<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493493
Report Date: 09/09/2021
Date Signed: 09/09/2021 06:47:31 PM

Document Has Been Signed on 09/09/2021 06:47 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:HILL FAMILY CHILD CAREFACILITY NUMBER:
197493493
ADMINISTRATOR:JILL HILLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 439-9311
CITY:COMPTONSTATE: CAZIP CODE:
90222
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 7DATE:
09/09/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Jill Hill; LICENSEETIME COMPLETED:
02:36 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
Licensing Program Analyst (LPA) Reiko Jones-Modeste conducted an announced annual random inspection at the facility listed above. LPA met with Licensee Jill Hill who guided analyst on a tour of the facility. Upon arrival were the LICENSEE, three LICENSEE ASSISTANTS, one VOLUNTEER, and an ADULT RESIDENT as well as seven children in care including one infant. A current children’s roster was not available for review. All were unmasked. All adults present criminally cleared.

This is a one-story home which consists of four bedrooms, two bathrooms, kitchen, living room, and backyard (fenced). The children use the bathroom located in the hallway. The restroom the children use was observed safe and sanitary but without COVID postings. Children’s areas include two children’s rooms and back yard. Per LICENSEE, areas off limits to children and parents include: all bedrooms, living room, kitchen and one bathroom. LPA observed kitchen and bedrooms inaccessible with two child safety gates. LPA did not observe a wall heater as central heat is used.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a landline and cellphone which remains at the facility during operating hours. LPA observed bedrooms inaccessible to children in care with child safety knobs.

Toys, children’s materials and equipment are age-appropriate and available; free of sharp edges and unbroken. Some child safety locks were observed in the kitchen, however an accessible drawer was observed with knives, scissors and sharp tools.
Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Reiko Jones
LICENSING EVALUATOR SIGNATURE: DATE: 09/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/09/2021
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 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: HILL FAMILY CHILD CARE
FACILITY NUMBER: 197493493
VISIT DATE: 09/09/2021
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
26
27
28
29
30
31
32
accessible to children in the play area. No poisons stored in the home per the LICENSEE. No bodies of water observed. The valve on the required 2A 10BC fire extinguisher indicates charged with no inspection date or service tag. Pull tab fire alarm observed and carbon monoxide detectors tested and operable.
LPA observed COVID postings but no PPE. Licensee stated she continues to use COVID screening protocol. LPA did not observe COVID screening materials. Licensee states that there are no firearms stored in the home. The Licensee provides food for children in care.

Currently, children use the back yard for outdoor play time. The outdoor play area was observed fenced. LPA observed appropriate toys and equipment used for children. LPA observed an open shed with paint and some hazards that can pose a danger to children in the outdoor yard. The Licensee states that supervision is always provided. LPA observed BBQ grill uncovered.

The LICENSEE has completed training on preventive health practices including Pediatric First Aid and CPR. The Licensee's Pediatric First Aid and CPR expires on 5/2023. LPA observed children’s files complete with the exception of C1 where no file was available. LPA observed staff files complete with the exception of no file available for S4, no immunization's for S2, S3 and S5 and no Mandated Reporter certificates available for all staff.

The Licensee provided proof of immunization against influenza, pertussis, and measles. LPA did not observe proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file for Licensee. All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. LPA did not observe a Disaster Drill log posted or available.
There are no pets on the premises. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed and posted. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that fall into these categories are not permitted in a family childcare facility. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Reiko Jones
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021
LIC809 (FAS) - (06/04)
Page: 2 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: HILL FAMILY CHILD CARE
FACILITY NUMBER: 197493493
VISIT DATE: 09/09/2021
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
26
27
28
29
30
31
32
Licensee states that she is currently caring for infants. Licensee was advised infants are to sleep in a play yard or standard crib only, where they are constantly supervised. LPA discussed with Licensee the Child Care Provider’s Guide to Safe Sleep to reduce the risk of SUID by the American Academy of Pediatrics. LPA also consulted and explained Never Shake a Baby, and Safe Sleeping practices. Appropriate sleeping equipment (mats, cots) and two Pack n Plays were observed.

Incidental Medical Services (IMS):


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.

Upon receipt of this report, the licensee shall post ANY licensing report documenting a type “A” citation. This must remain posted for 30 days during hours of operation. In addition to posting this report, the licensee will also provide copies to the parents of the children in care along with a copy of the LIC 9224 - Acknowledgement of Receipt of Licensing Reports, for up to one year.
LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov LPA provided email address in order to be placed on quarterly update subscription: ChildCareAdvocatesProgram@dss.ca.gov
Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited must be cleared to protect the children’s health & safety.
The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
Exit interview was conducted with the Licensee. Site Visit and Initial Appeal Rights discussed and provided.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Reiko Jones
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021
LIC809 (FAS) - (06/04)
Page: 3 of 7
Document Has Been Signed on 09/09/2021 06:47 PM - It Cannot Be Edited


Created By: Reiko Jones On 09/09/2021 at 01:40 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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: HILL FAMILY CHILD CARE
FACILITY NUMBER: 197493493

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/15/2021
Section Cited
CCR
102417(g)(4)

1
2
3
4
5
6
7
Operation of a Family Child Care Home: Poisons/Hazardous Items/Detergents

