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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364845434
Report Date: 05/19/2023
Date Signed: 05/19/2023 12:43:49 PM

Document Has Been Signed on 05/19/2023 12:43 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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:TAYLOR FAMILY CHILD CAREFACILITY NUMBER:
364845434
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
05/19/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:17 AM
MET WITH:Tammy Loring, Facility Representative TIME COMPLETED:
12:55 PM
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On this date and time, Licensing Program Analyst (LPA) Laura Mejorado arrived at the facility on another matter and conducted a Case Management inspection. LPA met with facility representative Tammy Loring, toured the facility, and took census. Licensee was not present in the home but LPA was able to make contact with Licensee via phone and reviewed the report with Licensee over the phone. Licensee stated facility representative can sign the report.

When LPA arrived an infant was observed swaddled in a blanket asleep in a bouncer. LPA informed facility representative this was a violation of title 22 regulations. Immediately, facility representative removed the blanket wrapped around the infant and placed the infant to sleep in a crib.

102425 Infant Safe Sleep


(f) An infant shall not be swaddled while in care.
(i) If an infant falls asleep before being placed in a crib or play yard, the provider shall move the infant to a crib or play yard as soon as possible.

1596.846 Baby walkers


(c) A "baby walker" means any article described in paragraph (4) of subdivision (a) of Section 1500.86 of Part 1500 of Title 16 of the Code of Federal Regulations.

LPA provided facility representative Provider Information Notice (PIN) 20-24 Safe Sleep, 102425 Infant Safe Sleep and discussed safe sleep regulations.

An exit interview was conducted with facility representative Tammy Loring, Appeal Rights were discussed and issued, a copy of this report was provided, and a Notice of Site visit was issued.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Laura Mejorado
LICENSING EVALUATOR SIGNATURE: DATE: 05/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/19/2023
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: TAYLOR FAMILY CHILD CARE
FACILITY NUMBER: 364845434
VISIT DATE: 05/19/2023
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The Notice of Site Visit (LIC 9213) shall be posted where the parent/guardian of children enter and exit the facility. The Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Upon receipt of this report, the Licensee shall post the Notice of Site Visit and any Licensing report documenting a type “A” deficiency. The report and the Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement of Receipt (LIC 9224 form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the Acknowledgement of Receipt of Licensing Reports (LIC 9224)

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Laura Mejorado
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 05/19/2023 12:43 PM - It Cannot Be Edited

Citations on this Visit Report are Under Appeal!


Created By: Laura Mejorado On 05/19/2023 at 12:05 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: TAYLOR FAMILY CHILD CARE
FACILITY NUMBER: 364845434

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type A
05/22/2023
Section Cited
CCR
102425(f)

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102425 Infant Safe Sleep (f) An infant shall not be swaddled while in care. This requirement is not met as evidence by:
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Immediately, facility representative removed the blanket wrapped around the infant and placed the infant to sleep in a crib. Licensee agrees to submit a written statement of their understanding of the safe sleep regulations and submit a copy to CCL by 5/22/23.
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Based on observation, LPA observed an infant swaddled in a blanket asleep in a bouncer, which poses an immediate Health, Safety, or
Personal Rights risk to persons in care.
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Licensee also agrees to conduct training with their staff on safe sleep regulations and submit proof to CCL by 5/22/23.
Under Appeal
Type A
05/22/2023
Section Cited
CCR102425(i)

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102425 Infant Safe Sleep (i) If an infant falls asleep before being placed in a crib or play yard, the provider shall move the infant to a crib or play yard as soon as possible. This requirement is not met as evidence by:
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Immediately, facility representative removed the blanket wrapped around the infant and placed the infant to sleep in a crib. Licensee agrees to submit a written statement of their understanding of the safe sleep regulations and submit a copy to CCL by 5/22/23.
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Based on observation, LPA observed swaddled in a blanket asleep in a bouncer, which poses an immediate Health, Safety, or
Personal Rights risk to persons in care.
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Licensee also agrees to conduct training with their staff on safe sleep regulations and submit proof to CCL by 5/22/23.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Kimberly Williams
LICENSING EVALUATOR NAME:Laura Mejorado
LICENSING EVALUATOR SIGNATURE:
DATE: 05/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/19/2023


LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 05/19/2023 12:43 PM - It Cannot Be Edited

Citations on this Visit Report are Under Appeal!


Created By: Laura Mejorado On 05/19/2023 at 12:15 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: TAYLOR FAMILY CHILD CARE
FACILITY NUMBER: 364845434

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type A
05/22/2023
Section Cited
HSC
1596.846(C)

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(c) A "baby walker" means any article described in paragraph (4) of subdivision (a) of Section 1500.86 of Part 1500 of Title 16 of the Code of Federal Regulations. This requirement is not met as evidence by:
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Immediately, facility representative removed the infant from the bouncer and into a crib to continue sleeping. Facility representative moved the bouncer to an off limits area. Licensee agrees to read Health and Safety Code Sections 1596.846(b) and (c) and agrees to write a statement outlining how she will not use baby bouncers for day care children and submit a copy to CCL by 5/22/23.
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Based on observation, LPA observed an infant swaddled in a blanket asleep in a bouncer, which poses an immediate Health, Safety, or Personal Rights risk to persons in care.
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Licensee also agrees to conduct training with their staff and submit proof to CCL by 5/22/23.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Kimberly Williams
LICENSING EVALUATOR NAME:Laura Mejorado
LICENSING EVALUATOR SIGNATURE:
DATE: 05/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/19/2023


LIC809 (FAS) - (06/04)
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