198400907-12-6-2024-54-CC-ACAN-DBMVAG-20241204151553

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400907
Report Date: 12/04/2024
Date Signed: 12/06/2024 10:13:15 AM

Document Has Been Signed on 12/06/2024 10:13 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	DICKERSON FAMILY CHILD CARE		FACILITY NUMBER:	198400907
ADMINISTRATOR/ DIRECTOR:	DICKERSON, ANITA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(424) 200-8647
CITY:	CARSON	STATE: CA	ZIP CODE:	90746
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 12	CENSUS: 2	DATE:	12/04/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:20 AM
MET WITH:	DICKERSON, ANITA / LICENSEE		TIME VISIT/ INSPECTION COMPLETED:	03:25 PM

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On December 04, 2024 at 11:20am; Licensing Program Analyst (LPA) Ashley Calderon conducted an unannounced annual/random inspection and follow up on Written Unusual Incident Report that was reported to the Department on 12/02/24 and met with Licensee Anita Dickerson. LPA disclosed the purpose of the inspection and was granted entry into the facility by Licensee.

Per Licensee, hours of operation are Monday through Friday, 6:30am to 6:00pm. Per Licensee, overnight care and weekend care can be provided if needed and will notify licensing if any changes. Licensee states she cares for children 0 months to 13 years of age.

This is a single story home consisting 3 bedrooms, 2 bathrooms, kitchen, dining area, living room, garage, isolation room/office, backyard and front yard. Areas used by children include: Living room, dining area, kitchen, bathroom, and back yard. Areas off limits include: 3 bedrooms, 1 bathroom, garage and right side yard (gated).

Upon arrival LPA Calderon observed (2) children in care (1 being an infant) and two individuals: Licensee and assistant staff (Licensee's family member). At approximately 11:35am Licensee husband stopped by at the facility and left shortly after. All adult individuals present during inspection are fingerprinted cleared.

LPA conducted a guided tour of the facility alongside with Licensee A.Dickerson.

The home was inspected for safety, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children.

(cont...)

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE:	DATE: 12/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2024

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: DICKERSON FAMILY CHILD CARE	FACILITY NUMBER: 198400907
	VISIT DATE: 12/04/2024

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LPA observed knives are located in high cabinet above the oven in the kitchen. Cleaning products are made inaccessible in high shelf cabinet near the sink. Licensee stated provides food for children in care. The home is observed to be clean and orderly, there are outlet covers throughout the home. Smoke detector and carbon monoxide detector were observed and not tested due to devices being interconnected with an American District Telegraph (ADT) system. Per Licensee, does a test monthly and contacts ADT before doing testing. Licensee informed LPA there is an additional carbon monoxide device located in the kitchen, Assistant Staff tested the carbon monoxide and it was tested and found operable. LPA observed Fire Alarm pull system, per Licensee interconnected with Carson Fire Department. LPA observed Fire and Earthquake Drill record documentation drill date: 9/23/24. The required (2A10BC) fire extinguisher was observed in the kitchen, LPA observed extinguisher was charged and had a service date inspection tag dated 10/31/24.

Detergents were observed above the washer/dryer up high and inaccessible to children in care. Per Licensee, stated no poisons stored in the home.

LPA observed age appropriate toys and learning materials inside and outside in the back yard. No bodies of water were observed at the facility. Per Licensee, there are no weapons or firearms in the facility, none were observed by LPA. LPA observed small dog placed in their dog crate in the living room and currently no children receive medication at the facility.

Per Licensee, the isolation area for a sick child waiting to be picked up will be in the isolation room next to the exit away from other children. LPA observed crib for infant in care placed in the living room, per licensee only has (1) infant currently enrolled.

LPA reviewed records. LPA reviewed Licensee and staff assistant records. Staff had proper documentation. Licensee Mandated Reporter certificate exp 6/18/26 Pediatric CPR and First Aid expires 9/25'. LPA reviewed records for (2) children present in the home, and record for (1) child in question reported in Incident Report, total (3) children files reviewed. LPA Calderon reviewed LIC282 Affidavit Regarding Liability Insurance for child records that were reviewed on today's visit. LPA reviewed current Child Roster. LPA interviewed Licensee.

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. (cont...)

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE:	DATE: 12/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2024

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: DICKERSON FAMILY CHILD CARE	FACILITY NUMBER: 198400907
	VISIT DATE: 12/04/2024

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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-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 no citations were given today. Due to insufficient information available at this time regarding Unusual Incident Report will need further investigation. A notice of site visit was given to Facility Representative and must remain posted for 30 days. Exit interview conducted and report was reviewed with Licensee Anita Dickerson. (End of Report.)

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE:	DATE: 12/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2024

LIC809 (FAS) - (06/04)

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