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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198012299
Report Date: 03/29/2024
Date Signed: 03/29/2024 11:05:49 AM

Document Has Been Signed on 03/29/2024 11:05 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:CROSBY FAMILY CHILD CAREFACILITY NUMBER:
198012299
ADMINISTRATOR:CROSBY, LYDIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 529-4335
CITY:ALTADENASTATE: CAZIP CODE:
91001
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
03/29/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Lydia Crosby - LicenseeTIME COMPLETED:
11:17 AM
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Licensing Program Analysts (LPAs) Nolan Tcheng and Jessica Hoplkins-Hernandez conducted an unannounced 3-Year inspection to the above facility. At 9am, LPAs met with licensee, Lydia Crosby. The licensee states that they currently has 7 children enrolled. A current children’s roster is available and is current. Licensee’s hours of operation are 6:30am-6pm, Monday-Friday.

The facility is the back house of the property. Entrance is through the driveway gate to access the facility. This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining area, living room, front yard and backyard (fenced). The children use living room, dining area, kitchen, hallway bathroom, and Master bedroom and bathroom if needed for emergency or isolation area. Per licensee, areas off limits to children and parents include: the back area and 2 bedrooms. All areas identified on the facility sketch were inspected. The licensee provides food for children in care.

The licensee states that 2 adults and 0 minors currently live on the property. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. Per licensee, there are no weapons, firearms or bodies of water on the premises.

At 9:10am, LPA was led on a tour of the facility by the licensee. Upon entry into the home, the living room was reviewed. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are observed to be posted. The living room is currently the main child care area. There are age appropriate toys and equipment available for children in care. To the left is the dining area where children will do meal time. The kitchen is available to children in care. Detergents, cleaning compounds, medications, and other items which could pose a danger are inaccessible to children, latched underneath the sink. Sharp knives are made inaccessible to children in care. There are first aid supplies available. 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. At 9:20am, a fire extinguisher was observed. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 04/04/22, as indicated on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. REPORT CONTINUES PAGE 1 of 3

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE: DATE: 03/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/29/2024
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CROSBY FAMILY CHILD CARE
FACILITY NUMBER: 198012299
VISIT DATE: 03/29/2024
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Licensee states that they had come out in the year 2023. During the inspection, Licensee contacted the company and scheduled another appointment to have them service the canister. An Advisory Note is being provided. Smoke and carbon monoxide detectors were tested and are operable. The bathroom in the hallway was reviewed next. Bathroom was observed to be safe and in good condition. LPA observed napping equipment in the form of foldable cots. Equipment is stored in the living room. The master bedroom and bathroom, is available to the children in care in case another child needs to use the bathroom. Per licensee, the master bedroom will be used as an area for an ill child until an authorized representative comes to pick up child.

At 9:30am, LPAs observed the front yard area (the backyard of the front house). The outdoor play area was observed to be fenced. At this time, children are using the back yard for outdoor play time. There were play houses and small slides available. Carts and bikes were present. The licensee is observed to be operating within the license capacity limitations.

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 7/2025. Licensee has complete mandated reporter training that expires on 07/18/2025. The licensee's Pediatric First Aid and CPR expires on 07/18/2025. The licensee does have proof of immunization against influenza, tuberculosis, pertussis, and measles. Children’s records were reviewed, including but not limited to, a copy of the emergency information card that contains all the information specified by regulation. LPA observed during children's record review, that all files were missing the LIC627 Consent for Emergency Medical Treatment. LPA discussed the importance of having this form complete.

The following was discussed:


-There are 7 small dogs on the property. Two stay in the master bedroom and occasionally have access to children in care. Five dogs stay outside in the off limit area of the house.
-Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that falls into these categories are not permitted in a family child care facility.
-Smoking is prohibited in a license family child care home.

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

REPORT CONTINUES PAGE 2 of 3

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2024
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CROSBY FAMILY CHILD CARE
FACILITY NUMBER: 198012299
VISIT DATE: 03/29/2024
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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 Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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.

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/.

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.

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Lydia Crosby, at 10:58am. Plan of corrections were developed and copy of report was provided.

END OF REPORT PAGE 3 of 3

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/29/2024 11:05 AM - It Cannot Be Edited


Created By: Nolan Tcheng On 03/29/2024 at 10:32 AM
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CROSBY FAMILY CHILD CARE
FACILITY NUMBER: 198012299

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(7)
Operation of A Family Child Care Home
(7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 3 out of 4 child files, Child #1, 3, & 4, did not have completed LIC627 Consent for Emergency Medical Treatment, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/05/2024
Plan of Correction
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Per Licensee, they will have the parents complete the LIC627 form and will send copies to LPA by POC date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Claudia Guangorena
LICENSING EVALUATOR NAME:Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:
DATE: 03/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/29/2024


LIC809 (FAS) - (06/04)
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