<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400169
Report Date: 12/21/2021
Date Signed: 12/21/2021 03:16:34 PM

Document Has Been Signed on 12/21/2021 03:16 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:HILES FAMILY CHILD CAREFACILITY NUMBER:
198400169
ADMINISTRATOR:CHELSEA A. HILESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 655-1233
CITY:LONG BEACHSTATE: CAZIP CODE:
90807
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 7DATE:
12/21/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:03 PM
MET WITH:Licensee Chealsea Hiles TIME COMPLETED:
03:30 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) Jeanette Estrada conducted an unannounced annual required inspection at the above facility on 12/21/21 at 1:03 PM. LPA met with Chelsea Hiles-Licensee, who guided analysts on a tour of the facility. There were 7 children present. Facility capacity is in compliance for a large Family Child Care Home. Currently the Licensee has 11 children enrolled. Individuals residing in the home have been discussed and noted. Hours of operation are Monday to Friday 8 AM to 4 PM.
This is a one-story home. On limit areas include one bedroom, the living room, dining room, kitchen, family room/day care room, half bathroom and back yard (fenced). Off limit areas include 2 bedrooms, 2 bathrooms and detached garage.

Areas that are used by children were inspected for safety, comfort, cleanliness, telephone service (cell phone), ventilation and heating (central air and heating- inaccessible to children).
Food is provided by Licensee. Licensee was reminded if children bring food from home it must be labeled with the child’s name and properly stored or refrigerated.

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. The last noted disaster drill took place on 08/20/21.

Smoke and carbon monoxide detectors are available in the hallway and in the dining room and are operable. The home maintains telephone service via cell phone. The home is observed to be clean and orderly. There are toys and other age appropriate material available for children. There is a fireplace in the living room that is inaccessible to children in care. LPA observed that detergents, cleaning compounds are stored in an upper cabinet in the laundry room, inaccessible to children. Medication is stored in an upper cabinet in the kitchen.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 12/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/21/2021
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: HILES FAMILY CHILD CARE
FACILITY NUMBER: 198400169
VISIT DATE: 12/21/2021
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
26
27
28
29
30
31
32
Page 2
Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, not only inaccessible to children. Isolation area for sick children waiting to be picked up is in the covered back patio. Child/children in isolation area will be supervised by an adult. There is a firearm in the home. LPA observed that the firearm is stored separately in a locked container away from the ammunition. Firearm is located in an off limits bedroom that is kept locked during operating hours.
The half bathroom that children use is located in the laundry room area and was observed to be clean and free of hazards.
Infant Care: Currently the licensee has 6 infants in enrolled. LPA discussed the following: Napping equipment shall not block entrances or exits. Infant mattresses shall be firm with tightly fitted sheets. There shall be no loose objects, bumpers, objects hanging, or objects attached to the cribs/play yards. Each infant shall have their own crib/ play yard and bedding. Bedding shall be washed as needed. LPA observed one crib with sleeping infant during visit. Licensee stated 5 other infants enrolled are each over 12 months and are sleeping on napping mats. LPA informed licensee of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months, and provided PIN 20-24-CCP.

Outdoor Area


There is a fenced back yard in the home. The back yard is on limits but there is a designated area for the day care. This area was observed to be fenced and free of hazards. Per Licensee, children are supervised in the the outdoor area.

Children’s records were reviewed (LIC) 282- Affidavit Regarding Liability Insurance, Immunizations Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights.

Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement of Child and Mandated Reporter Training Certificate- Licensee's Mandated Reporter certificate expires 12/2/2023. LPA discussed Personal rights with Licensee: all children shall be treated with dignity and respect. Children shall receiving safe, healthful and comfortable accommodations, furnishings and equipment, and shall be free from corporal and/or unusual punishment.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2021
LIC809 (FAS) - (06/04)
Page: 3 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: HILES FAMILY CHILD CARE
FACILITY NUMBER: 198400169
VISIT DATE: 12/21/2021
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
26
27
28
29
30
31
32
Page 3
To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

Licensee 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.

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.

No deficiencies were cited during this visit. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Facility Representative/Licensee, Chelsea Hiles

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3