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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400248
Report Date: 08/30/2021
Date Signed: 08/30/2021 10:56:48 AM

Document Has Been Signed on 08/30/2021 10:56 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:MCDONALD FAMILY CHILD CAREFACILITY NUMBER:
198400248
ADMINISTRATOR:SHALETHA D. MCDONALDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 305-2870
CITY:LAKEWOODSTATE: CAZIP CODE:
90715
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 4DATE:
08/30/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Shaletha McDonald, LicenseeTIME COMPLETED:
11:10 AM
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Licensing Program Analyst (LPA)Katrina Chicote conducted an Unannounced Required Annual inspection to the above facility on 08/30/2021 at 9:20 AM. LPA conducted COVID-19 Screening call prior to entering home. Upon arrival, LPA disclosed the purpose of the inspection and met with Licensee, Shaletha McDonald, who guided the LPA on a tour of the facility. Also present were three adults, Licensee's Assistants, who have criminal record clearance. There are two people living in the home and all have criminal record clearance. There were four infant day care children present during today’s inspection. Licensee states that there are currently five children enrolled. The children's roster was reviewed and is current. Per licensee, the facility’s hours of operation are Monday thru Friday, 7:30 AM to 5:00 PM. Emergency Disaster Plan, License, and Parents’ Rights were posted at the time of inspection. Disaster drill log was also available during today’s inspection, last disaster drill conducted on 07/2021.

This is a single-story home which consists of three bedrooms and two bathrooms, kitchen, living room, dining room, daycare space, and detached garage. At 9:43 AM, LPA observed that there is a fireplace in the home that is barricaded by a gate. Areas used by the children include Bedroom 1 (Infant Room), Bedroom 2 (Toddler Room) Bathroom 1 (down hallway, past Bedroom 1 and Bedroom 2, to the left of the home). Per Licensee, areas off limits to children and parents include kitchen, dining room, living room which LPA observed to have babygate barricading area making it off limits to children in care and Bedroom 3 which contains Bathroom 2 to be locked as well as a barricade making area off limits to children in care.

All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. LPA observed ceiling fans through out home. There is a working telephone maintained in the home. At 9:38 AM, LPA observed Bedroom 1 to have 1 crib, 2 pack n plays, and 1 bassinet that will be used for infant sleeping and a diaper changing table. At 9:39
AM, LPA observed Bedroom 2, across from Bedroom 1, to have a loft bed with stairs barricaded and cots that
Report continues- Page 1 of 3
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE: DATE: 08/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/30/2021
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MCDONALD FAMILY CHILD CARE
FACILITY NUMBER: 198400248
VISIT DATE: 08/30/2021
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will be used for sleeping. At 9:40 AM, LPA observed Bathroom 1, which will be used by the children, to have adequate hand washing supplies, to be free of hazards and to have child safety locks on all cabinets and drawers at time of inspection. Licensee states main day care space is the rear room of the home. At 9:43 AM, LPA observed main day care space to have large sectional couch, child appropriate tables and chairs, books with space for children to sit, puzzles, blocks, and other age appropriate toys, free of loose and sharp parts. At 9:36 AM, LPA observed a small dog that Licensee states that little dog is kept in off limits areas. Licensee states she has another dog that also stays in off limits garage during daycare hours. LPA observed electrical cover outlets all through the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. Licensee states all these items are kept in off limits detached garage. The Licensee states that there are no poisons in the home. The Licensee does understand that poison must be locked with a key or combination lock.

Per Licensee, the children will have access to backyard area through sliding glass doors off Main Day Care Space. At 9:45 AM, LPA observed backyard has grass and adequate perimeter fencing through-out the yard. LPA observed plastic ride along toys, a shaded area with child appropriate seating, covered sand bin, and other age appropriate toys free of loose and sharp parts available for the children in the backyard and all trees, shrubs, and plants are maintained at time of inspection.

Per Licensee, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPA observation did not see any weapons in the home or any bodies of water around the premises at time of inspection. Per Licensee, they provide food for children in care. Licensee states she has updated her sick policy and isolation area for children will be on couch in Living Room space next to office.

The valve on the required 2A 10BC fire extinguisher indicates fully charged. At 9:46 AM, LPA observed smoke and carbon monoxide detectors are in operable condition at time of inspection. Per Licensee, First Aid kit is kept in each room, and LPA observed First Aid kit and was inventoried for necessary supplies. The Licensee has current Pediatric First Aid and CPR. Proof of immunization against influenza, pertussis, and measles was readily available during today’s inspection. The Licensee has also taken the Mandated Reporter Training
—CPR Card valid until: 02/23/2022
—Fire Extinguisher was last serviced on: 11/2021
—Mandated Reporter AB1207 Completed: 05/16/2020
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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2021
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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MCDONALD FAMILY CHILD CARE
FACILITY NUMBER: 198400248
VISIT DATE: 08/30/2021
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The following were discussed:
Incidental Medical Services (IMS)
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

Licensee (or facility representative) 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.

Rooms that are off-limits need to be made inaccessible during operating hours. NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers and any other item that falls into that category are permitted in the facility. Effective January 1, 2010, licensees of family child care homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.



The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today 08/30/2021.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.



Exit interview was conducted and report was reviewed with the Licensee, Shaletha McDonald.
Report ends- Page 3 of 3
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3