197495061-3-7-2023-30-CC-ARIR-CPPQKK-20230307111427

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197495061
Report Date: 03/07/2023
Date Signed: 03/07/2023 11:14:38 AM

Document Has Been Signed on 03/07/2023 11:14 AM - 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:	DIXON FAMILY CHILD CARE		FACILITY NUMBER:	197495061
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 8	DATE:	03/07/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Tabina Dixon, Licensee		TIME COMPLETED:	11:20 AM

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On 3/07/2023, Licensing Program Analyst (LPA) Adrian Risher conducted an announced Case Management visit for the purpose of an inspection for a proposed capacity increase. LPA met with Tabina Dixon, Licensee and toured the facility inside and out. The facility is applying for a capacity increase from 8 to 14. Upon arrival, LPA observed 8 children in care with 2 staff. The hours of operation are Monday through Friday from 6:00 AM – 7:00 PM. The fire clearance was granted on 2/23/2023 by inspector Henry Medina.

The single family home has 3 bedrooms and 2 bathrooms. The daycare will consist of the bonus room and the living room. These areas were inspected by LPA. The other bedrooms and rooms are considered off-limits and inaccessible. Applicant is renting the home. Applicant provided property owner/landlord consent form with the application.

The bonus room is used for daily activities, eating and napping. LPA observed cots that are being used for napping. The living room is used for toddlers: daily activities, eating and napping. LPA inspected the bathroom and did not observe any medications or poisons that could pose a potential risk to children in care. The kitchen was inspected during the visit. LPA did not observe any knives or sharp objects, detergents or cleaning supplies that would pose a potential risk to children in care. These items were made inaccessible to the children.

LPA observed age appropriate toys, furniture and activities for children while in care at the facility. LPA inspected the outside of the home and observed age appropriate toys/equipment. There are no bodies of water at the home. The outside play area is fenced all around.

LPA observed a charged fire extinguisher (2-A:10-B:C). LPA tested the smoke detector and carbon monoxide detector. Licensee has a first aid kit which includes band aids and a thermometer. The home has central air and heat.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Adrian Risher
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

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: DIXON FAMILY CHILD CARE	FACILITY NUMBER: 197495061
	VISIT DATE: 03/07/2023

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Applicant has current CPR, first aid, health and safety which expires 05/2023. Licensee provided copies of immunization records and mandated reporter training certificate.

There are no firearms on the premises. Licensee reports that there is 1 dog, 2 birds and fish in the home. LPA did not observe any baby walkers, exersaucers or bouncers.

The parent board will be posted for parents to view required information such as the license, parent's rights poster, personal rights, and emergency disaster plan. A copy of the children's roster will be kept accessible.

The following corrections were discussed with applicant in order for the home to be ready for conducting child care:

1. remove cans of paint from the yard
2. Complete Updated Landlord Consent Form

A license to operate a Large Family child care home will be reviewed following final administrative review, and receipt of outstanding corrections needed. No license will be issued today 03/07/2023. Applicant will notify LPA when corrections have been made, and the Applicant has 30 days to complete corrections.

Licensee was reminded that all adults 18 and over living in the home, persons who provide 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 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: Maureen Neal
LICENSING EVALUATOR NAME: Adrian Risher
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

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: DIXON FAMILY CHILD CARE	FACILITY NUMBER: 197495061
	VISIT DATE: 03/07/2023

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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.

Incidental Medical Services (IMS) policy was discussed. For IMS information , see PIN 22-02-CCP. 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

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the licensee Tabina Dixon.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Adrian Risher
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

LIC809 (FAS) - (06/04)

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