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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494269
Report Date: 02/16/2023
Date Signed: 02/16/2023 04:23:03 PM

Document Has Been Signed on 02/16/2023 04:23 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:BOOKER FAMILY CHILD CAREFACILITY NUMBER:
197494269
ADMINISTRATOR:BOOKER, TAMIKAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(424) 374-8229
CITY:INGLEWOODSTATE: CAZIP CODE:
90303
CAPACITY: 14TOTAL ENROLLED CHILDREN: 7CENSUS: 4DATE:
02/16/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:59 PM
MET WITH:Tamika Booker-licenseeTIME COMPLETED:
04:40 PM
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On 2/2/2023 Licensing Program Analyst (LPA), Jillinda Chandler conducted an unannounced one year required visit for Booker Family Child Care Home. Present in the home was licensee, licensee's assistant, licensee's adult son and 4 day care children. The home is a single family, single story home, that consists of a living-room, kitchen, two bathrooms, three bedrooms and a bonus room. Day care operations are conducted in the bonus room in the rear of the home. The home was inspected inside and out for Health and Safety compliance per Title 22.
LPA observed the following:
Care and supervision were observed, upon arrival LPA observed care and supervision being provided by licensee's assistance.
The homes capacity was within the scope of the license
Appropriate size fire extinguisher carbon and smoke detector present & operable. The fire extinguisher was within range, however an annual inspection shall be conducted at least once a year.
Detergents, and knives were inaccessible, Toxins were locked and inaccessible.
The homes kitchen was inaccessible to children in care, no hazardous conditions were observed.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE: DATE: 02/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/16/2023
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: BOOKER FAMILY CHILD CARE
FACILITY NUMBER: 197494269
VISIT DATE: 02/16/2023
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No guns or weapons present as stated by the Licensee, no weapons observed by LPA. The home has a properly working telephone LPA observed the homes parent notification board; the license, facility sketch, Emergency Disaster Plan, Notification of Parent’s Rights Poster, Lead Poison Awareness, Safe Sleep and California Safety Seat Law were posted. Licensee was informed that the parent board shall be placed in a prominent area for parents, authorized representative or visitors viewing. A first aid kit was observed containing the required supplies: scissors, tweezers, bandages, medical ointment and a thermometer. Licensee’s Pediatric CPR and First Aid Card expires 4/2022 No bodies of water were observed on the premises
Children records available and in good(need of updating) order.
Personal records were reviewed, LPA did not observe(d); immunization records for licensee's assistant, licensee was advised to provide immunization records for; Pertussis, Measles and Influenza no later than 2/22/2023
Licensees Mandated Reporter certificate expires (4/25/2023)
A roster was current readily available for review.
Parents and authorized adults sign children in and out using their original signatures
Licensee provides Individual Medical Services (IMS). Proper IMS guide lines were being followed.
All adults in the home cleared a Criminal Background Clearance.
Toys, equipment and materials were available and in good order Children napped on mats that were found to be in good condition.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: BOOKER FAMILY CHILD CARE
FACILITY NUMBER: 197494269
VISIT DATE: 02/16/2023
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Infant safe sleeping was discussed with licensee. LPA reminded licensee that children are only to use car seats during transportation, and appropriate children’s feeding chairs shall only be used during mealtime. Outdoor activities were conducted in the back yard, LPA did not observe any hazardous conditions in this area.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: BOOKER FAMILY CHILD CARE
FACILITY NUMBER: 197494269
VISIT DATE: 02/16/2023
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LPA discussed the safe sleep regulations with licensee 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 licensee 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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Tamika Booker

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023
LIC809 (FAS) - (06/04)
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