key or combination lock.

Per applicant, there are no pets, firearms, weapons or bodies of water on the premises. LPA observed age appropriate toys and napping equipment for the children. LPA observed electrical outlet covers throughout the facility. LPA observed the required fire extinguisher (2A-10BC) that is fully charged with a purchase receipt of 04/21/22. Applicant was informed to have the fire extinguisher serviced yearly. Smoke and carbon monoxide detectors (located in the den) were tested and are operable.

A First Aid kit and emergency supplies are available in the office in den. The applicant was advised that if food is brought from the children’s home, all containers must be labeled with the child’s name and properly stored or refrigerated.

The applicant has proof of pediatric First Aid/CPR certification (expire 3/23/24). Both applicants have proof of immunization against pertussis and measles. Applicant has a written Flu vaccine declination on file. Applicant completed the Preventative Health and Safety training, including the Nutrition and Lead components on 5/10/2022, and Mandated Reporter training (AB 1207) on 05/12/22. Applicant was advised that the mandated reporter training must be completed every 2 years and is available at www.mandatedreporterca.com.

There are age appropriate toys available for children.


The applicant states that they will provide food for children in care. If food is not provided and food is brought from the children’s homes; container shall be labeled with child’s name and properly stored or refrigerated.
Playpens and cots were observed and available for napping infants and toddler.
LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant 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.

Applicant states that they will care for infants. LPA advised the applicant to sleep infants where they can be directly supervised at all times and advised against sleeping infants in a separate room. The applicant states the following is a supervision plan for infants: Applicant states that infants will sleep in the living room where they will be providing supervision. LPA provided the applicant with a copy PIN 20-24-CCP LPA also provided the LIC 9227 to Applicant. ------Page 2

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

DATE: 06/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022
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: MAJIED FAMILY CHILD CARE
FACILITY NUMBER: 198400580
VISIT DATE: 06/09/2022
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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: http://www.ada.gov/childqanda.htm

LPA Ayala with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted

LPA Ayala provided Technical Assistance for COVID-19. Applicant completed a COVID -19 Self Assessment.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.



LPA Ayala provided assistance to the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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

DATE: 06/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022
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: MAJIED FAMILY CHILD CARE
FACILITY NUMBER: 198400580
VISIT DATE: 06/09/2022
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Per applicant, there are no dual licenses at this address. Applicant’s email address was obtained during this inspection. The applicant was advised that email may be public information.

A final review of the application will be conducted by the Department. Once licensed, the applicant is required to adhere to the terms and limitations stated on the license.

Exit interview conducted and report was reviewed with the applicant, Libertie Majied.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022
LIC809 (FAS) - (06/04)
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