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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400831
Report Date: 09/06/2023
Date Signed: 09/07/2023 10:34:21 AM

Document Has Been Signed on 09/07/2023 10:34 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:GILMORE FAMILY CHILD CAREFACILITY NUMBER:
198400831
ADMINISTRATOR:GILMORE, SHAINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 903-2115
CITY:LOS ANGELESSTATE: CAZIP CODE:
90018
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
09/06/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Shaina Gilmore, ApplicantTIME COMPLETED:
02:45 PM
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On 09/06/2023 at 12:20PM, Licensing Program Analyst (LPA) Alicia Mooberry conducted an Announced – Prelicensing Inspection to the above facility. LPA met with Shaina Gilmore, Applicant and provided Prelicensing Entrance Checklist (LIC 9280). The applicant is requesting to operate a Large Family Day Care Home (up to 14 children), a Fire clearance was granted on 8/24/23. LPA was taken on tour of the facility both indoors and outdoors. Adults in the home were discussed and all have criminal record clearance. Per Applicant the hours of operation will be Monday through Friday from 6:00 am to 6:00

All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. The facility if one unit out of a fourplex. The home consists of one (1) bedroom, one (1) restroom, living room, dining room, and backyard.

Off limits areas of the home will be. Bedroom, Kitchen, storage room. LPA observed there are doors to each bedroom and bathroom that Applicant states will be closed during operating hours.

The kitchen will only be used as an emergency exit. Cleaning compounds and sharp items were observed to be inaccessible to children in care. The Applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary.

Per Applicant, Main Care Areas will be the Living Room (located upon entry of the home), Dining Room, the living room and dining room are converted into a classroom and playroom. Bathroom located down the hallway was observed to be clean and free of hazards. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service (land line cell phone), ventilation and heating (wall units). LPA observed a barricaded wall heater in the living room.

The applicant states that meals will be provided by facility and parents will also have the option to bring food from home. Applicant was informed that any food brought from the children’s homes must be labeled with child’s name and properly stored or refrigerated.

The isolation area for a sick child waiting to be picked up will be in the dining room/playroom away from other children. --------------Page 1

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE: DATE: 09/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/06/2023
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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: GILMORE FAMILY CHILD CARE
FACILITY NUMBER: 198400831
VISIT DATE: 09/06/2023
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LPA observed the required 2A10 BC fire extinguisher in kitchen, with service dated 8/21/23. Applicant was reminded that fire extinguishers need to be purchased or serviced yearly.

The applicant provided proof of control of property. LPA discussed weapons or firearms in the facility.

The applicant has completed the required Health and Safety Training, Nutrition, and Lead Training, Mandated Reporter Training (AB1207) and EMSA approved Pediatric First Aid/CPR expires on 06/2025 Required immunization's are current.

Per applicant, the back yard will be used as outdoor play area. The yard are enclosed on all sides. LPA observed safe and age appropriate outdoor toys available. A preschool age play structure was observed anchored to the ground. There are no bodies of water on the premises. Applicant has no pets at this time.

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) or (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 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.

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.

Applicant was informed of the MyChildCarePlan.org site, 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.

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 platforms. 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. -----Page 2

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

DATE: 09/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023
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: GILMORE FAMILY CHILD CARE
FACILITY NUMBER: 198400831
VISIT DATE: 09/06/2023
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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, 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 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.

On this date, 9/5/23, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility address. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

A Large family childcare license will be granted upon a final review and approval of the application. Once licensed, the applicant is required to comply with the terms and limitations stated on the license.

Exit interview conducted and report was reviewed with Shaina Gilmore, Applicant

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

DATE: 09/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023
LIC809 (FAS) - (06/04)
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