Poisons detergents, cleaning compounds, medicines, firearms, and other items which could pose a danger to children shall be stored where they
1
2
3
4
5
6
7
LICENSEE understands proof of correction must be provided by POC due date via email or inspection.
8
9
10
11
12
13
14
are inaccessible to children.
Based on LPAs observation this requirement has not been met as evidenced by LPA observation of laundry detergent and chemicals accessible to children in care in play room laundry, kitchen drawer and outdoor shed.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Karen Chambers
LICENSING EVALUATOR NAME:Reiko Jones
LICENSING EVALUATOR SIGNATURE:
DATE: 09/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/09/2021


LIC809 (FAS) - (06/04)
Page: 4 of 7
Document Has Been Signed on 09/09/2021 06:47 PM - It Cannot Be Edited


Created By: Reiko Jones On 09/09/2021 at 01:46 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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: HILL FAMILY CHILD CARE
FACILITY NUMBER: 197493493

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/16/2021
Section Cited
CCR
1597.622(a)(1)

1
2
3
4
5
6
7
Staff Immunizations
Employee and Volunteer Immunization Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
1
2
3
4
5
6
7
LICENSEE understands proof of correction must be provided by POC due date via email or inspection.
8
9
10
11
12
13
14
Based on LPAs record review this requirement has not been met as evidenced by Licensee provided no proof of immunization for S2, S3 and S5 . This poses a potential risk to the health and safety of children in care.
8
9
10
11
12
13
14
Type B
09/16/2021
Section Cited
HSC1596-8662

1
2
3
4
5
6
7
Mandated Reporter
Availability of information regarding detecting and reporting child abuse and neglect; training for mandated reporter who is licensed day care provider, administrator, or employee of a licensed child day care facility; proof of completion.
1
2
3
4
5
6
7
LICENSEE understands proof of correction must be provided by POC due date via email or inspection.
www.mandatedreporterca.com
8
9
10
11
12
13
14
Based on LPAs record review this requirement has not been met as evidenced by no Mandated Reporter Certification. available for S1-S4 provided. This poses a potential risk to the health and safety of children in care.
8
9
10
11
12
13
14
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:Karen Chambers
LICENSING EVALUATOR NAME:Reiko Jones
LICENSING EVALUATOR SIGNATURE:
DATE: 09/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/09/2021


LIC809 (FAS) - (06/04)
Page: 5 of 7
Document Has Been Signed on 09/09/2021 06:47 PM - It Cannot Be Edited


Created By: Reiko Jones On 09/09/2021 at 01:55 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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: HILL FAMILY CHILD CARE
FACILITY NUMBER: 197493493

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/16/2021
Section Cited
CCR
102417(g)(8)

1
2
3
4
5
6
7
Facility Roster
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement has not been met as evidenced by LPAs
1
2
3
4
5
6
7
LICENSEE understands proof of correction must be provided by POC due date via email or inspection.
8
9
10
11
12
13
14
observation of no facility roster available. This poses a potential risk to the health and safety of children in care.
8
9
10
11
12
13
14
Type B
09/16/2021
Section Cited
CCR102416.1(d)

1
2
3
4
5
6
7
Personnel Records (Staff)
(d) All personnel records shall be maintained at the child care home and shall be available to the licensing agency for review. This requirement has not been met as evidenced by LPAs
1
2
3
4
5
6
7
LICENSEE understands proof of correction must be provided by POC due date via email or inspection.
8
9
10
11
12
13
14
observation of no file available for S4. This poses a potential risk to the health and safety of children in care.
8
9
10
11
12
13
14
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:Karen Chambers
LICENSING EVALUATOR NAME:Reiko Jones
LICENSING EVALUATOR SIGNATURE:
DATE: 09/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/09/2021


LIC809 (FAS) - (06/04)
Page: 6 of 7
Document Has Been Signed on 09/09/2021 06:47 PM - It Cannot Be Edited


Created By: Reiko Jones On 09/09/2021 at 02:02 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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: HILL FAMILY CHILD CARE
FACILITY NUMBER: 197493493

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/16/2021
Section Cited
CCR
102417(g)(9)(A)(1)

1
2
3
4
5
6
7
Disaster/Fire Drill Log
(1) The licensee shall document the drills, including the date and time of each drill. This documentation shall be kept at the family child care home. Based on LPAs record review this requirement has not
1
2
3
4
5
6
7
LICENSEE understands proof of correction must be provided by POC due date via email or inspection.
8
9
10
11
12
13
14
been met as evidenced by no disaster log available at the facility. This poses a potential risk to the health and safety of children in care.
8
9
10
11
12
13
14
Type B
09/16/2021
Section Cited
CCR102421

1
2
3
4
5
6
7
Children’s Records
This requirement was not met as evidenced by no file available for infant C1 did not have a file available at the facility. This poses a potential risk to the health and safety of children in care.
1
2
3
4
5
6
7
LICENSEE understands proof of correction must be provided by POC due date via email or inspection.
Type B
09/16/2021
Section Cited
CCR
102417(g)(1)

1
2
3
4
5
6
7
Fire Extinguisher Missing or Needs Servicing
The home shall contain a fire extinguisher which meets standards established by the State Fire Marshal. Based on LPAs observations this requirement has not been met as evidenced by fire extinguisher has No proof of annual service.
1
2
3
4
5
6
7
LICENSEE understands proof of correction must be provided by POC due date via email or inspection.
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:Karen Chambers
LICENSING EVALUATOR NAME:Reiko Jones
LICENSING EVALUATOR SIGNATURE:
DATE: 09/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/09/2021


LIC809 (FAS) - (06/04)
Page: 7 of 7