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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400604
Report Date: 06/17/2022
Date Signed: 06/17/2022 01:35:06 PM

Document Has Been Signed on 06/17/2022 01:35 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:PERDUE FAMILY CHILD CAREFACILITY NUMBER:
198400604
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
06/17/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Robin Perdue - LicenseeTIME COMPLETED:
01:40 PM
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This is an announced Pre-licensing Inspection conducted today by Alicia Bailey Licensing Program Analyst (LPA) on 06/17/2022 at 9:30 am conducted with the licensee Robin Perdue to inspect the facility for licensing. At 9:38 am during the inspection, LPA Bailey discussed, assessed, and noted individuals residing in the home. The licensee Perdue is applying for a small family childcare home relocation from facility 198400199. This is a one-story home with a attached garage. The operating hours would be Sunday thru Saturday from 6:00 am to 5:59 AM 23 hours. 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.

The licensee Perdue renting the property. The licensee Perdue provided a copy of the rental agreement showing as proof of renting.

All areas identified on the facility sketch were inspected. This facility is a one story family home that consists of three (4) bedrooms, two (2) bathroom, living room, dinning room, kitchen, Den, backyard, and garage.

Areas used by the children were inspected as follows: living room , (day care room) bedroom one, bedroom two, one bathroom, Den and backyard. Licensee Perdue states the main day care in the day care room and second bedroom.

Areas off-limits include the Garage ( lock on the garage door to prohibited access during hours children are in care) two (2) bedrooms, one (1) bathroom and the kitchen, dining room.

**Rooms that are off-limits need to be made inaccessible during operating hours** The licensee Perdue does understand that licensing staff may have access to off-limit areas during inspection visits if necessary.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Alicia Bailey
LICENSING EVALUATOR SIGNATURE: DATE: 06/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/17/2022
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: PERDUE FAMILY CHILD CARE
FACILITY NUMBER: 198400604
VISIT DATE: 06/17/2022
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Licensee Perdue completed the Pediatric CPR/First Aid on 03/16/2022 and expires on 03/16/2024 as indicated on the certificates. Preventative Health practices and Lead component certification were completed on 03/28/2022. The mandated reporter training was completed on 03/16/2022. The licensee completed the COVID-19 Self-Assessment on 05/03/2022.

Per the licensee Perdue , there are no firearms in the facility. There is no swimming pool, spa, or other bodies of water observed on the premises. LPA Bailey asks applicant Perdue do you have any pets. licensee Perdue stated yes. Licensee Perdue state the dog is in off-limit area of the backyard and is not involve in the family child care home.

At 10:10 AM LPA Bailey asks the licensee to be guided on how the children will enter the facility. licensee Perdue demonstrates the parents and children will walk thru the front door through the living room to hallway that leads to the day-care room.

At 10:15 AM LPA Bailey observed a parent board at the entrance of the facility with the required posting. LPA Bailey observed wellness station at the entrance of the facility with the following items ( thermometer, hand sanitizer, extra mask, and gloves).

At 10:18 AM LPA Bailey observed in day-care room one age-appropriate furniture, toys, and equipment. At 10:26 AM LPA Bailey observed all the electrical wall socket in the day care room one was child proof and advised the licensee to check often to ensure that they are covered. Licensee Perdue state she understood. At 10:36 AM LPA Bailey inspected the bedroom two, LPA Bailey observed two cribs, cots, bedding and rocking chair. LPA Bailey observed electrical wall socket in bedroom two was child proof covered. LPA Bailey advise licensee Perdue to check often.

At 10:47 AM LPA Bailey inspected the kitchen ( off-limit). LPA Bailey observed fire extinguisher (2A 10BC) purchase on 04/18/2022. LPA Bailey observed child proof latches on the kitchen cabinet. LPA Bailey asked the licensee where do you keep the knives. The licensee showed the knives on the top cabinet.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Alicia Bailey
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: PERDUE FAMILY CHILD CARE
FACILITY NUMBER: 198400604
VISIT DATE: 06/17/2022
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LPA Bailey ask Licensee Perdue will she provided meals for the children in care? Licensee Perdue stated yes, Breakfast, Lunch, and Snack. Licensee Perdue stated will provide meals outside the area following COVID-19 protocol when weather permits.

