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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400586
Report Date: 06/20/2022
Date Signed: 06/20/2022 11:27:35 AM

Document Has Been Signed on 06/20/2022 11:27 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:NORMAN FAMILY CHILD CAREFACILITY NUMBER:
198400586
ADMINISTRATOR:ROBIN NORMANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 658-9658
CITY:CARSONSTATE: CAZIP CODE:
90746
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/20/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Robin Norman, LicenseeTIME COMPLETED:
11:50 AM
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On June 20, 2022 Licensing Program Analyst (LPA) Susann Sanchez conducted a pre-licensing inspection for the above address. LPA met with Robin Norman, Licensee, who guided LPA on a tour of the facility. Individuals residing in the home were discussed and noted. Licensee is co-licensee with her sister (198019864), but has moved out to the above address. Per Licensee, hours of operation will be Monday through Sunday, 12:00 am to 11:57 pm and does not to exceed 24 hour care at one time. Licensee states that she will care for children 0-12 years of age. Entrance Checklist was provided to the applicant.

This is a two-story home which consists of 5 bedrooms (all upstairs), 4 bathrooms, classroom/den, kitchen, dining room, living room, garage, front and backyard. The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children.

Areas used by children include: classroom/den, living room, bathroom located in the living room, and backyard.


Areas off limits include: All of upstairs which include 5 bedrooms and 3 bathrooms, kitchen, dining room, garage, and front yard.

The off limit areas need to be inaccessible. The stairs and kitchen need a gate.

Knives and other sharp utensils are located in high cabinet in the kitchen.

The home is clean and orderly, there are outlet covers throughout the home. Smoke detectors and carbon monoxide detector were observed, tested and found to be operable.

Licensee states she has completed the required health and safety training but still needs to submit proof., the Pediatric First Aid and CPR Exp. 08/1/22 . Licensee has proof of immunization against pertussis and measles, influenza. Proof of Mandated Reporter Training was also submitted and expires on 04/18/2024.

Licensee states she will provide food for children in care.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 06/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/20/2022
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: NORMAN FAMILY CHILD CARE
FACILITY NUMBER: 198400586
VISIT DATE: 06/20/2022
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LPA observed age appropriate toys and learning materials. The required (2A10BC) fire extinguisher was observed in the kitchen and needs to be service. First Aid kit is available. Per Licensee, there are no weapons or firearms in the facility, none were observed by LPA. There is central air in the home. LPA did not observe any gates or latches on the fireplace in the classroom/den.

LPA observed one small dog (however Licensee stated that dog visiting) and a fish tank in the living room.

Per Licensee, the back yard will be used as outdoor play area. Per Licensee children will fully supervised when playing in the backyard. Safe and age appropriate toys were available. LPA observed an Aloe Vera pant outside in the backyard.

There is a fountain in the front yard. Licensee has removed the water and signed a declaration stating the fountain will always be empty and children are not allowed in the front yard alone. Front yard is only used for drop off and pick up.

LPA provided the Safe Sleep regulation and provided PIN 20-24-CCP and the Infant Sleep Plan LIC 9227. Children and infants will nap in the classroom/den room, cots are available.

LPA discussed the safe sleep regulations with applicant 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 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.

LPA reviewed with Licensee that napping equipment should not block entrances or exits. Infant mattresses w must be to be firm with tightly fitted sheets. Loose object, bumpers, objects hanging, or objects attached to the cribs/play yards are not allowed. Each infant should their own crib/ play yard and bedding. LPA informed licensee of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months, and provided PIN 20-24-CCP. Licensee states the following a sleep supervision plan for infants: will sleep in the classroom/den room.

LPA discussed self-assessment and answered question regarding COVID-19 procedures. LPA advised applicant to ensure they are following the guidance from the local health authorities in order to prevent and reduce the transmission of diseases.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2022
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: NORMAN FAMILY CHILD CARE
FACILITY NUMBER: 198400586
VISIT DATE: 06/20/2022
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The isolation area for a sick child waiting to be picked up will be in the living room from other children.
The following was discussed with the Licensee:

· In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR & Pediatric First Aid certification, TB clearance, immunization, Mandated Reporter training certificate www.mandatedreporterca.gov, and a valid criminal record clearance associated to the facility license. A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.

· Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.


· Fire and safety drills must be performed every six months and documented for review by the Department.
· Smoking is prohibited in a family child care home.
· Children and Staff records must be maintained and updated as needed and must be available for review by the Department.
· No infant walkers, No Johnny jumpers, No saucer chairs, and any other item that falls into that category are not permitted in the facility.
· Inspection Authority: All adults living and working in the home shall be made of aware of the Department’s right to inspection the home, which includes, but is not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.
· The facility license number must be on all advertisements, publications or announcements with the intent to attract clients.
· Isolation for Ill children: When a child is ill he/she shall be separated from other children (reference 102417(e) Operation of a Family Child Care Home).
· Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information. Licensee states she does not have liability insurance. But will look into it.

LPA reviewed 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

OTHER INFORMATION THAT WAS DISCUSSED:


· Never Shake a Baby, Sudden Infant Death Syndrome (SIDS) and Safe Sleeping practices.
Per applicant, there are no dual licenses at this address.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2022
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: NORMAN FAMILY CHILD CARE
FACILITY NUMBER: 198400586
VISIT DATE: 06/20/2022
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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.

APPLICANT WILL WAIT UNTIL FACILITY OPENS TO DETERMINE IMS NEEDS: 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

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. 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.

A small family childcare license will be granted and submitted to the department final application review once all plan of corrections have been submitted.

Corrections Need by 07/20/22

  • Stairs need to be gated
  • Fire places need to be blocked off
  • Aloe Vera plant in the backyard needs to be removed or blocked off.
  • Fire extinguisher needs to be serviced.
  • Health and Safety course needs to be submitted.
  • Fingerprints need to be transferrer from previous license.

Once licensed, the Licensee is required to comply with the terms and limitations stated on the license.
Exit interview conducted and report was reviewed with the licensee Robin Norman.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2022
LIC809 (FAS) - (06/04)
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