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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400789
Report Date: 06/19/2023
Date Signed: 06/19/2023 03:04:10 PM

Document Has Been Signed on 06/19/2023 03:04 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:WILLIAMS FAMILY CHILD CAREFACILITY NUMBER:
198400789
ADMINISTRATOR:WILLIAMS, MARJANI MANDISAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 484-9888
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/19/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Applicant Marjani Williams TIME COMPLETED:
03:10 PM
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On 6/19/23 Licensing Program Analyst (LPA) Jeanette Estrada conducted an announced pre-licensing inspection. The purpose of this inspection is to inspect and evaluate the facility for a new large license. LPA met with applicant Marjani Williams who provided a tour of the facility. LPA provided the pre-licensing entrance checklist to applicant. Care will be provided for children ages 6 weeks to 13 years old. Facility will operate 24hours/7 days a week. Applicant was advised care cannot be provided for a continuous 24 hours. All residents living in the home were discussed and verified and have obtained a criminal record clearance. The Applicant is a certified foster parent through LA County . An approved fire clearance for a capacity of 14 was issued on 5/24/23.

The day care facility is a four bedroom, two bathroom home with a front yard, living room (day care area), kitchen, fenced backyard, laundry room and attached garage (access from inside the home).

Off Limit areas to children in care: three bedrooms (safety knobs installed), one bathroom inside one off limit bedroom and garage.

On Limit areas to children in care: Living room (main day care area), one bedroom used for napping, hallway bathroom, fenced backyard and laundry room in passing to backyard.

The day care areas that will be used by children were observed for safety, comfort, cleanliness, telephone service (landline), ventilation and heating. There is central air and heating in the home. Per Applicant, children will have access to one bedroom that will be used as the a napping room and the living room which will be the main day care area. Per Applicant, the living room will be used for activities and meals. LPA observed age appropriate materials and toys available for children in the day care area. Napping cots are available for children that don't use a crib or play yard. One crib is currently available in the napping room. Per Applicant, infants will nap in the day care area or in the napping room. Per Applicant, food will be provided for children in care and children will be supervised while eating. Applicant was advised that if food is brought from the children’s homes, the container shall be labeled with the child’s name and properly stored or refrigerated.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 06/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/19/2023
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 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: WILLIAMS FAMILY CHILD CARE
FACILITY NUMBER: 198400789
VISIT DATE: 06/19/2023
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LPA observed two high chairs in the day care area. There is a safety gate blocking the entrance to the kitchen next to the day care area, making it inaccessible to children in care.
Detergents, cleaning compounds, sharp objects and hazardous items that can pose a danger to children are inaccessible to children in care. Knives are kept above the refrigerator. Cleaning products and laundry detergent are kept in the off limits garage. LPA observed a safety knob installed on the garage door. Per Applicant personal medicine is also kept in the garage. Per Applicant, medicine for children will be administered by prescription, if required. Children's medicine will be kept in a cabinet in the kitchen.
Children will use the bathroom in the hallway. LPA observed the cabinets where supplies are stored had latches installed to prevent access. LPA did not observe any cleaning supplies or medicine in the bathroom. Per Applicant, there are no poisons kept in the home. LPA advised that if any poisons are kept in the home at a later date to keep them in a locked cabinet or container. LPA observed an operable smoke detector and an operable carbon monoxide detector in the day care room. There is a 2A10BC fire extinguisher in the kitchen with proof of purchase dated 4/13/23. LPA observed electrical outlets covered throughout the home.
Children will have access to all of the backyard. Per applicant, children will walk through the laundry room to access the backyard. Per the Applicant there are no bodies of water on the premises such as pools/ hot tubs or spas. LPA did not observe any bodies of water. Applicant stated there are no weapons or firearms in the home. Per Applicant, there are no pets currently in the home. Per Applicant, the isolation area will be in the napping room or the day care area, separated from other children in care.
Applicant completed the required Health and Safety Training, Nutrition Training, Lead training on 4/16/23 . Applicant completed an pediatric first aid/cpr course by the American Heart Association on 7/7/2022. Applicant also completed the required Mandated Reporter Training for child care providers on 7/7/2024. Applicant has proof of required immunization against measles, pertussis and the flu. Applicant has submitted proof of TB clearance.
LPA discussed the safe sleep regulations with Applicant. Applicant stated they plan to enroll infants in the facility. LPA advised Applicant that there shall be no loose objects in the cribs/play yards. LPA advised Applicant that high chairs shall be used for their intended use and children shall not be left in car seats.
LPA advised sleeping equipment shall not block entrances or exits and the door shall remain open in the napping room when an infant is sleeping. LPA advised applicant of the 15 minute sleeping log and the LIC 9227 individual infant sleeping plan. LPA 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.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2023
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: WILLIAMS FAMILY CHILD CARE
FACILITY NUMBER: 198400789
VISIT DATE: 06/19/2023
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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. Per applicant, they do plan to administer medication. 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: http://www.ada.gov/childqanda.htm



LPA reviewed with Applicant LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensing related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.
Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.
A large family child care license will be granted upon Department approval. Once licensed, the Licensee is required to comply with the terms and limitations stated on the license. Exit interview conducted and report was reviewed with Applicant Marjani Williams.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3