198401120-12-10-2024-54-CC-AMOY-DBU82T-20241210210829

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198401120
Report Date: 12/10/2024
Date Signed: 12/10/2024 09:08:50 PM

Document Has Been Signed on 12/10/2024 09:08 PM - 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:	THOMPSON-LAVELLE FAMILY CHILD CARE		FACILITY NUMBER:	198401120
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	12/10/2024
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:00 PM
MET WITH:	Ronald Thompson, Applicant		TIME VISIT/ INSPECTION COMPLETED:	03:30 PM

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On 12/10/24 Licensing Program Analyst (LPA) Alicia Mooberry conducted an announced pre-licensing inspection for the above address. LPA met with Ronald Thompson, Applicant, who guided LPA on a tour of the facility. Individuals residing in the home were discussed and noted. Per Applicant, hours of operation will be Monday - Saturday, 6:00 am to 6:00 pm. The applicant plans to offer overnight care, LPA discussed with applicant that "Overnight Care" means care being provided to children anytime between the hours of 6 p.m. and 6 a.m. Care provided during the day and overnight combined shall not exceed 24 hours from the time the child entered care. Applicant states they will care for children Infants -12 years of age. A plan for overnight care will be created for children that are staying overnight.

This is a one-story home which consists of 3 bedrooms, 1 bathroom, living room, kitchen, laundry room (outside), front and backyard and detached garage located in the backyard of the home. 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 in care.

Areas used by children include: Living Room (main daycare area), kitchen, bathroom, bedroom 3 (theater room) front and back yards.

Areas off limits include: Bedroom #1, #2, detached garage and laundry room in back yard.

The off limit bedrooms are kept closed and locked are maintained inaccessible to children in care. Cleaning products are located in hallway closet locked (Janitorial closet). There are outlet covers throughout the home. Smoke detectors and carbon monoxide detectors were observed, tested and found to be operable.

The home was observed to be clean and orderly. LPA observed age appropriate toys and learning materials in the daycare area. First Aid kit available located in kitchen. Applicant will obtain emergency supplies prior to being licensed. -------------PAGE 1

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: THOMPSON-LAVELLE FAMILY CHILD CARE	FACILITY NUMBER: 198401120
	VISIT DATE: 12/10/2024

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LPA observed the required 2A10 BC fire extinguisher in the door way to the kitchen, with purchase receipt dated 12/2/24. Applicant was reminded that fire extinguishers need to be purchased or serviced yearly.

There is a wall heater on wall to the daycare room and the hallway was observed to be covered and secured to the wall. The applicant will use fans to maintain home comfortable.

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 applicant has completed the required Health and Safety Training, Nutrition, and Lead Training, Mandated Reporter Training on 7/16/24 and Pediatric First Aid/CPR expire on 7/18/26. Required immunization's are current.

Per Applicant, there are no weapons or firearms in the facility, none were observed by LPA. Applicant has no pets at this time.

Per applicant, the front and back yard will be used as outdoor play area. The front yard has gates that are less than 4 feet in height, per applicant the children will be supervised when they play in the front yard. Back yard is enclosed, the detached garage is observed to be locked and is utilized storage. Safe and age appropriate toys were available. The applicant will add cushioning material under play structures due to the ground is entirely concrete. There are no bodies of water on the premises.

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

LPA observed posted document on parent board in living room, visible to parents in care. Entrance Checklist was provided to the applicant.

LPA discussed the Safe Sleep Regulation and provided PIN 20-24-CCP and Infant Sleep Plan LIC 9227 for when Applicant is ready to enroll infants. Children will nap in the living room, mats and a play yard are available.

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. --------- Page 2

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: THOMPSON-LAVELLE FAMILY CHILD CARE	FACILITY NUMBER: 198401120
	VISIT DATE: 12/10/2024

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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.

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)/ (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

The isolation area for a sick child waiting to be picked up will be in the living room next to the exit away from other children.

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, 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.

-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 adult/infant CPR & Pediatric First Aid certification, TB clearance, immunization, Mandated Reporter training certificate www.mandatedreporterca.gov, and a valid criminal record clearance associated to the facility license.

-A current roster of children enrolled must be available and maintained for a period of three years, even after children are no longer attending the facility.

-Unusual incident or any changes will be reported to Licensing within 24 hours and an LIC 624B will be submitted within 7 days.

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SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: THOMPSON-LAVELLE FAMILY CHILD CARE	FACILITY NUMBER: 198401120
	VISIT DATE: 12/10/2024

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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 platform. 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 applicant provided proof of control of property. Because the applicant rents/leases the home, proof of landlord notification is required. 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).

On this date, 12/10/24, 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. 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.

The applicant was advised that email may be public information.

The following corrections need to be made prior to obtaining a small family child care license.
Proof of corrections are due by 12/20/24
1. Applicant will add cushioning material under play structures int eh backyard due to the ground is entirely concrete.
2. Applicant will obtain emergency supplies prior to being licensed.
3. The applicant will purchase a stove cover to ensure the children do not have access to stove..

A small family childcare license will be granted upon completion of all required documentation and corrections. 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 Ronald Thomson, applicant

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024

LIC809 (FAS) - (06/04)

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