198000938-8-23-2023-33-CC-CGRN-CUYTLA-20230823144914

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198000938
Report Date: 08/23/2023
Date Signed: 08/23/2023 02:49:23 PM

Document Has Been Signed on 08/23/2023 02:49 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	WILLIAMS, QUEEN ESTHER FAMILY DAY CARE		FACILITY NUMBER:	198000938
ADMINISTRATOR:	WILLIAMS, QUEEN ESTHER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 712-9580
CITY:	ALTADENA	STATE: CA	ZIP CODE:	91001
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 3	CENSUS: 1	DATE:	08/23/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Queenn Esther Williams		TIME COMPLETED:	03:15 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	Licensing Program Analyst (LPA) Crystal Green conducted an unannounced required 1 year inspection. LPA met with Licensee, Queen Esther Williams, who guided analyst on a tour of the facility. During this inspection, there were 1 child present. Licensee states that there are currently 3 children enrolled. This is a one- story home which consists of 3 bedrooms, 2 bathrooms, living room, dining room, kitchen, rear family room (main activity area) and backyard (fenced). Children have access to the rear family room, and the bathroom near the laundry area. Per Licensee, the three bedrooms, and bathroom near the bedrooms are considered off-limits to children in care. The LPA toured all areas used by children during this visit. The licensee provides food for the children in care. There are only 2 adult that resides in the home (criminal record clearances on file). Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating or safety and comfort. There were safe toys, play equipment and materials observed for children. There is a working telephone service maintained in the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children should be made inaccessible. The licensee states that there are no poisons in the home. The licensee does understand that poison must be locked with a key or combination lock. Report Continues Page 1 of 3

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023

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 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: WILLIAMS, QUEEN ESTHER FAMILY DAY CARE	FACILITY NUMBER: 198000938
	VISIT DATE: 08/23/2023

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
26
27
28
29
30
31
32

Per licensee, there are no weapons, firearms on the premises. Children’s records were reviewed to ensure that each child has an Identification and Emergency form and copy of their Immunization Record’s. The valve on the required 2A 10BC fire extinguisher indicates fully charged.

LPA tested the smoke detector and carbon monoxide detector located in the children main activity area, which was observed to be in operable condition. LPA reviewed Licensee Pediatric First Aid and CPR, which was observed to be current.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018, any person who works in a childcare facility shall complete the training and renew the training every 2 years. LPA reviewed the licensee completion certificate dated 08/01/2023.

LPA observed sleeping equipment for infants. At this time, Licensee does not care for infants. LPA advises licensee on Infant Safe Sleep. There are no objects hanging above or attached to the side of the crib. LPA observed that cribs and play yards do not hinder the entrance or exit to and from the space they are sleeping in. Mattresses were observed to be firm and covered with a fitted sheet that is appropriate to the mattress size. Each infant has their individual bedding and is washed weekly as required. Soiled bedding is replaced when wet or soiled and is placed in an area inaccessible to infants. Pacifiers were observed to not be attached to anything and are labeled. Licensee was advised that infants shall not be swaddled while in care and all infants up to 12 months should be placed on their back for sleeping.

LIC 9227 (Individual Sleeping Plan) for infants up to 12 months was explained and issued. LPA discussed the safe sleep regulations with the 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 licensee [or facility representative] 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. LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at:
Report Continues Page 2 of 3

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: WILLIAMS, QUEEN ESTHER FAMILY DAY CARE	FACILITY NUMBER: 198000938
	VISIT DATE: 08/23/2023

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
26
27
28
29
30
31
32

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.

The following was discussed:
• Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.
• The Licensee shall be present in the home and shall ensure that children are supervised at all times.
• Children shall not be left in park vehicles.
• The capacity specified on the license shall be the maximum number of children for whom care can be provided.
• Car seats shall only be used for transportation purposes and shall not be used for sleeping.
• All children in care have the right to receive safe, healthful, and comfortable accommodations, furnishings and equipment.
• When a child shows signs off illness, they will be separated from other children until the nature if the illness is determined.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

No citations are being issued today. Exit interview conducted and report was reviewed with the licensee and appeal rights were provided. A notice of site visit was given and must remain posted for 30 days.

Report Ends Page 3 of 3

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Crystal Green
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3