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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198401212
Report Date: 03/28/2025
Date Signed: 03/28/2025 05:05:02 PM

Document Has Been Signed on 03/28/2025 05:05 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:POPE FAMILY CHILD CAREFACILITY NUMBER:
198401212
ADMINISTRATOR/
DIRECTOR:		POPE, SHAQUINTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(213) 448-4105
CITY:LAKEWOODSTATE: CAZIP CODE:
90712
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
03/28/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Licensee, Shaquinta PopeTIME VISIT/
INSPECTION COMPLETED:
05:15 PM
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Licensing Program Analyst (LPA) Jonnisha Culbert conducted an announced pre-licensing inspection at the address mentioned above. The purpose of the visit is to inspect the facility for a large family childcare home. LPA met with Applicant, Shaquinta Pope who guided LPA on a tour of the facility. Applicant is currently licensed for a small family home (198400893) and is requesting a capacity increase and to relocate. Operating hour will be Sunday through Saturday from 6am to 12am. Per applicant, she is open to providing care all hours. Care will be provided to children aged 0 to thirteen years old. All individuals residing in the home were discussed and noted.

This is a one-story single-family home that consist of three bedrooms, four bathrooms, living room, dining area, kitchen, laundry room, front yard, family room, and fenced backyard with pool. On limits areas include bathroom 2 (per, facility sketch), living room, dining room, kitchen, front yard (through passing), and family room. Off limits areas includes three bedrooms, three bathrooms, laundry room, and fenced backyard with pool. Per applicant, parents will utilize side gate to pick up and drop off children. Upon accessing side gate, LPA observed various hazards such as water holes, a bucket, a crate, and a pipe. Per applicant, children will be guided through the path to the front door. LPA advised applicant to remove all hazards from path.

The areas that will be used by children were observed for safety, comfort, cleanliness, and telephone service. LPA observed outlet covers (in family room), child safety magnetic cabinet and drawer locks, an operable combination smoke and carbon monoxide detector, fire alarm pull station, and a fire extinguisher. LPA observed a 3A40BC fire extinguisher that was last serviced on 01/10/2025. LPA observed one play yard and 16 cots available for napping, child size tables and chairs, and vents for ventilation. Per applicant, the home is equipped with central heating and air. In the family room, LPA observed age-appropriate toys.
NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Jonnisha Culbert
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2025
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
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: POPE FAMILY CHILD CARE
FACILITY NUMBER: 198401212
VISIT DATE: 03/28/2025
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Detergents, cleaning compounds, sharp objects and hazardous items that can pose a danger to children are inaccessible. Per licensee, knives are in a locked drawer in the kitchen. Cleaning compounds are placed in a locked cabinet in the hallway and in the locked laundry room. LPA observed a combination lock on hallway door and a lock that requires a key on laundry room door. Per applicant, poisons are inside of the laundry room. LPA reminded applicant that poison must remain in an area that is locked and inaccessible to children. Per applicant, there are no firearms on premises. Through the family room window, LPA observed an in-ground pool situated in the backyard.

LPA evaluated pool area for safety. LPA observed the following safety equipment visible from the swimming pool and readily available: A rescue pole with a body hook and a fixed length of 12 feet and a life ring with an exterior diameter of 20 inches and labeled as approved by the United Stated Coast Guard (approval #160.064/2925/0). LPA measured the mesh fenced gate blocking access to the pool. The gate has a height of 5 feet and a vertical clearance of 3 inches from the ground to the bottom of the enclosure. LPA informed applicant that the clearance must be 2 inches or less. Applicant agreed to bring fence into compliance. There are no gaps or voids that will allow passage of a sphere with a diameter equal to or greater than 4 inches. Applicant provided LPA with documentation that establishes the mesh fencing is compliant with the American Society for Testing and Materials (ASTM) International Standard F2286 and a document stating that applicant agrees that the fencing will remain in place whenever licensed care is provided, and so long as the mesh fence makes the swimming pool inaccessible to children as determined by licensing staff.

LPA evaluated alarm in pool. LPA observed that the alarm in the pool did not sound upon detecting entrance into the water. Per applicant, they will fix the alarm. LPA informed applicant that a subsequent visit is required to ensure alarm is working properly. Applicant provided LPA with documentation to show pool alarm conforms to the requirements of ASTM F2208.

Per applicant, outdoor play will be at a local park. Applicant provided LPA with a Park Safety Plan.

Per Applicant, breakfast, morning snack, lunch, afternoon snack, and dinner will be provided to children in care. Applicant was advised that if food is brought from the children’s homes, the container shall be labeled with the child’s name and properly stored or refrigerated. Per applicant, children will eat in the family room. LPA observed two booster chairs for infants to utilize while eating. LPA advised applicant that highchairs/booster chairs are to only be used for eating during mealtimes.

NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Jonnisha Culbert
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2025
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: POPE FAMILY CHILD CARE
FACILITY NUMBER: 198401212
VISIT DATE: 03/28/2025
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Applicant has completed the required Health and Safety Training, Nutrition Training, Lead training completed on 12/03/2023 and Pediatric First Aid and CPR which expires 02/2027. Applicant has also completed the required Mandated Reporter Training which expires 01/31/2026. Applicant has proof of the required immunizations for measles, pertussis, and flu. Applicant has submitted proof of TB clearance for all adults in the home.

The following items must be submitted by 04/04/2025.

-Second visit to verify operable pool alarm

-Pool gate must have: a maximum vertical clearance of 2 inches from the ground to the bottom of enclosure.

-Remove hazards from walkway

-Personnel documents for prospective staff (including Pediatric first aid and CPR for at least one person besides applicant)

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.

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).

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) tollfree 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.

NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Jonnisha Culbert
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2025
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: POPE FAMILY CHILD CARE
FACILITY NUMBER: 198401212
VISIT DATE: 03/28/2025
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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-andresources/safe-sleep, as an additional resource. LPA also informed [applicant, licensee, or facility representative] 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, 02/28/2025, 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.

Exit interview conducted and report was reviewed with the applicant, Shaquinta Pope.

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.

NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Jonnisha Culbert
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2025
LIC809 (FAS) - (06/04)
Page: 5 of 5