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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494970
Report Date: 03/23/2022
Date Signed: 03/23/2022 04:04:16 PM

Document Has Been Signed on 03/23/2022 04:04 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:REAL FAMILY CHILD CAREFACILITY NUMBER:
197494970
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
03/23/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:ApplicantTIME COMPLETED:
04:15 PM
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On 03/23/2022 Licensing Program Analyst (LPA) Meghan McGee conducted an announced inspection with applicant, Brian Real, for the purpose of a pre-licensing inspection of 859 West 9th Street San Pedro, CA 90731. The purpose of this inspection is to ensure the standards for a Family Child Care Home are being met in accordance to California Title 22 Regulations and California Health and Safety Codes.

The applicant is applying for a small family childcare license with a maximum capacity of 8. Property owner/landlord consent (LIC 9151) is currently on file. The applicant rents/leases property. Lease agreement/control of property was received.

Per the application, currently, the ages the applicant wished to provide services for children are 2 months to 12 years old with the hours of operation Monday through Friday from 6:30am - 7:00pm. Applicant 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.

The home is a single-family home with 2 bedrooms, 1 bathroom, living room, dining room, kitchen, laundry room, side yard, and backyard. Applicant's mother, Ana Real was present during the walk through of the facility.

Parents will enter the home through the front door. Upon entering the home, LPA observed the living room, which applicant stated is the primary childcare area. LPA observed the following: 2 adult couches, child couch with bookshelf, shelves with age appropriate toys, dramatic play area with pillows, and toy horse. LPA observed outlets with safety covers.

The living room leads to the dining room. LPA observed the following: child size tables and chairs, age appropriate toys, a table covering the wall/ floor heater with art supplies for children in care. Applicant’s mother stated that the wall/ floor heaters that connects to hallway have been permanently turned off by the gas company. Applicant's mother provided a formal notification from the gas company that states the heaters are turned off from valve under the house.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Meghan McGee
LICENSING EVALUATOR SIGNATURE: DATE: 03/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/23/2022
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: REAL FAMILY CHILD CARE
FACILITY NUMBER: 197494970
VISIT DATE: 03/23/2022
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Next to the dining room is the hallway that leads to bedrooms and bathroom. Bedroom 1 and 2 is OFF LIMITS to children in care. LPA observed a key lock on the doorknobs.

Bathroom is accessible from the hallway. LPA observed the following: toilet, bathtub, hand soap and paper towels. LPA observed air freshener spray on a shelf inaccessible to children in care. LPA discussed COVID-19 recommendation such as using paper towels and displaying a hand washing sign for children to view.

Next to the dinning room is the kitchen. LPA observed safety gate that makes the kitchen inaccessible to children. Applicant stated that children will only walk through kitchen with staff to access the back yard. LPA observed the following: two refrigerators, adult table and chairs, and stove. LPA observed cabinet below sink with safety latch made inaccessible to children in care. Knives are located in plastic container with a lid in cabinet high up inaccessible to children in care. LPA discussed food preparation, storage and ensuring a log and information regarding dietary restrictions and allergies are kept up to date. As a COVID precaution, LPA advised applicant to use disposable paper goods. The kitchen leads to laundry room. LPA observed hot water heater, cabinets, extra plastic safety gates, and air pumps for jumpers.

Exit door is located in kitchen, next to laundry room that leads to backyard. In back yard, LPA observed the following: artificial grass with covering over it, play house, water table, play structure with slide, and child size bench. Towards the back gate, LPA observed 3 cars parked. Applicant stated that van is currently not in use. LPA observed gate with a lock. LPA observed right side of house with a safety gate that makes it inaccessible to children in care. LPA observed left side of house with lock on gate. Per applicant, there are no weapons or firearms in the home.

There are corrections that need to be made that were noted in the report to be in compliance with Title 22 and California Health and Safety Codes. LPA is requesting a barrier to separate play space where the cars are parked. LPA will schedule a follow up inspection to observe corrections.

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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Meghan McGee
LICENSING EVALUATOR SIGNATURE:

DATE: 03/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2022
LIC809 (FAS) - (06/04)
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