198401287-7-31-2025-54-CC-CKAM-DK4UK5-20250731153832

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198401287
Report Date: 07/31/2025
Date Signed: 07/31/2025 03:39:26 PM

Document Has Been Signed on 07/31/2025 03:39 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:	BANKS FAMILY CHILD CARE		FACILITY NUMBER:	198401287
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: 14	CENSUS: 0	DATE:	07/31/2025
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:14 PM
MET WITH:	Cheyenne Banks		TIME VISIT/ INSPECTION COMPLETED:	03:40 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 07/31/2025 at 1:00 PM, Licensing Program Analyst (LPA) Claudia Kam conducted an Announced Prelicensing Inspection to the above facility. Upon arrival, LPA disclosed the purpose of the inspection and met with Applicant, Cheyenne Banks, who guided the LPA on a tour of the facility both indoors and outdoors. Applicant is requesting a large family child care home license (max capacity 14, Landlord Consent on file). Fire clearance was granted on 07/08/2025. There were no day care children present during today’s inspection. Per Applicant, the facility’s hours of operation are Monday to Sunday 7:00 AM to 6:00 PM. Applicant states that they will care for children ages 0 - 13 years old. 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 are the Kitchen and Bedrooms. LPA observed a child safety knob cover on door blocking access to off limits bedrooms and safety gate preventing access to the kitchen. Applicant states door will be opened as needed by staff to access the bathroom. Per applicant doors to bedrooms will be locked during care hours. Applicant states isolation area for sick children will be in the rear of the living room. Per Applicant and Facility Sketch, children will use front yard for outdoor play. LPA observed front yard has turf grass and adequate perimeter fencing through-out the yard. LPA observed age appropriate toys such as ride along toys and a wooden play structure with swings and slide. The area was observed to free of loose and sharp parts available for the children in the front yard. LPA did observe bougainvillea plants handing over the fence with sharp thorns at time of inspection. Per applicant she will share the yard with the next door facility and will create a schedule for the shared play space. Page 1 of 5

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Claudia Kam
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2025

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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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: BANKS FAMILY CHILD CARE	FACILITY NUMBER: 198401287
	VISIT DATE: 07/31/2025

NARRATIVE

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Per Applicant, the children will have access to Living Room located at the entry of the home, and Bathroom located to the rear of the home to the right of the living room. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service, ventilation and heating. Per applicant the portable air conditioning unit will be brought from the current facility. 2 Ceiling fans were observed in the living room at time of inspection. Living room was observed furnished with a child size table and chairs, cubbies with toys for various age groups, cubbies for children's personal belongings, and book case with books for various age groups.

Per Applicant, she will be providing food to children in care. Food preparation area was toured and found in compliance for safety, cleanliness, and proper storage. LPA observed a wall heater in Living Room that has a secure cover at time of inspection. Per Applicant, she will be using mats and cots for napping which are currently in use at the other location. LPA observed Bathroom to have operable equipment, adequate supplies, and to have general area safety and sanitation.

LPA 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. LPA observation did not observe any bodies of water around the premises or firearms/weapons at time of inspection. All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. The applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary.

LPAs observed the valve on the required 2A-10BC fire extinguisher indicates fully charged with service tag dated 01/09/2025. LPAs tested dual smoke and carbon monoxide detectors and observed to be in operable condition. LPAs observed First Aid kit in the main care area and was inventoried. Applicant has current Pediatric First Aid and CPR valid until 01/2026 and has taken required AB1207 Mandated Reporter training is valid through 1/2026. Applicant has submitted proof of immunization against influenza, pertussis, and measles and proof of negative TB test.

Report Continues - Page 2 of 5

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Claudia Kam
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2025

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: BANKS FAMILY CHILD CARE	FACILITY NUMBER: 198401287
	VISIT DATE: 07/31/2025

NARRATIVE

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The bathroom was observed to be clean with an operable sink, faucet and toilet. Licensee has reported that food will be provided by the applicant. Meal area will be in the living room. Applicant's kitchen has been observed to be free of hazards. The refrigerator will be moved once the location has been approved for licensing.

LPA observed operable telephone service via a cell phone and landline. Applicant was advised the cell phone must be kept at the facility during operation hours.

Applicant was reminded that smoking is prohibited on the premises. LPA advised to read the Child Care quarterly updates every season as the come out to stay informed of any changes or updates to the regulations. LPA informed the Child Care Advocate Program (CCAP) provide many other helpful resources to the licensees and the public. Visit www.cdss.ca.gov to receive important updates.

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.

Because the applicant rents 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).

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) 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.

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NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Claudia Kam
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2025

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: BANKS FAMILY CHILD CARE	FACILITY NUMBER: 198401287
	VISIT DATE: 07/31/2025

NARRATIVE

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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.

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 Cheyenne Banks report was given, and appeal rights were issued and discussed.

Prior to approval the following items will need to be corrected:
- schedule for outdoor play
- trimming of plants in play area

Applicant has stated that corrections will be completed by 8/17/25.

A family childcare license may be granted upon Licensing Program Manager (LPM) Approval for requested large facility license. Once licensed, the applicant is required to comply with the terms and limitations stated on the license.

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NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Claudia Kam
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2025

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: BANKS FAMILY CHILD CARE	FACILITY NUMBER: 198401287
	VISIT DATE: 07/31/2025

NARRATIVE

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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.

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NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Claudia Kam
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2025

LIC809 (FAS) - (06/04)

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