198011217-1-21-2025-54-CC-PBIP-DD5T8T-20250121133052

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198011217
Report Date: 01/21/2025
Date Signed: 01/21/2025 01:31:07 PM

Document Has Been Signed on 01/21/2025 01:31 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	SIMPSON-GIPSON FAMILY CHILD CARE		FACILITY NUMBER:	198011217
ADMINISTRATOR/ DIRECTOR:	SIMPSON-GIPSON, DEBRA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 329-3270
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90059
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 8	DATE:	01/21/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Debra Gipson		TIME VISIT/ INSPECTION COMPLETED:	01:30 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's (LPA) P Bishop and T Reyes arrived at the above facility for the purpose of an Unannounced Annual Inspection at 9:30. Upon arrival, LPA's announced the purpose of the visit and was granted entry into the facility by Licensee Debra Gipson who provided a tour of facility. LPA's provided the inspection Entrance Checklist, LIC 126. LPA's inspected rooms/areas on the facility sketch in which child-care services are provided and to which children have access. Per licensee, the current hours of care provided are Sunday – Saturday 5:00 am -- 6:00 pm overnight care will be provided as needed. There were eight children present during today's inspection. Licensee stated that she and her husband are the only one that lives here, and current criminal background clearances are present. LPA's observed the facility license, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness forms. All documents were on Parent Board to the left upon entering the home. At 10:00 LPA's were given a tour of the facility. This is single - family home consists of three bedrooms, 1 bathroom, kitchen, living/dining area and backyard and garage. Per licensee, the areas used by children include: Living Room, Bathroom 1, rear outside play area. Areas that are used by children were inspected for safety, comfort, cleanliness, telephone service, ventilation, and heating. Off limit areas are all bedrooms, kitchen and garage. Licensee states that the living room will be used as a Isolation area for sick children waiting to be picked up by a parent. Rooms that are off-limits need to be made inaccessible during operating hours. The licensee does understand that licensing staff may have access to off-limit areas during inspection visit, if necessary. At 10:30 am, life-saving devices were inspected throughout the home. The smoke detector is located in the hallway which leads to the kitchen. The carbon monoxide detector is located in the main care area in the living room. All devices were tested and operable. The 2A 10 BC Fire extinguisher is located in the kitchen and indicates fully charged and was serviced on 09/2024. Licensee was reminded that fire extinguisher needs to be serviced yearly. The home maintains telephone service via cell phone/LAN line. 1 of 4

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Peter Bishop
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025

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

FACILITY NAME: SIMPSON-GIPSON FAMILY CHILD CARE	FACILITY NUMBER: 198011217
	VISIT DATE: 01/21/2025

NARRATIVE

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At 10:45 Living Room (Main care area) was observed to be clean and orderly. There are toys and other age-appropriate materials for the children. LPA's observed the room to have a table for four children to sit, area rug with shapes and a playhouse. There were colorful storage boxes, and a crib.

LPA's observed the kitchen. Licensee states that the door to enter the kitchen is always closed to make off limits kitchen inaccessible to children in care. LPA's observed that cleaning compounds in kitchen are made inaccessible to children in care with lock and key on cabinets. Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, not only inaccessible to children. Licensee further stated that all other pesticides are kept in the garage which is also off limits to the children.
At 11:00 a.m., LPAs observed that the bathroom the children use is clean and free of floor hazards. There was toilet paper, hand-washing soap, and towels for the children. LPA's did not observed any chemicals stored under the sink.
Per Licensee there are no firearms or weapons stored in the home. LPA's did not observe any firearms or weapons in the home. Licensee states that there are no body of water present. LPA's did not observe any bodies of water on the premises.
At 11:15 a.m., LPA's observed the back yard for outdoor play. The outdoor play area was observed to be completely fenced. At the time of the inspection there was one clubhouse climber playset multiple benches and other ride toys for the children. LPA's observed one small dog in the back yard. Per licensee, the pet will be kept in back yard during daycare hours away from the children.

At 11:30 a.m., Staff records were reviewed for approved Pediatric First Aid and CPR certification. Valid CPR/First Aide was available two of two expire 01/28/2025. although the CPR Certificate is not expired Licensee stated that it has been recently renewed. LIC-501: Personnel Record, LIC 9052- Employee Rights, Proof of immunizations against measles was not available, pertussis and influenza or influenza declination, TB clearance or risk assessment was available at the time of the visits. LIC 9108- Statement Acknowledging Requirement to Report Child Abuse is available and current Mandated Reporter Training Certificate was available two of two has current mandated reporter certificate

Five Children’s records were available and reviewed. LIC 627 was not complete for 2 children

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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Peter Bishop
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025

LIC809 (FAS) - (06/04)

Page: 2 of 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: SIMPSON-GIPSON FAMILY CHILD CARE	FACILITY NUMBER: 198011217
	VISIT DATE: 01/21/2025

NARRATIVE

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The following information was discussed:
LPA discussed the safe sleep regulations with licensee Licensee Gipson and discussed the Child Care Licensing Safe Sleep. LPA Bishop provided Licensee Gipson with a CDSS resource video made available through YouTube. Also, webpage resources provided at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA P Bishop and T Reyes also informed Licensee Gipson 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. Licensee states she does not provide medication. 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) or (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

Criminal Record Clearance - Family Child Care Homes - Licensee Gipson 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.

Licensee Gipson 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.
Based on the LPA's observations, record review, and interviews, there will be one deficiency cited today in accordance with California Title 22 Regulations. Two children did not have a sleep log. Licensee stated that the following Technical Violations will be corrected by February 2, 2025.
LIC 627 Consent for Emergency Treatment

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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Peter Bishop
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025

LIC809 (FAS) - (06/04)

Page: 3 of 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: SIMPSON-GIPSON FAMILY CHILD CARE	FACILITY NUMBER: 198011217
	VISIT DATE: 01/21/2025

NARRATIVE

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During the exit interview, the licensee, confirmed that there are no Registered Sex Offenders (RSO) living in the facility and LPA completed the RSO search in Megan’s Law Website.
A notice of site visit was given and must remain posted for 30 days. Failure to post will result in a $100 civil penalty. Exit interview conducted and report was reviewed with Licensee Gipson.
A copy of the report and appeal rights was given to Licensee Gipson.

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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Peter Bishop
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025

LIC809 (FAS) - (06/04)

Page: 4 of 7

Document Has Been Signed on 01/21/2025 01:31 PM - It Cannot Be Edited

Created By: Peter Bishop On 01/21/2025 at 12:52 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: SIMPSON-GIPSON FAMILY CHILD CARE	FACILITY NUMBER: 198011217
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/21/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(j)(2)(D)(c)

Infant Safe Sleep

Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review the licensee did not comply with the section cited above in 2 out of 2 infants enrolled which did not have a 15 minute sleeping log which poses/posed a potential health, safety or personal rights risk to persons in care
	POC Due Date: 01/28/2025
	Plan of Correction
1 2 3 4	Per Director, the documentation for the 15 minute sleep log will be kept for all infants enrolled. Proof will be submitted to LPA via photo by due date to include date, infant name and time of check.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Karen Chambers

LICENSING EVALUATOR NAME:

Peter Bishop

LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025

LIC809 (FAS) - (06/04)

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