198005223-7-15-2021-54-CC-DCHS-C4Y2YU-20210715174919

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198005223
Report Date: 07/15/2021
Date Signed: 07/15/2021 05:49:34 PM

Document Has Been Signed on 07/15/2021 05:49 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	DAVID FAMILY CHILD CARE		FACILITY NUMBER:	198005223
ADMINISTRATOR:	DAVID, ROWENA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 426-3211
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90806
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 3	DATE:	07/15/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Rowena David, Licensee		TIME COMPLETED:	02:45 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	On July 15, 2021 at 12:45PM, Licensing Program Analyst (LPA) Dayna Chambers conducted an unannounced annual random inspection to the above facility. LPA Chambers contacted the licensee prior to inspection to conduct a COVID 19 assessment for safety. LPA met with Rowena David, licensee who guided analyst on a tour of the facility. The completed inspection report will be emailed to Rowena David at: wendydaycare@yahoo.com Licensee will reply to LPA Chambers email and this will serve as the acknowledgement receipt and signature for report. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed childcare home. Also present during this inspection, was Licensee’s Assistant. Per Licensee, there are 10 children that are currently enrolled. There were 3 children present upon arrival. The licensee is observed to be operating within the license capacity limitations. A current children’s roster was available for review. Licensee's hours of operation are 6:00am to 6:00pm: Monday to Friday. Licensee states that there are no firearms stored in the home. There is one dog on the premises not accessible to children. Emergency Disaster Plan, Parent’s Rights Poster, and the Facility License were observed by LPA to be posted in living room. This is a one-story home which consists of 3 bedrooms, 2.5 bathrooms, kitchen, dining room, living room, front yard and backyard (fenced). Per Licensee, areas off limits to children and parents include: all three bedrooms, 1.5 bathrooms (master and half bath).

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: DAVID FAMILY CHILD CARE	FACILITY NUMBER: 198005223
	VISIT DATE: 07/15/2021

NARRATIVE

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The licensee provides food for children in care.

The children use the bathroom in the in the backroom. The restroom that children use was observed to be safe and sanitary.

LPA observed during inspection in the bathroom and kitchen that detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. LPA did not observe any poisons but advised licensee that any poison shall always be locked and inaccessible to children. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock.

Main play area is in the back room near kitchen and there is also an outside activity room in the backyard. The house also includes a living room, dining room, kitchen with washer and dryer.

LPA observed there is central heat and air for ventilation and heating.

LPA observed the fire extinguisher is in kitchen area. The valve on the required 2A:10BC, fire extinguisher indicates fully charged and was serviced on 09/31/2020, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable. All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. The following was observed and reviewed during this inspection:
All areas identified on the facility sketch that are accessible for children’s use were inspected for safety, comfort, and cleanliness. There is telephone service via cellphone and this cellphone stays at the facility during operation hours.
The home is observed to be clean and orderly. LPA viewed safe age appropriate toys and play equipment in the main play area located in the back room and the outside activity room. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family childcare facility.

LPA observed the outdoor area is used by children. The outdoor area is fenced in and free from defects or dangerous conditions. The yard was clean with age appropriate clean safe toys with appropriate shading.
LPA did not observe any bodies of water on the premises.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: DAVID FAMILY CHILD CARE	FACILITY NUMBER: 198005223
	VISIT DATE: 07/15/2021

NARRATIVE

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The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 10/17/2022. There are first aid supplies available.
Children’s records were reviewed, including emergency information and were observed to be complete.
The licensee and assistant have proof of immunizations. LPA observed that the Licensee and assistant have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. LPA issued a Confidential Names List (LIC 811) to the licensee which documents staff and children’s files reviewed during this inspection. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Following Items were Discussed with Licensee:
IMS SERVICES
Licensee does not provide IMS services.
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

All adults living and working in the home must be fingerprinted and cleared prior to entering the facility. 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. Civil Penalties will be assessed if not in compliance. The licensee was informed that the presence of adults in the home without Criminal Record Clearance or Exemption will be cited and civil penalty assessed for $100 per day. The licensee may find additional information and forms on the DSS website at www.ccld.ca.gov including information on the Live Scan application (LIC 9163). Appointments can be made for Live Scan at 1-800-315-4507.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: DAVID FAMILY CHILD CARE	FACILITY NUMBER: 198005223
	VISIT DATE: 07/15/2021

NARRATIVE

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Licensee was reminded it is the licensee’s responsibility to know the regulations as well as anyone who assists in providing care. Licensee was advised on how to access quarterly reports, forms, and regulations for Child Care online at www.ccld.ca.gov. Licensee was also encouraged to read the Child Care quarterly updates every season as the come out to stay informed of any changes or updates to the regulations.

In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR certification and a valid criminal record clearance associated to the facility license.

Annual fees must be paid promptly and by the due date or a late fee shall be assessed, and/or the License may be terminated.

Reporting Requirements: Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.

Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.

Smoking is prohibited in a family childcare home.

Children and Staff records must be maintained and updated as needed and must be available for review by the Department.

INSPECTION AUTHORITY: All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults, and review documentation.

Licensees shall reveal each facility license number in all advertisements, publications or announcements with the intent to attract clients.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: DAVID FAMILY CHILD CARE	FACILITY NUMBER: 198005223
	VISIT DATE: 07/15/2021

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Liability Insurance: Per applicant, she will be obtaining liability insures. LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information.

UPDATE: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The licensee and all adults working with children have proof of immunizations.

UPDATE: Health and Safety Code 1596.7995: Beginning January 1, 2018, all licensed providers, applicants, directors and employees to complete training as specified on mandated reporter duties. Training is available at: www.mandatedreporterca.com

Infant Care: When Applicant states that they will care for infants. LPA advises applicant to sleep infants where they can always be directly supervised and advised against sleeping infants in a separate room.
LPA provided the applicant with a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. Online copy can be downloaded at: https://www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

LPA advised the applicant how to access forms, regulations, and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.
LPA reviewed and issued the Forms/Records to Keep in Your Family Child Care Home (LIC 311D)

CHILD CARE Advocate:
You may contact the Child Care Advocate Program directly:
Phone number: (916) 654-1541
Email address: childcareadvocatesprogram@dss.ca.gov

Currently, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Rowena David, Licensee, including, but not limited to Appeal Procedures, Site Visit and Initial Appeal Rights.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021

LIC809 (FAS) - (06/04)

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