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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198401035
Report Date: 04/26/2024
Date Signed: 04/26/2024 10:59:34 AM

Document Has Been Signed on 04/26/2024 10:59 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:WILLIAMS FAMILY DAY CAREFACILITY NUMBER:
198401035
ADMINISTRATOR/
DIRECTOR:		WILLIAMS, EMMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 253-4638
CITY:LONG BEACHSTATE: CAZIP CODE:
90815
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
04/26/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Emma Williams, ApplicantTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Dayna Chambers conducted a pre-licensing inspection on April 26, 2024. LPA arrived at the facility and met with Emma Williams, Applicant, who guided analyst on a tour of the facility. The applicant was a previous co-licensee at another family childcare. During the inspection individuals residing in the home were discussed and noted. The applicant is qualified and requesting a large family childcare home license. The fire department granted the fire safety inspection on 04/09/2024. Per applicant, operation hours will be Monday through Friday, 8:00am to 5:00pm. Applicant states that they (he/she) will care for children 0 to 5 years of age. Entrance Checklist was provided to the applicant.
All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a two-story home that consists of: First Floor: entry hallway, office on left side of entry in hallway, family room, dining room/kitchen, garage door entryway (attached garage), Bedroom #1 is on right side and will be used for the infant room, activity room on left side in hallway (children’s napping, activities, meals), children’s bathroom in hallway, hallway closet, stairs to level two (gated). Second Floor: Laundry Room, Bedroom #1 (master and bath), Bedroom #2 and bath, Bedroom #3, and hallway bathroom. Front yard is off-limits. Backyard (Fenced) will be used for children’s activities. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service is via cell phone that will stay in the home during operation hours. Home has central heat and air, and fans. Detergents, cleaning compounds, medicines, sharp objects, and hazardous items that can pose a danger to children are inaccessible in areas designated for children. The applicant was advised that any poisons must be locked with a key or combination lock.
Based on the Facility Sketch submitted, areas off limits to children and parents are: First Floor kitchen, dining room, family room, and all of the second floor. The applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary. The children will use the back yard for outdoor play, which was observed to be fenced. LPA did not observe any bodies of water on the premises. Per applicant, there are no pets on the premises. Storage areas for poisons, firearms and other dangerous weapons shall be locked. Per applicant, there are firearms in the home. The firearms meet the title 22 regulations and are stored properly in the home.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE: DATE: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/26/2024
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: WILLIAMS FAMILY DAY CARE
FACILITY NUMBER: 198401035
VISIT DATE: 04/26/2024
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In lieu of locked storage of firearms, the licensee may use trigger locks or remove the firing pin, the guns are stored in locked cases and there is no ammunition on the premises. Ammunition shall be stored and locked separately from firearms. The value on the 3A40BC fire extinguisher indicates fully charged, however, applicant will need to locate the receipt or replace the fire extinguisher. Smoke and carbon monoxide detectors were tested and are operable. There are toys available for children. The applicant states that they will provide food for children in care. If food is not provided and food is brought from the children’s homes; container shall be labeled with child’s name and properly stored or refrigerated. The applicant has completed the required Health and Safety Training, Nutrition Training and Pediatric First Aid and CPR which expires 06/22/2024. Applicant will make a new appointment for renewal. There are first aid supplies available and located in the children’s activity room. Applicant was reminded of all the terms and conditions noted on the LIC 279 – Application of a Family Child Care Home that applicant signed and agreed to. Applicant will provide care to infants. LPA advised the applicant to sleep infants where they can be directly supervised at all times and advised against sleeping infants in a separate room. The applicant states the following as a supervision plan for infants: Applicant states that infants will sleep in the infant room (bedroom #1) where she will be providing supervision. Campaign which has links to information on Safe Sleep and SIDS. LPA also provided the LIC 9227 to Applicant. 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 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. Applicant has landlord consent and provides proof. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149). Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, an updated Plan of Operation that includes 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
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024
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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: WILLIAMS FAMILY DAY CARE
FACILITY NUMBER: 198401035
VISIT DATE: 04/26/2024
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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. 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, April 26, 2024, 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 childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California. A notice of site visit was given to applicant and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview conducted and report was reviewed with the applicant Emma Williams. 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.
The following corrections need to be corrected prior to obtaining a small family childcare license.
Corrections are due by April 28, 2024
• Applicant states they will fix the backyard gate and provide LPA with photo.
• Applicant will obtain the receipt for the fire extinguisher or replace.
A large family childcare licensee may be granted upon receipt of proof of corrections for the above. Once licensed, the applicant is required to adhere to the terms and limitations stated on the license. A copy of this report and all other Licensing reports must be made available to the public for 3 years.
Exit interview conducted and report was reviewed with the applicant Emma Williams.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024
LIC809 (FAS) - (06/04)
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