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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400181
Report Date: 10/04/2024
Date Signed: 10/04/2024 02:33:18 PM

Document Has Been Signed on 10/04/2024 02:33 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:PATRICK FAMILY CHILD CAREFACILITY NUMBER:
198400181
ADMINISTRATOR/
DIRECTOR:		JENNIPHER PATRICKFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 354-8735
CITY:COMPTONSTATE: CAZIP CODE:
90220
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
10/04/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Jennipher Patrick, LicenseeTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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On 10/4/24 Licensing Program Analysts (LPAs) Portia Bowden and Jeanette Estrada conducted an unannounced annual inspection at the above facility. Upon arrival at 10:30AM LPAs met with Destiny Villalobos, assistant and were granted entry into the home. At 10:35AM LPAs observed 5 children in care including 1 infant in a highchair. At 10:40AM Assistant Destiny called Licensee Jennipher who was not at the facility. LPA Portia Bowden spoke with Licensee via telephone who stated she was not at the facility due to a doctors appointment and she would join the inspection later. At 10:40 AM LPAs were guided on a tour of the home by Assistant Destiny.

This is a one story home that consists of 3 bedrooms, 2 bathrooms, kitchen/dining area, living room, laundry room, garage, front yard and back yard (fenced). Main care areas include the living room, 1 bedroom, 1 bathroom outside of daycare bedroom, and the backyard. The off limit areas of the home include 2 bedrooms, 1 bathroom, and front yard. At 10:40AM LPAs observed children's roster to be current. Emergency Disaster Plan, License, and Parents’ Rights were viewed at the time of inspection. Disaster drill log was also available during today’s inspection, last disaster drill conducted June 10th 2024.



At 10:45AM LPAs observed two electrical outlets uncovered in the living room where children were present. At 10:47AM LPAs observed insect and rodent poison on top of the refrigerator, scissors on the kitchen counter and Rx medication on the top of the microwave in the off limits kitchen area. Per Assistant Destiny they usually have baby gates up separating the kitchen from the living room. At 10:50AM LPAs observed the off limits laundry area ungated. At 10:51AM LPAs observed daycare room (on limits bedroom) to have toys piled high on table. At 10:52 LPAs observed uncover electrical outlet in daycare room. At 10:45AM LPAs observed two electrical outlets uncovered in the living room where children were present. At 10:47AM LPAs observed insect and rodent poison on top of the refrigerator, scissors on the kitchen counter and Rx medication on the top of the microwave in the off limits kitchen area. Per Assistant Destiny they usually have baby gates up separating the kitchen from the living room.

______________________________Page 1 of 4____________________________

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Portia Bowden
LICENSING EVALUATOR SIGNATURE: DATE: 10/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/04/2024
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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PATRICK FAMILY CHILD CARE
FACILITY NUMBER: 198400181
VISIT DATE: 10/04/2024
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At 10:50AM LPAs observed the off limits laundry area ungated. At 10:51AM LPAs observed daycare room (on limits bedroom) to have toys piled high on table. At 10:52 LPAs observed uncover electrical outlet in daycare room. At 10:45AM LPAs observed two electrical outlets uncovered in the living room where children were present. At 10:47AM LPAs observed insect and rodent poison on top of the refrigerator, scissors on the kitchen counter and Rx medication on the top of the microwave in the off limits kitchen area. Per Assistant Destiny they usually have baby gates up separating the kitchen from the living room. At 10:50AM LPAs observed the off limits laundry area ungated. At 10:51AM LPAs observed daycare room (on limits bedroom) to have toys piled high on table. At 10:52 LPAs observed uncover electrical outlet in daycare room At 10:54AM LPAS observed a broken mirror approximately 3ft tall and 3 ft wide leaning against the hallway wall right outside the daycare bedroom. At 10:55AM LPAs observed the bathroom lower sink cabinet to be unlocked and contain Lysol disinfectant spray. At 11:00AM LPAs observed the outdoor backyard area to have a broken toys with sharp edges exposed. At 11:01AM LPAS observed a play kitchen along the side of the house to have a broken window, a play house disassembled laying on the ground, animal feces on the ground near a plastic play structure. At 11:05 LPAs observed a storage shed with a broken door leaning against shed permitting entry. At 11:06 LPAs observed a deep freezer unlocked but not in use. LPAs advised Licensee to lock the deep freezer to prevent children from gaining entry.

At 11:11AM Licensee Jennipher Patrick arrived at the home and continued inspection. Per Licensee her hours of operation are 24 hours 7 days a week. LPAs discussed Overnight Care procedures with Licensee and license limitations that care for children is limited to 23 hours. Licensee stated there are currently 9 children enrolled. Per Licensee she provides transportation to and from school. Licensee also provides breakfast, lunch, dinner and two snacks.

At 11:20AM Licensee removed poisons, scissors and Rx medication from kitchen. At 11:25AM Licensee placed baby gates in the kitchen and laundry areas.

At 11:30AM 4 children’s records were reviewed. 3 out of 4 were not complete. 1 Child out of 5 in care did not have a file. At 11:45 AM LPAs observed a combination smoke detector connected to the homes alarm system. At 11:50 AM LPAs observed a 210ABC fire extinguisher with no tag. At 12:05 PM Licensee presented a receipt dated 2/27/23.