At 10:52 AM LPA Bailey ask Licensee Perdue do you have medication in the cabinet, licensee Perdue stated there is no medication in the cabinet. At 10:41 AM LPA Bailey asks the licensee Perdue where do you keep your cleaning supplies? The applicant stated in the cabinet in the kitchen with a child proof latch.



At 10:55 AM the smoke detectors and carbon monoxide were tested by LPA and are in operable condition.

At 11 10 AM LPA Bailey reviewed the facility sketch ask Licensee Perdue to guide on a tour of the children’s bathroom. LPA Bailey opens cabinet doors at 11:12 AM LPA Bailey did not observe any accessible hazards. LPA Bailey observed child proof lock on the cabinet. LPA Bailey observed first aid kit locate in drawer in the children bathroom.

After leaving the children’s and bathroom heading back down the hallway at 11:17 AM LPA Bailey reviewed the map of the facility asks Licensee Perdue tour the off-limit bedrooms. LPA Bailey tour the off-limit bedrooms and bathroom and advise Licensee Perdue that the doors need to be lock at all time during child care hours. Licensee Perdue state she understood.

At 11:38 AM LPA Bailey requested to tour the outside play area. Licensee Perdue guided LPA Bailey out the through kitchen out the back door day care room. At 11:42 AM LPA Bailey observed an outdoor backyard fence with shade canopy area. LPA Bailey observed age appropriateness toys. LPA Bailey observed off-limit area west side of the facility fence off from the rest of the backyard. Licensee Perdue stated that the area I keep my dog. LPA observed fence and enclosed area away from the children in care.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Alicia Bailey
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022
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: PERDUE FAMILY CHILD CARE
FACILITY NUMBER: 198400604
VISIT DATE: 06/17/2022
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At 11:58 AM LPA Bailey observed attach garage ( off-limits), Licensee Perdue stated the garage is used for storage and will be locked during childcare hours.

At 12:07 PM LPA Bailey reviewed protocols with Licensee Perdue regarding the COVID-19 for Family Child Care Home. LPA Bailey also consulted with the Licensee Perdue regarding COVID-19 health and safety guidelines .The Licensee Perdue was provided forms to post via email.

Licensee Perdue state she will provide Transportation.

During the inspection at 12:18 PM LPA Bailey reviewed and advised Licensee Perdue of the following:

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.



LPA Bailey reviewed Sudden Infant Death Syndrome (SIDS), Shaken Baby Syndrome, and safe sleep practices with licensee. *Infants should always sleep on their backs, mouths facing up


LPA discussed the safe sleep regulations with and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the site director 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. CPSC to be notified of any recalls of their purchased equipment
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Alicia Bailey
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022
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: PERDUE FAMILY CHILD CARE
FACILITY NUMBER: 198400604
VISIT DATE: 06/17/2022
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Infant Needs and Services Plan: The written infant needs and services plan shall be updated at least quarterly, or as often as necessary to assure its accuracy. Infant Care: LPA advised the applicant to sleep infants where they can be directly supervised at all time. LPA advised against sleeping infants in a separate room. LPA reviewed SIDs, Never Shake A Baby, and safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. Safe sleep concepts were provided. LPA discussed PIN 20-24-CCP.

Overnight Care: There is no overnight care provided at the moment. LPA Bailey discussed the following: Licensee is aware that they must remain awake while children are awake. If children sleep in a separate area from the licensee, the door must remain open. If the licensee cannot hear children when they wake up, a video or audio device can be use.

The licensee Perdue is not providing Incidental Medial Services currently.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Family Child Care Homes Section 102417. 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

The following was discussed with Licensee Perdue Individuals who are 18 years of age or older living in the home must be fingerprint cleared prior to licensure. Individuals within one month of their 18th birthday must be fingerprinted immediately. The existing, immediate $100 per individual Civil Penalty has been increased to an immediate $100 per day Civil Penalty, for a maximum of five days for the first violation and a maximum of 30 days for subsequent violations. If an individual has a clearance with the Department a criminal record clearance may be transferred. LIC 9182 Criminal Background Clearance Transfer Request may be used.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Alicia Bailey
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022
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: PERDUE FAMILY CHILD CARE
FACILITY NUMBER: 198400604
VISIT DATE: 06/17/2022
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Exit interview was conducted with the Licensee Perdue who is in agreement with the above. A copy of this report and all other licensing reports must be made available to the public for 3 years.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Alicia Bailey
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022
LIC809 (FAS) - (06/04)
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