198400181-3-24-2023-54-CC-RDEO-CQ8Q2B-20230324114649

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400181
Report Date: 03/24/2023
Date Signed: 03/24/2023 11:47:01 AM

Document Has Been Signed on 03/24/2023 11:47 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	PATRICK FAMILY CHILD CARE		FACILITY NUMBER:	198400181
ADMINISTRATOR:	JENNIPHER PATRICK		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 354-8735
CITY:	COMPTON	STATE: CA	ZIP CODE:	90220
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 10	CENSUS: 6	DATE:	03/24/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Licensee - Jennipher Patrick		TIME COMPLETED:	12:05 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) R. Derraco conducted an unannounced required one year inspection to the above facility on 03/24/23. LPA arrived at the facility at 9:15 AM and met with Licensee, Jennipher Patrick, who guided analyst on a tour of the facility. Also present during this inspection were two assistants. Per Licensee, there are 10 children that are currently enrolled. There were 6 children present upon arrival. This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen/dining room, living rooms, garage, front yard and backyard (fenced). The off limit areas include 2 bedrooms, 1 bathroom, front yard, and garage. Due to the recent rain storms, licensee states she the backyard play area will be temporarily off-limits. An updated facility sketch was provided to LPA during inspection. The main care area is located in the living room. LPA observed child sized table, child sized chairs, a wooden cubby locker for storing children's personal belongings, age appropriate toys, two high chair feeding tables, wall mounted television, and educational posters. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted in the main care area. The kitchen/dining area was observed with locks on all kitchen cabinets. Licensee states that she provides food for children in care. No sharp or pointy objects were observed to be accessible in the kitchen. Cleaning supplies were observed locked beneath the kitchen sink. Bedroom 1 was observed with sleeping cots, two baby cribs, and an enclosed play yard. Additional age appropriate toys and art supplies were observed in the closet of bedroom 1. The bathroom was observed to have an operable sink, toilet, and faucet. Per licensee, she plans to have bathroom sink replaced after day care hours. LPA observed the bathroom sink to be missing the doors. LPA did not observed any objects beneath the bathroom sink or in the bathroom that could be a danger to children in care. Per licensee, isolation area for children showing signs of illness will be located in Bedroom 1 while they await parent pick up. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs. No bodies of water were observed in the back yard play area. (page 1 of 3)

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023

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

FACILITY NAME: PATRICK FAMILY CHILD CARE	FACILITY NUMBER: 198400181
	VISIT DATE: 03/24/2023

NARRATIVE

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There are no pets on the premises. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Individuals who reside in the home were noted and discussed. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated. Licensee states that there are no firearms stored in the home.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety,

comfort, and cleanliness. There is telephone service via a cellphone that is used and the cellphone stays at the facility during operation hours. Per Licensee, the home is equipped with central heating. The licensee understands that storage areas for poisons must be locked, not just inaccessible. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was purchased on 02/17/23, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable.

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-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 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 in 06/2024. LPA observed that the Licensee and assistant do have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. File review was observed to not have proper immunization records for assistant S2. LPA advised licensee that a citation under Health and Safety Code Section 1597.622(c) will be issued. Children’s records were reviewed, including emergency information and were observed to be complete. A current children’s roster was available for review.

(page 2 of 3)

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: PATRICK FAMILY CHILD CARE	FACILITY NUMBER: 198400181
	VISIT DATE: 03/24/2023

NARRATIVE

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Incidental Medical Services (IMS):
IMS was discussed with licensee. Per licensee, there are no children enrolled that require IMS at this time. 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.

LPA advised the licensee to access forms, regulations and quarterly updates online at: www.cdss.ca.gov.

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. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Assistant Ana Molina.

(page 3 of 3)

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 03/24/2023 11:47 AM - It Cannot Be Edited

Created By: Randy Derraco On 03/24/2023 at 11:35 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: PATRICK FAMILY CHILD CARE	FACILITY NUMBER: 198400181
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(c)

Administration of Child Day Care Licensing

(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not maintain documentation of the required immunizations for S2 which poses a potential Health, safety and/or personal rights risk to persons in care.
	POC Due Date: 04/03/2023
	Plan of Correction
1 2 3 4	Licensee will email LPA a copy of the completed immunization records documented the required immunizations

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:

Randy Derraco

LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023

LIC809 (FAS) - (06/04)

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