__________________Page 2 of 4_______________________

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Portia Bowden
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2024
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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PATRICK FAMILY CHILD CARE
FACILITY NUMBER: 198400181
VISIT DATE: 10/04/2024
NARRATIVE
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At 12:15PM LPAs observed attached garage to be in use. Per fire clearance the garage is not permitted to use. Per licensee they requested use of attached garage, per report dated 7/14/23 garage was approved to use. On 10/2/24 LPA Portia conducted a file review and reviewed fire clearance date 2/5/20 which states garage is not permitted to use. LPA advised Licensee to cease use of garage while discrepancy is reviewed upon return to office. Licensee stated garage will not be used at this time. At 12:20PM LPAs observed records for the Licensee and Assistant to not be complete. Licensee CPR expired 6/24. Assistant CPR was done online and is not from an approved CPR EMSA, Heart Association or Red Cross organization.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or

CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

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 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/.

________________________PAGE 3 of 4___________________________

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Portia Bowden
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2024
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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PATRICK FAMILY CHILD CARE
FACILITY NUMBER: 198400181
VISIT DATE: 10/04/2024
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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.

During the exit interview, the Jennipher Patrick , confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

4 Type A, 2 Type B and 1 Technical Violation deficiencies are being cited based on LPA's observation, interviews and record review in accordance with the California Code of Regulations, Title 22, see LIC 809D. LPAs will include photographic evidence of deficiencies with report.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon their return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled child for the next 12 months. A signed Acknowledgement of Receipt (LIC9224) shall be in each child’s file, acknowledging receipt.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee, Jennipher Patrick.

________End of Report Page 4 of 4____________

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Portia Bowden
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2024
LIC809 (FAS) - (06/04)
Page: 2 of 8
Document Has Been Signed on 10/04/2024 02:33 PM - It Cannot Be Edited


Created By: Portia Bowden On 10/04/2024 at 01:27 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: PATRICK FAMILY CHILD CARE
FACILITY NUMBER: 198400181

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/04/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(d)(1)
Operation of A Family Child Care Home
(d) The home shall provide safe toys, play equipment and materials. (1) Fixtures, furniture, and equipment that have been banned or recalled by the United States Consumer Product Safety Commission shall not be used for children in care or accessible to children in care.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with Section102417(d)(1) in that backyard play area contained a disasembled play house, broken play kitchen, broken door on storage shed, and had animal feces on the ground which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/05/2024
Plan of Correction
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Licensee made broke play kitchen in accessible to children, re assembled play house, picked up animal feces and reattached door on storage shed
Licensee will remove deep freezer from the backyard and send LPA photographic proof via email
Type A
Section Cited
CCR
102417(g)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with section 102417(g) in that electrical outlets were not covered, scissors were on the kitchen counter, and Medication was left on top of microwave, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/05/2024
Plan of Correction
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2
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Licensee covered all electrical outlets, placed Medication in locked off limits area, placed scissors in drawer inaccessible to children. Licensee placed baby gates in kitchen and laundry area to make areas inaccessible to children in care.
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:Portia Bowden
LICENSING EVALUATOR SIGNATURE:
DATE: 10/04/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/04/2024


LIC809 (FAS) - (06/04)
Page: 5 of 8
Document Has Been Signed on 10/04/2024 02:33 PM - It Cannot Be Edited


Created By: Portia Bowden On 10/04/2024 at 01:27 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: PATRICK FAMILY CHILD CARE
FACILITY NUMBER: 198400181

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/04/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with section 102417(g)(4) in that insect poison was placed on top of refridgerator, lysol spray was placed in an unlocked bathroom sink cabinet accessible to children, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/05/2024
Plan of Correction
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Licensee removed poison from top of refridgerator and placed it in a locked off limits area inaccessible to children.
Licensee removed Lysol spray from bathroom sink and made it inaccessible to children in care
Type A
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
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Based on interview and record review, the licensee did not comply with section 102416(c) in 2 out of 2 staff did not have a current pediatric CPR/First Aid Certification which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/05/2024
Plan of Correction
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Licensee will enroll in Pediatric CPR/ First Aid and submit photographic proof to LPA via email.
Licensee will ensure Assistant Destiny enrolls in Pediatric CPR/First aid and submit photographic proof to LPA via email.
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:Portia Bowden
LICENSING EVALUATOR SIGNATURE:
DATE: 10/04/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/04/2024


LIC809 (FAS) - (06/04)
Page: 6 of 8
Document Has Been Signed on 10/04/2024 02:33 PM - It Cannot Be Edited


Created By: Portia Bowden On 10/04/2024 at 01:27 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: PATRICK FAMILY CHILD CARE
FACILITY NUMBER: 198400181

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/04/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(1)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on observation and interview the licensee did not comply with section 102417(g)(1) in that fire extinguisher was expired 2/24 which posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/18/2024
Plan of Correction
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2
3
4
Licensee will have fire extinguisher serviced or purchase a new one and submit receipt to LPA via email.
Type B
Section Cited
CCR
102418(a)
Immunizations
(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on record review, the licensee did not comply with section 102418(a) in that 3 out of 4 childrens file were not complete. 1 Child out of 5 in care did not have a file, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/18/2024
Plan of Correction
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2
3
4
Licensee will obtain missing documents from children's file and submit photographic proof to LPA via email.
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:Portia Bowden
LICENSING EVALUATOR SIGNATURE:
DATE: 10/04/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/04/2024


LIC809 (FAS) - (06/04)
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