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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495074
Report Date: 04/25/2022
Date Signed: 04/25/2022 12:03:03 PM

Document Has Been Signed on 04/25/2022 12:03 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:BECKER FAMILY CHILD CAREFACILITY NUMBER:
197495074
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
04/25/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Stephanie BeckerTIME COMPLETED:
12:00 PM
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On 4/25/2022, Licensing Program Analyst (LPA) Lillian Casillas conducted an announced Pre-Licensing Inspection. LPA met with Applicant, Stephanie Becker, who guided LPA on a tour of the inside and outside of the home. Applicant carried her infant along with her during the tour. LPA observed 0 in care. Hours of operation are scheduled for Monday through Friday, 9:00AM to 2:00PM.

Applicant is applying for a Small Family Child Care Home with maximum capacity of 8 children with an assistant, ages 15 months to 5 years old.

This is a single-story home with 2 bedrooms, 2 bathrooms, living room, dining room, kitchen, laundry room, office, front yard, backyard, garage, and guest house with 1 bathroom. Childcare areas are: living room, bedroom 1, bathroom 1, kitchen, dining room, backyard, and guest house. Off-limits areas are: bedroom 2, bathroom 2, bathroom 3, office, front yard, and garage.

Indoor


LPA entered the home by walking up the driveway to the gate that leads to the backyard. Upon entering the backyard, LPA observed cubbies and a drinking water station. Applicant stated the living room is the primary childcare area. To access the living room, children will be escorted through the laundry room, kitchen, and dining room. In the living room, LPA observed 1 sofa, age-appropriate toys, books, a children's floor mat, and fireplace. The fireplace is made inaccessible by a screen. In the dining room, LPA observed 1 highchair and a dining table with 6 chairs. Applicant stated she will provide 1 snack and parents will provide lunch. Children will eat in the dining room. Although the kitchen is not off-limits, LPA observed a child safety gate blocking off the kitchen from the dining room. In the kitchen, LPA observed locks on all lower cabinet drawers. Bathroom 1 is adjacent to the living room and is located in the hallway. In bathroom 1, LPA observed 1 shower/tub, 1 toilet, 1 sink, and 1 potty training seat. LPA did not observe any shampoos/soaps in the shower. Bedroom 1 can be accessed via the hallway. In bedroom 1, LPA observed 1 crib, 1 diaper changing table, 1 diaper genie, and cots. Applicant stated bedroom 1 will be used for napping. [CONTINUE ON PAGE 2]
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Lillian J Casillas
LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2022
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 4
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: BECKER FAMILY CHILD CARE
FACILITY NUMBER: 197495074
VISIT DATE: 04/25/2022
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In the laundry room, LPA observed a lock on a cabinet where Applicant stores detergents. LPA observe a serviced fire extinguisher and first-aid kit on shelves above the washer and dryer. LPA observed a functioning carbon monoxide detector and a smoke/carbon monoxide detector in the hallway as well as in bedroom 1. The Isolation area is located in bedroom 1 or guest house.

LPA discussed Connections for Children, the local Resource & Referral agency, with Applicant to inquire about food programs, child care referrals, and professional development training. Connections for Children contact information: (310) 452-3325, info@cfc-ca.org, https://www.connectionsforchildren.org/

Indoor Off-Limits
LPA observed key locks on the doors to bedroom 2 and office. Bathroom 2 can only be accessed via bedroom 2.

Outdoor
LPA observed a large, enclosed outdoor area. In the bottom half, LPA observed patio furniture, age-appropriate toys, wagon, sandbox, watertable, and picnic table. Applicant stated children will eat on the picnic table when the weather permits. LPA observed a small stairway that leads to the grassy area and guest house. This small stairway is blocked off with a small gate. In the grassy area, LPA observed a garden, sandbox, swings, and a shed which is made inaccessible by a combination lock. The guest house includes a a children's art table, toy marketplace set, sensory table, age-appropriate toys (tea set, dress up), books, a first-aid kit, a serviced fire extinguisher, and a smoke/carbon monoxide detector. .

Outdoor Off-Limits
Applicant stated the front yard is off-limits to children. The garage can only be accessed via the driveway and will remain closed during hours of operation. The bathroom in the guest house is off-limits and will remain locked during hours of operation.

Applicant states there are no firearms or weapons of any kind in the facility at the time of the visit. LPA

[CONTINUE ON PAGE 3]

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Lillian J Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: BECKER FAMILY CHILD CARE
FACILITY NUMBER: 197495074
VISIT DATE: 04/25/2022
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reviewed all required documents to keep in the children’s files and facility file according to Title 22 Regulations. LPA observed a parent board on the door to the guest house with Emergency Disaster Plan, Notification of Family Child Care (PUB394), If You See Something, Say Something poster, and a space for the License. LPA observed all electrical outlets covered.


Criminal Record Statement
Applicant 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.

Safe Sleep


LPA discussed the safe sleep regulations with Applicant 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 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


[CONTINUE ON PAGE 4]
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Lillian J Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: BECKER FAMILY CHILD CARE
FACILITY NUMBER: 197495074
VISIT DATE: 04/25/2022
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Exit Interview
Exit interview conducted and report was reviewed with the Applicant, Stephanie Becker.

Family Child Care Homes
LPA reviewed with Applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.


Subscribe to CCLD important information
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: Maureen Neal
LICENSING EVALUATOR NAME: Lillian J Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4