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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019492
Report Date: 05/08/2024
Date Signed: 05/08/2024 03:55:33 PM

Document Has Been Signed on 05/08/2024 03:55 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:PHILLIPS FAMILY CHILD CAREFACILITY NUMBER:
198019492
ADMINISTRATOR/
DIRECTOR:		JEYANA PHILLIPSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 688-2875
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY: 14TOTAL ENROLLED CHILDREN: 7CENSUS: 3DATE:
05/08/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:LICENSEE /JEYANA PHILLIPSTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Ashley Calderon conducted an unannounced random annual inspection at the above facility and met with Licensee Jeyana Phillips. LPA disclosed the purpose of the inspection and was granted entry into the facility by Licensee.

LPA provided the inspection Entrance Checklist (LIC 126). Licensee guided LPA on a tour of the facility. Individuals residing in the home have been discussed and noted. Licensee provides care during operation hours/ days of: Monday-Friday 8:00am-4:00pm.

This home is a one story home which consists of two bedrooms, one bathroom, kitchen, living room, dining room (day care/ activity room) , garage / granny pod, front yard (not fenced) and backyard. Main care is provided in the activity room, living room is used as a passage way to access day care room only. Per Licensee, areas off limits to children include: Two bedrooms (locked), kitchen, living room, and backyard / garage inaccessible to children in care. LPA observed a child safety gate that separates the activity room from all inaccessible areas of the home. Children use the restroom in the hallway. Per Licensee, children are escorted to and from the restroom. The restroom that children use was observed safe and sanitary. LPA observed sleeping cots in the activity room, during part of the inspection children were taking a nap/resting. 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. All documents were observed to be posted in the activity room. Facility records were reviewed for LIC 9040- Facility Roster, LIC 610A- Emergency Disaster Plan and Verification of Disaster and Fire Drills provided and up to date. The last drill was conducted May 2024. There is an operable interconnected carbon monoxide /smoke detector in the home. A fully charged Fire extinguisher was observed in the kitchen with a purchase receipt dated 2/01/24.
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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE: DATE: 05/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/08/2024
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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PHILLIPS FAMILY CHILD CARE
FACILITY NUMBER: 198019492
VISIT DATE: 05/08/2024
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LPA Calderon reviewed three (3) children records, all documentation's were in place. Licensee record file were reviewed for approved Pediatric First Aid and CPR expires on 3/2025 and Mandated Reporter Training Certificate was completed on 03/05/24. All records were observed to be complete. During today's visit LPA was provided with an updated facility sketch, Child #4 LIC 9166 Nebulizer Care Consent Form, and Rental Lease Agreement.

Licensee informed LPA Child #4 has medication and informed LPA licensee stores medication in hallway closet inaccessible to children in care, Child #4 was not present during time of visit. LPA observed medication inaccessible to children in care. The home maintains telephone service (mobile phone ). LPA observed cleaning compounds, poisons and sharp objects such as knives located in off limits kitchen area inaccessible to children in care. Per Licensee there are no firearms or weapons stored in the home. Food is provided by Licensee. LPA advised Licensee if children bring food from home it must be labeled with the child’s name and properly stored or refrigerated. The home is observed to be clean and orderly. There are toys and other age-appropriate materials available for children. The outdoor play area was observed, facility uses front patio area that has picnic table with shade. Licensee informed LPA would like to use front yard. LPA advised Licensee front yard is not fenced children must supervised at all times. Per Licensee, children are supervised while playing outside. Backyard is inaccessible to children in care, kitchen is an off limit area that has a locked door that leads to the backyard. Per Licensee, home is a rental property and landlord has plans for backyard/garage. LPA advised for any physical sketch changes update Licensing and submit updated facility sketch. LPA did not observe any pools, spas, or other bodies of water. Licensee informed LPA children are taken to a local community (Mayfair) on Thursdays and during the summer Licensee plans field trips for children in care. During the inspection, children present was observed to be treated with dignity and respect, observed to be receiving safe, healthful, and comfortable accommodations, furnishings, and equipment, and free from corporal and/or unusual punishment.

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 [email protected]. 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.

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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2024
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: PHILLIPS FAMILY CHILD CARE
FACILITY NUMBER: 198019492
VISIT DATE: 05/08/2024
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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 [or facility representative] 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.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are 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 Regulations Title 22 the 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 Jeyana Phillips.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2024
LIC809 (FAS) - (06/04)
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