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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400852
Report Date: 02/27/2024
Date Signed: 02/27/2024 11:47:25 AM

Document Has Been Signed on 02/27/2024 11:47 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:EDWARDS FAMILY CHILD CAREFACILITY NUMBER:
198400852
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
02/27/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Applicant Dena EdwardsTIME COMPLETED:
12:05 PM
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On February 27, 2024 at 9:15 am, Licensing Program Analyst (LPA) Angelica Wallin conducted an announced Pre-Licensing inspection. The purpose of the visit was to ensure that health, safety and personal rights, as required by Title 22 Regulations governing California Family Child Care Homes, will be met by applicant, Dena Edwards. Applicant applied for a Small Family Child Care Home with maximum capacity of eight children. LPA met with applicant and was guided on a tour of the home, indoor and outdoor.

LPA discussed residents in the home. LPA reviewed the facility sketch (indoor and outdoor) and it was observed to match the physical plant of the home. Applicant's home is a one story three-bedroom, two-bathroom home with a living room, dining room, kitchen, family room/den, garage, front and back yard. During inspection, LPA discussed with applicant regarding area of isolation space. Per applicant, no space set up as an isolation space at this time. LPA discussed with applicant regarding having a space for isolation if children develop symptoms while in care. Per applicant, couch in family room to be used as an isolation space. LPA observed workout bike and metal xylophone in family room. LPA observed applicant remove workout bike and metal xylophone to off-limits bedroom during inspection. The primary childcare area of the home shall be one bedroom used as daycare room, one bathroom, family room/den used as isolation room only and, outdoor patio of backyard. Areas off limits include: 2 bedrooms, one bathroom, living room, dining room, kitchen, 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. LPAs noted space with age-appropriate toys. LPAs observed working smoke detector and carbon monoxide detector. LPAs observed 2A10BC fire extinguisher with purchase receipt of 2/26/24 and in operable condition. LPAs inspected kitchen and observed knives on high shelf located in kitchen cabinet. During inspection, LPA observed 2 bottles of wine located in fridge. LPA advised wine bottles be made inaccessible.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Angelica Wallin
LICENSING EVALUATOR SIGNATURE: DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2024
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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: EDWARDS FAMILY CHILD CARE
FACILITY NUMBER: 198400852
VISIT DATE: 02/27/2024
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LPA observed cleaning supplies and chemicals secured in off-limits garage via child proof doorknob. LPAs observed main childcare bathroom located next to family room. LPA observed medications and personal care items secure in closet in bathroom via child proof lock. According to the applicant, there are no weapons or firearms at the home; LPA did not observe any firearms or weapons at the time of the inspection

Per applicant, the outdoor play area is located in backyard on outdoor patio space. During inspection, LPA observed on-limits outdoor patio play area secured with retractable screens attached to outdoor patio awning. Picture attached in file. Per applicant, children to enter facility via left side gate through outdoor patio play area to backdoor of day care room. Per applicant, one retractable screen to remain open to allow children to pass through to day care room. Per applicant, retractable screen to be closed during outdoor play. During inspection, LPA observed shed located on off-limits area of backyard without lock and a bucket of water by trash. During inspection, LPA observed applicant place lock on outdoor shed and disposed on bucket of water. LPA did not observe bodies of water on the facility premises. LPAs advised applicant that supervision to be maintained at all times during outdoor play.

Per applicant file review, a review of staff records indicates that applicant has updated pediatric CPR/First Aid certificate with expiration date of 12/2025, updated mandated reporter certificate with expiration date of 8/2025, completed health and safety orientation with lead and nutrition component dated 10/6/23 and updated immunization records on file for measles, pertussis, TB clearance and a declination of the influenza vaccine. 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. Entrance Checklist was provided to the applicant.

The 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.

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.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Angelica Wallin
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2024
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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: EDWARDS FAMILY CHILD CARE
FACILITY NUMBER: 198400852
VISIT DATE: 02/27/2024
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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 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-andresources/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 10/3/2023, 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 addresses. 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.

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-carelicensing/subscribe and select the Child Care option to receive email communication.

During the interview, applicant confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. Exit interview conducted and report was reviewed with applicant, Dena Edwards.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Angelica Wallin
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2024
LIC809 (FAS) - (06/04)
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