197494601-11-14-2022-30-CC-JLAO-CL6VWD-20221114154746

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494601
Report Date: 11/08/2022
Date Signed: 11/14/2022 03:48:02 PM

Document Has Been Signed on 11/14/2022 03:48 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:	SMITH FAMILY CHILD CARE		FACILITY NUMBER:	197494601
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	11/08/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Zekai Smith		TIME COMPLETED:	02:30 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 11/08/2022 Licensing Program Analyst (LPA) Judy Laureano conducted an announced inspection with Zekaia Smith for the purpose of an increase of capacity inspection for 1201 Ocean Park Blvd. Apt. A, Santa Monica, CA 90405. The purpose of this increase of capacity visit is to ensure the standards for a Family Child Care Home are being met in accordance to California Tittle 22 Regulations and California Health and Safety Codes. The licensee is applying for an increase of capacity; Large Family Child Care Home license for a max capacity of 14. Landlord notification on file. Applicant will care for only 12 children. A fire clearance was approved by Santa Monica Fire Department on 9/22/2022. Facility was licensed for a Small (8) Family Child Care Home on 07/24/2020. The capacity of the Large Family Child Care Home is 12. Per the application, at this time, the ages the applicant wishes to provide services for are children 3 months old to 13 years old with the hours of Monday- Saturday 5:00 a.m. to 11:30 p.m. Licensee was informed that any changes to ages, hours and days of operation shall be submitted to the department for approval prior to initiation of changes. Facility is located in a 4 unit apartment building on a main street. The unit is located in the bottom floor, 2 bedroom, 1 bathroom, kitchen and dining room area. Parents access the facility through main door and/or side door of the home. Front yard is not gated and is OFF LIMITS to the children in care. Entering the front door, LPA observed the living space designated as the day care space. Dramatic play area with age appropriate toys were observed in the space. Behind the main door, LPA observed applicant’s certification and parent information. LPA observed a mounted television set and a parent board with all necessary notification. Living room space was observed to have a closet that have extra day care supplies and a mounted fire extinguisher.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2022

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: SMITH FAMILY CHILD CARE	FACILITY NUMBER: 197494601
	VISIT DATE: 11/08/2022

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Next to the living room you are led to the kitchen area. Applicant confirmed children eat in the kitchen/dinning room area. The kitchen, stove and refrigerator were observed and inspected. Applicant confirmed facility will be providing meals and snacks. Sink and counter space area were observed and inspected. Knives and sharp object were observed to be made inaccessible to the children in care in a latched cabinet. Kitchen was observed to have a pantry next to the refrigerator. LPA discuss food preparation, storage and ensuring a log and information regarding dietary restrictions and allergies are kept up to date. Applicant has a menu posted on the refrigerator door. Kitchen was observed to have a side door that is used by parents to drop off or pick up. The side door leads to the side of the unit.

Next to the kitchen, you led to small hallway that gives access to bedroom 1 and bedroom 2 with a bathroom. LPA observed applicant test the carbon monoxide and smoke detector in the hallway next to bedroom 1. LPA observed an open face heater with a metal barricade. Bedroom 1 is OFF LIMITS and made inaccessible to the children in care with a plastic door knob cover. Licensee confirmed that bedroom 1 will remain closed during the hours of operations.

Bedroom 2, next to the bathroom,is designated as day care space. LPA observed children size tables an chairs. A closet was observed and inspected. Applicant tested the carbon monoxide and smoke detector in the room.
The bathroom that children will use is located outside the kitchen. LPA observed and inspected the sink, cabinet above the toilet and medicine cabinet.

No outdoor space is used. Applicant confirmed she uses the local park for outdoor space. LPA discussed emergency contact information as well as authorization to be able to take the children to the local park. Applicant confirms program offers transportation- pick up and drop off at school. LPA discussed car safety, car seats and whoever provides transportation needs to have a current driver licenses and vehicle insurance.
The following areas are OFF LIMITS:
1. Bedroom 1
Exit interview was conducted with applicant, Zekai Smith. The licensing determination of this application will be reviewed with Licensing Program Manager for final resolution.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2022

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: SMITH FAMILY CHILD CARE	FACILITY NUMBER: 197494601
	VISIT DATE: 11/08/2022

NARRATIVE

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The following was discussed with the applicant:

Applicant was made aware of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on childcare licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541

Email Address: childcareadvocatesprogram@dss.ca.gov

Immunizations: Commencing September 1, 2016, SB 792, prohibits a person from being employed or volunteering at a childcare facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the inspection.

Mandated Reporter Training: Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com. Licensee was reminded of their responsibility to report suspected child abuse.

LPA reviewed with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Home, children’s forms/records, family forms/records, and information to be posted. LPA provided applicant a copy of teh LIC311D.

Licensee was made reminded that it is the licensee’s, as well as anyone who assists in providing care responsibility to know the regulations. Licensee was also encouraged to read the Child Care quarterly updates every season as they come out to stay informed of any changes or updates to statutes and regulations.

Applicant was advised that regulation prohibits the smoking of tobacco in a private residence licensed as a family childcare home during the hours of operation.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2022

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: SMITH FAMILY CHILD CARE	FACILITY NUMBER: 197494601
	VISIT DATE: 11/08/2022

NARRATIVE

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Applicant was made aware that state law prohibits baby walkers, bouncy seats, exer-saucers and any other items that fall into that category. Applicant was also reminded that only children who are eating may be in highchairs and that car seats are utilized only for transportation.

Applicant was also informed that the provider is required to wash hands after every diaper change and to never shake a baby to prevent the Shaken Baby Syndrome.

LPA discussed the safe sleep regulations with applicant [or facility representative] 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.

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

Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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 Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed.

In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR & Pediatric First Aid certification and a valid criminal record clearance associated to the facility license.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2022

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: SMITH FAMILY CHILD CARE	FACILITY NUMBER: 197494601
	VISIT DATE: 11/08/2022

NARRATIVE

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A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.

Annual fees must be paid promptly and by the due date or a late fee shall be assessed, and/or the License shall be terminated. (If paying by check please make sure to write facility number on check to ensure that payment is applied to your facility number)

The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked, and batteries should be replaced.

Changes should be reported the to the Department as soon as they occur such as construction and remodeling, telephone number changes and/or if you move from home.

Reporting requirements: Applicant must report any unusual incident or injuries to the Child Care Regional office by telephone within 24 hours and in writing within 7 days. Applicant was provided with LIC 624 as a reference.

Fire and safety drills must be performed every six months and documented for review by the Department.

All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.

LPA advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov

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.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2022

LIC809 (FAS) - (06/04)

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