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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400181
Report Date: 07/14/2023
Date Signed: 07/14/2023 12:50:25 PM

Document Has Been Signed on 07/14/2023 12:50 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:PATRICK FAMILY CHILD CAREFACILITY NUMBER:
198400181
ADMINISTRATOR:JENNIPHER PATRICKFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 354-8735
CITY:COMPTONSTATE: CAZIP CODE:
90220
CAPACITY: 14TOTAL ENROLLED CHILDREN: 16CENSUS: 11DATE:
07/14/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Licensee - Jennipher PatrickTIME COMPLETED:
01:05 PM
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Licensing Program Analyst (LPA) R. Derraco conducted an unannounced case management visit to the above mentioned facility on 07/14/23. LPA arrived at the facility at 9:15 AM and was met by assistant S1. LPA announced name, title, and reason for visit to S1 and was let inside the home by S2. Upon entry to the home, LPA observed 3 adults, and 11 children in care. The purpose of this visit is to observe the backyard play area and the garage area to be used as an activity space for children in care. LPA observed the licensee arriving to the home at 10:15 PM and continuing the tour with LPA.

This is a one-story home which consists of 3 bedrooms,2 bathrooms, a living room, kitchen/dining area, garage, front yard, and backyard (fenced). The off-limit areas include 2 bedrooms and 1 bathroom.

During the visit, LPA observed 5 infants in care located in the bedroom designated for use by the day care. LPA advised licensee that a Type A citation under California Code of Regulation (CCR) section 102416.5(d)(1) will be issued. LPA observed 2 cribs in the bedroom designated for care. One crib was observed missing a wheel on the leg while occupying an infant. The infant was removed from the crib during LPA visit and is no longer in use. LPA advised licensee that a citation under CCR section 102425(a)(1) will be issued. LPA observed that the home has two cribs available for infants in care. Licensee states that infants do not sleep at the same time and she alternates the infants in the crib for nap. LPA advised licensee that a citation under CCR section 102425(a) will be issued.

The backyard play area was observed to have perimeter fencing, age appropriate toys, child sized picnic tables, and child sized outdoor play equipment. The backyard floor was observed with artificial grass. The garage area was observed to have carpeted flooring, age appropriate toys, art supplies, child sized couch, children's reading material, and a wall mounted television. LPA advised that doors to the garage should be left open when occupied by children. Licensee states she has a portable fan she will use for ventilation. Licensee states there is central heat for the home. LPA observed air vents in the ceiling of the garage to access central heat. Licensee understands that the garage area is only to be used as an activity space. LPA (page 1 of 2)
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE: DATE: 07/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/14/2023
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 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: 07/14/2023
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advised licensee the children in care are not to take meals or naps in the garage area.

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.

Based on todays inspection, the backyard play area and the garage area are in compliance with California Code of Regulation Title 22 and can be used by children in care. Licensee provided LPA with an updated facility sketch during inspection.

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.



LPA R. Derraco informed licensee Jennipher Patrick that this report dated 07/14/23 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA R. Derraco informed the licensee Jennipher Patrick to provide a copy of this licensing report dated 07/14/23 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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, appeal rights provided, and report was reviewed with the licensee Jennipher Patrick (page 2 of 2)

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 07/14/2023 12:50 PM - It Cannot Be Edited


Created By: Randy Derraco On 07/14/2023 at 11:49 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: 07/14/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/15/2023
Section Cited
CCR
102416.5(d)(1)

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102416.5 Staffing Ratio and Capacity (d) For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time...(1) Twelve children, no more than four of whom may be infants. This requirement is not met as evidenced by:
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Licensee will develop a schedule for infants in care that is compliant with CCR Title 22 guidelines. Licensee will host a parent meeting to confirm schedules and day care expectations.
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Based on observation, interview and record review, 5 infants were observed in care which poses an immediate Health, safety and/or personal rights risk to persons in care.
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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:Karen Chambers
LICENSING EVALUATOR NAME:Randy Derraco
LICENSING EVALUATOR SIGNATURE:
DATE: 07/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/14/2023


LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 07/14/2023 12:50 PM - It Cannot Be Edited


Created By: Randy Derraco On 07/14/2023 at 11:55 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: 07/14/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/16/2023
Section Cited
CCR
102425(a)

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102425 Infant Safe Sleep (a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. This requirement is not met as evidenced by:
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Licensee states she will purchase additional cribs/play yards (playpen) for infants. Licensee states she will email LPA pictures of the newly assembled cribs/play yards and their postion in the designated room for care.
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Based on observation, interview the licensee did not provide one crib or play yard for each infant in care which poses a potential Health, safety and/or personal rights risk to persons in care.
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Type B
07/23/2023
Section Cited
CCR102425(a)(1)

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102425 Infant Safe Sleep (a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard (1) All cribs or play yards shall meet the United States Consumer Product Safety Commission safety standards. This requirement is not met as evidenced by:
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Licensee will fix / replace missing wheel on the cirb or replace the crib entirely. Licensee states she will email LPA pictures of the repaired crib or newly assembled crib.
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Based on observation, interview and record review, the licensee did not use a crib that meets the United States Consumer Product Safety Commision Standards which poses a potential Health, safety and/or personal rights risk to persons in care.
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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:Karen Chambers
LICENSING EVALUATOR NAME:Randy Derraco
LICENSING EVALUATOR SIGNATURE:
DATE: 07/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/14/2023


LIC809 (FAS) - (06/04)
Page: 4 of 4