198400520-11-7-2024-54-CC-ACAN-DASRR4-20241107121431

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400520
Report Date: 11/07/2024
Date Signed: 11/07/2024 12:14:39 PM

Document Has Been Signed on 11/07/2024 12:14 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:	DAVID FAMILY CHILD CARE		FACILITY NUMBER:	198400520
ADMINISTRATOR/ DIRECTOR:	DAVID, MICHELLE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 213-2090
CITY:	CARSON	STATE: CA	ZIP CODE:	90746
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 11	CENSUS: 7	DATE:	11/07/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:46 AM
MET WITH:	Michelle David / Licensee		TIME VISIT/ INSPECTION COMPLETED:	12:35 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) Ashley Calderon conducted an unannounced annual random inspection at the above facility on 11/07/2024 at 10:46AM. LPA met with Michelle David, Licensee who guided analysts on a tour of the facility. There were a total of 7 children at the time of visit, 3 whom were infants. Present adult at the home was Licensee and a Volunteer. Facility capacity is in compliance for a Large Family Child Care Home. Hours of operation are Mon-Fri 6:30 AM - 6:00PM. This is a two-story home which consists of 4 bedrooms, 3 bathroom, (2) daycare room(s), kitchen, living room, garage, front and backyard. Children use: (2) Daycare Rooms, bathroom located downstairs and front yard. Off limit areas: All of upstairs, kitchen, living room, (1) bedroom downstairs, backyard, and garage. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection: LPA reviewed required posted documentation for Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. Facility records were reviewed for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster drill log, last drill conducted on 09/09/2024. Per licensee, conducts per personal preference drill every month. Smoke and carbon monoxide detectors were tested and are operable. Fire extinguisher was observed to be fully charged with proof of purchase dated 1/10/24. LPA observed central heating and A/C for ventilation. Stair way has a baby safety gate in place. Fireplace is not operable, it was observed to be converted into a storage space for day care learning materials. (Continuation...)

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024

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: DAVID FAMILY CHILD CARE	FACILITY NUMBER: 198400520
	VISIT DATE: 11/07/2024

NARRATIVE

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The home maintains telephone service via cell phone. The home is observed to be clean and orderly. There are toys and other age appropriate materials available for children. Isolation area for sick children waiting to be picked up is in the daycare room, in the far left corner away from the other children. Per Licensee there are no firearms or weapons stored in the home. LPA observed pet dogs, Per Licensee also has a Board and Care for dogs that is off limit in the garage, garage door kept locked.

Kitchen was observed, per Licensee provides food for children in care. The kitchen is an off limit area, there are baby gates to make area inaccessible. Cleaning compounds were observed under the kitchen cabinet sink with a baby safety latch in place. Knives were observed stored up high on the kitchen cabinet shelf.

Per licensee no poisons stored in the home and will store any poisons brought to the home in the locked garage.

Outdoor areas were observed and no bodies of water was observed. Licensee stated using the front yard occasionally, Licensee ensure children are supervised outside at all time.

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.

(continuation...)

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: DAVID FAMILY CHILD CARE	FACILITY NUMBER: 198400520
	VISIT DATE: 11/07/2024

NARRATIVE

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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.

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/.

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 Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. Based on today’s visit, Per California Code of Regulations Title 22 facility was found in compliance, and no citations were given today.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee Michelle David.

(End of Report)

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024

LIC809 (FAS) - (06/04)

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