Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197405128
Report Date: 06/21/2017
Date Signed: 06/21/2017 11:14:02 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME:TROY FAMILY CHILD CAREFACILITY NUMBER:
197405128
ADMINISTRATOR:TROYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 727-1749
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY:14CENSUS: 9DATE:
06/21/2017
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Miriam TroyTIME COMPLETED:
11:15 AM
NARRATIVE
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This is an unannounced annual comprehensive visit conducted by Margarit Sislyan, Licensing Program Analyst (LPA). LPA Sislyan met with Miriam Troy, Licensee, who guided analyst on a tour of the facility. This is a single story single family home. The home was inspected inside and out 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. The First Aid kit was observed and complete. Per LIS the facility annual fees are current. The facility roster was observed, and current.

Per licensee, there are no weapons or firearms of any kind in the facility at this time. The LPA did not observe any weapons. There is no pool, spa or other bodies of water on the premises. There are age appropriate toys and napping equipment on the premises. The required fire extinguisher (2A 10BC) and smoke detectors are in operable condition. Licensee has current copies of CPR/First Aid; expiration dates are 2/2019. Licensee has posted as required the License, disaster plan, Parents Rights Poster, Child Seat Safety Law and Earthquake Preparedness Checklist.

The following were discussed: No smoking, No infant walkers, Johnny jumpers, exersaucers and any other item that falls into that category. The LPA also discussed earthquake safety and necessity of drills, required forms for children’s files, facility files and posting requirements and penalty. Fingerprint clearance, transfer process and penalty. The new regulation 102416.3 Alterations to Existing Buildings or Grounds. The Parent Notification AB633 and the licensee discipline practiced by the licensee.
SUPERVISOR'S NAME: Sharon GreeneTELEPHONE: (310) 337-4313
LICENSING EVALUATOR NAME: Margarit SislyanTELEPHONE: (310) 337-4346
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2017
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, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME: TROY FAMILY CHILD CARE
FACILITY NUMBER: 197405128
VISIT DATE: 06/21/2017
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

Update on Incidental Medical Services: Facilities that provide Incidental Medical Services (IMS) must identify those services in their facility’s Plan of Operation and submit an updated Plan of Operation to the Department. Incidental Medical Services Include: Blood-Glucose Monitoring for Diabetic Children, Administering Inhaled Medication, Administering EpiPen Jr. and EpiPen or other Epinephrine Auto-Injectors, Glucagon Administration, Gastrostomy Tube Care (G-tube care), Insulin Injections Administration, Anti-Seizure Administration, and Emptying an Ileostomy Bag. Please see Child Care Quarterly Report on www.ccld.ca.gov

Licensee was informed that she is a mandated child abuse reporter with the responsibility of reporting any suspected child abuse to the Child Abuse Hotline at (800) 540-4000.
Senate Bill 792: This bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles.
New Immunization Requirement: Law enacted by SB 277, beginning January 1, 2016, personal beliefs exemptions will no longer be an option for the vaccines that are currently required for entry into child care or school in California. Personal beliefs exemptions already on file will remain valid until the child reaches the next immunization checkpoint.
Exit Interview Conducted
For additional information and forms visit our website at: www.ccld.ca.gov
SUPERVISOR'S NAME: Sharon GreeneTELEPHONE: (310) 337-4313
LICENSING EVALUATOR NAME: Margarit SislyanTELEPHONE: (310) 337-4346
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2017
LIC809 (FAS) - (06/04)
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