198004718-2-23-2024-33-CC-MSIA-D2QQF6-20240223110726

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198004718
Report Date: 02/23/2024
Date Signed: 02/23/2024 11:07:42 AM

Document Has Been Signed on 02/23/2024 11:07 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	UNDERWOOD FAMILY CHILD CARE		FACILITY NUMBER:	198004718
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	02/23/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Licensee George Underwood & Assistant Brenae Underwood		TIME COMPLETED:	11:30 AM

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 Analysts (LPAs)Mary Silva and Saul Valenzuela conducted a Case Management - Licensee Initiated visit for the purpose of evaluating a request for a capacity increase from 8 to 14 and to add daughter Brenae Underwood to the facility license. LPAs met with Licensee George Underwood and assistant Brenae Underwood who guided LPA on a tour. There are three adults and no minor children living in the home. There were no children present during this visit. Per Licensee, there are 8 children currently enrolled. The hours of operation are Monday through Friday 6:00am-6:30pm. Fire clearance for a capacity of 14 was granted on 02/07/2024. All areas identified on the facility sketch were inspected. The facility is a two story home that consist of 3 bedrooms, 3 bathrooms, kitchen, dining area, living room, daycare room(den), front yard, backyard, and garage. The areas accessible to children are kitchen, dining area, living room, daycare room(den), one bathroom located downstairs and backyard. There is a separate entrance for parents to access the facility located to the right side of the front yard that leads to kitchen side door and the back door. LPA(s) observed a fish tank in the day care room/den. The areas inaccessible to children are 3 bedrooms(one located upstairs and two located downstairs), 2 bathrooms(located upstairs), front yard and garage. LPA(s) observed the stairway to the second floor is blocked with a safety gate making it inaccessible to children in care. The Licensee uses the back yard for outdoor play. The outdoor play areas were observed to be fenced. Licensing staff observed that the outdoor yards have toys and other materials for children to play with. LPA(s) observed a trampoline in the side of the yard. Licensee submitted a declaration with instructions for supervision. The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. There are age-appropriate toys and equipment on the premises. Licensee prepares dinner for children including pm snack and provides transportation before and after school. _________________________Page 1_____________________________________________

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: UNDERWOOD FAMILY CHILD CARE	FACILITY NUMBER: 198004718
	VISIT DATE: 02/23/2024

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

The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 08/30/23, as indicated on service tag. Licensee stated there are no weapons or firearms in the facility. Smoke and carbon monoxide detectors were tested and are operable on this day. Licensee has current CPR/First Aid certification, expires on 01/07/2026 for George and Brenae Underwood and Mandated Reporter Training Certificate, expires on 05/22/2025 on for George Underwood and on 07/15/2025 for Brenae Underwood.

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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleephttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep

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: https://www.ada.gov/resources/child-care-centers/.

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.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
___________________________________Page 2___________________________________________

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: UNDERWOOD FAMILY CHILD CARE	FACILITY NUMBER: 198004718
	VISIT DATE: 02/23/2024

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

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited. The capacity increase request for a Large Family Child Care will be submitted for review. Once a capacity increase is issued, the Licensee is required to adhere to the terms and limitations as stated on the license.

A notice of site visit was given and must remain posted for 30 days. Appeal rights were provided. Exit interview conducted and report was reviewed with the Licensee, George Underwood.

______________________________________Page 3____________________________________

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024

LIC809 (FAS) - (06/04)

Page: 3 of 3