198400955-4-5-2024-54-CC-KCHE-D42Q5R-20240405115223

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400955
Report Date: 04/05/2024
Date Signed: 04/05/2024 11:52:32 AM

Document Has Been Signed on 04/05/2024 11:52 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	BANKS FAMILY CHILD CARE		FACILITY NUMBER:	198400955
ADMINISTRATOR/ DIRECTOR:	BANKS, CHEYENNE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 214-9282
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90018
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	04/05/2024
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:15 AM
MET WITH:	Cheyenne Banks, Applicant		TIME VISIT/ INSPECTION COMPLETED:	12:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 04/05/2024 at 9:20 AM, Licensing Program Analysts (LPAs)Katrina Chicote and Claudia Kam conducted an Announced Prelicensing Inspection to the above facility. Upon arrival, LPAs disclosed the purpose of the inspection and met with Applicant, Cheyenne Banks, who guided the LPAs on a tour of the facility both indoors and outoors. Applicant is requesting a large family child care home license (max capacity 14, Landlord Consent on file). Fire clearance was granted on 03/25/2024. Adults in the home were discussed and all have criminal record clearance. There were no day care children present during today’s inspection. Per Applicant and application, the facility’s hours of operation are 8:00 AM to 5:30 PM though she will be flexible based on the needs of the parents. Required postings were discussed, per Applicant she will post items on wall in Main Care Area. All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a single story home that consists of two bedrooms, one bathroom, Kitchen, Living Room, and Front Yard. Areas off limits to children is Kitchen and Bedroom 2. LPAs observed a child safety gate blocking access to off limits areas. Applicant states she will only allow children to walk through Kitchen area as access way to get to Bathroom 1 and they will be supervised. Applicant states isolation area for sick children will be in area of the home currently not being used by the children. Per Applicant and Facility Sketch, children will use front yard for outdoor play. At 9:27 AM, LPAs observed front yard has turf grass and adequate perimeter fencing through-out the yard. LPAs observed age appropriate toys such as ride along toys that are free of loose and sharp parts available for the children in the front yard. LPAs did not observe any hazards in outdoor play area at time of inspection. Per Applicant, the children will have access to Living Room (located upon entry of the home), Bedroom 1 (located to the left of Living Room), and Bathroom 1 (located to the rear of the home). Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service, ventilation and heating (central air and heat). At 9:35 AM, LPAs observed couch, child size tables and chairs, cubbies Report Continues - Page 1 of 5

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024

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 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BANKS FAMILY CHILD CARE	FACILITY NUMBER: 198400955
	VISIT DATE: 04/05/2024

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for children's belongings, and toy storage filled with a variety of age appropriate toys such as books, stacking toys, and musical environments that are free of loose and sharp parts and well maintained at time of inspection. Per Applicant, she will be providing food to children in care and using Living Room for eating, LPAs observed appropriate equipment for children's eating in Living Room. At 9:36 AM, LPAs observed a wall heater in Living Room that is barricaded making it off limits to children. At 9:38 AM, LPAs observed Bedroom 1, which Applicant states will be for activity space and used for napping. LPAs observed a large multi-level doll house in Bedroom 1, child size tables and chairs, and other dramatic play toys well maintained at time of inspection. LPAs provided advisement on safety of toys at time of inspection. Per Applicant, she will be using mats for napping which LPAs observed in closet. At 9:41 AM, LPAs observed Kitchen area (next to Living Room) and Bedroom 2 (next to Kitchen) and discussed storage of hazards such as cleaning solutions, sharp knives/utensils, and medicines. Applicant was advised that inaccessibility of hazards must be constantly reassessed depending on the age, height, and abilities of children in care. At 9:45 AM, LPAs observed Bathroom 1 to have operable equipment, adequate supplies, and to have general area safety and sanitation. LPAs did not observe any hazards in Bathroom 1 at time of inspection.

LPAs did not observe any pets at time of inspection and Applicant confirms she has no pets. Per Applicant, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPAs observation did not see any bodies of water around the premises or firearms/weapons at time of inspection. LPAs discussed regulation requirements for firearms/weapons and pets at time of inspection.

LPAs observed the valve on the required 2A-10BC fire extinguisher indicates fully charged with service tag dated 03/09/2024. LPAs tested dual smoke and carbon monoxide detectors and observed to be in operable condition. LPAs observed unopened First Aid kit is kept in the Kitchen. Applicant has current Pediatric First Aid and CPR valid until 01/2026 and has taken required AB1207 Mandated Reporter training on 01/08/2024. Applicant has submitted proof of immunization against influenza, pertussis, and measles and proof of negative TB test. LPAs discussed requirement to have these documents to be readily available during inspections.

The following were discussed:
· The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked and batteries replaced as needed.
Report Continues - Page 2 of 5

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024

LIC809 (FAS) - (06/04)

Page: 2 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BANKS FAMILY CHILD CARE	FACILITY NUMBER: 198400955
	VISIT DATE: 04/05/2024

NARRATIVE

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· 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 Pediatric First Aid and CPR training, Immunizations (TDAP, MMR, Influenza), mandated reporter training and a valid criminal record clearance associated to the facility license.
· Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License may be terminated.
· Reporting Requirements: Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.
· 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 for a minimum of 3 years.
· No infant walkers, No Johnny jumpers, No saucer chairs, No incline sleepers 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
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for 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
Report Continues - Page 3 of 5

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024

LIC809 (FAS) - (06/04)

Page: 3 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BANKS FAMILY CHILD CARE	FACILITY NUMBER: 198400955
	VISIT DATE: 04/05/2024

NARRATIVE

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· Immunization Requirement: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The licensee and all adults working with children have proof of immunizations.
· Mandated Reporter Training: H&S 1596.8662: Beginning January 1, 2018, all licensed providers, applicants, directors and employees to complete training as specified on mandated reporter duties. Training is available at: www.mandatedreporterca.com

Applicant was reminded that all adults 18 and over living or working in the home, 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.

LPAs 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 and issued the LIC 311D - Forms/Records to Keep in Your Family Child Care Home. Mandatory Forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. The Licensee was advised how to access forms and Regulations online at www.ccld.ca.gov. Licensee was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care.

OTHER INFORMATION AND FORMS PROVIDED:
· Capacity Handout for a Small Family Child Care Home and Large Family Child Care Home was provided.
· PIN 20-24-CC Safe Sleep Regulations
· LIC 9227 Individual Infant Sleeping Plan
· Example of Safe Sleep Log
· Example of Fire & Safety Drills
Report Continues - Page 4 of 5

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024

LIC809 (FAS) - (06/04)

Page: 4 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BANKS FAMILY CHILD CARE	FACILITY NUMBER: 198400955
	VISIT DATE: 04/05/2024

NARRATIVE

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Per Applicant, there are no dual licenses at this address.

Based on LPAs' observation today, 04/05/2024, LPAs will submit to Manager for review and approval for a large family child care home license. Pending approval, once licensed, the Applicant is required to comply with the terms and limitations stated on the license.

Exit interview was conducted and report was reviewed with the Applicant, Cheyenne Banks.

Report Ends - Page 5 of 5

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024

LIC809 (FAS) - (06/04)

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