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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198401098
Report Date: 08/14/2024
Date Signed: 08/15/2024 07:51:05 AM

Document Has Been Signed on 08/15/2024 07:51 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:WOFFORD FAMILY CHILD CAREFACILITY NUMBER:
198401098
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
08/14/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Patricia Wofford, ApplicantTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Dayna Chambers conducted a pre-licensing inspection on August 14, 2024. LPA arrived at the facility at 11:30am and met with Patricia Wofford, Applicant, who guided analyst on a tour of the facility. During the inspection individuals residing in the home were discussed and noted. The applicant is requesting a small family childcare home license. Per applicant, operation hours will be Monday through Sunday 6:00am to 12:00am and 12:30am to 6:00am. Applicant states that they (he/she) will care for children 0 to 12 years 0of 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-building duplex in one lot. The duplex is in the rear behind the front duplex. This is a two-story duplex with 3 bedrooms, 2 bathrooms, living room, kitchen, dining room, activity room 1, and activity room 2, bedroom, and attached garage. On the first floor is a living room, bathroom in hallway, kitchen, dining room, two activity rooms, and the attached garage entrance which is locked. Second floor: two bedrooms, and one bathroom. Per applicant, the children will use the restroom on the first floor in the hallway near the living room. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service via cell phone, ventilation central heat and air conditioning. 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: The first floor, kitchen is off-limits. Second Floor, all off limits. LPA observed a gate to block the second-floor entrance located in the living room. The applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary. Per applicant, there are no firearms, weapons, or bodies of water on the premises.
During inspection, LPA did not observe any bodies of water. Per applicant, there are birds in a birdcage outside and a turtle in an off-limit room. LPA observed the birdcage and the turtle aquarium.
Per applicant, there are no firearms or weapons on the premises. The value on the 2A10BC fire extinguisher indicates fully charged, as indicated on receipt submitted dated 08/04/2024. 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
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE: DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/14/2024
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: WOFFORD FAMILY CHILD CARE
FACILITY NUMBER: 198401098
VISIT DATE: 08/14/2024
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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 12/14/2025. There are first aid supplies available and located hallway closet near living 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 states that they will care for 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. Applicant states that infants will sleep in the bedroom on lower floor where she will be providing supervision. 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 owns the duplex and LPA obtained proof of mortgage bill. 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 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, 08/14/24, 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.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024
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: WOFFORD FAMILY CHILD CARE
FACILITY NUMBER: 198401098
VISIT DATE: 08/14/2024
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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, or Licensee] 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 Patricia Wofford. .

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 home was observed to be in compliance.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024
LIC809 (FAS) - (06/04)
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