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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400595
Report Date: 07/27/2022
Date Signed: 07/27/2022 12:06:39 PM

Document Has Been Signed on 07/27/2022 12:06 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:ALLEN FAMILY CHILD CAREFACILITY NUMBER:
198400595
ADMINISTRATOR:EBONI LANAY ALLENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 812-3683
CITY:LOS ANGELESSTATE: CAZIP CODE:
90059
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
07/27/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Eboni Lanay Allen, ApplicantTIME COMPLETED:
12:20 PM
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On July 27, 2022 Licensing Program Analyst (LPA) Alicia Mooberry conducted a pre-licensing inspection for the above address. LPA met with Ebony Allen, Applicant, who guided LPA on a tour of the facility. The Applicant is requesting Large Family Child Care License, Fire clearance granted on 6/10/22.

This is a change of location - previous license #197492777. Individuals residing in the home were discussed and noted. Entrance Checklist was provided to the applicant.

Per Applicant, hours of operation will be Monday - Sunday, 6:00 am to 6:00pm. Applicant state they will provide after hours and overnight care. Applicant knows not to exceed 24 hour care at one time. Applicant states they will care for children Infants -13 years of age. A plan for overnight care will be created for children that are staying overnight.

This is a one-story home which consists of 2 bedrooms, 2 bathroom, den, living room, kitchen, laundry area, front and backyard (fenced) and detached garage. The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children in care.

Areas used by children include: Den (main daycare area/rear of home), bathroom, dining room (used for Infant napping and eating), kitchen, and back yard (enclosed)

Areas off limits include: Bedroom 1 and 2, living room, and detached garage.

The off limit bedrooms were observed to be locked and the detached garage was closed.


LPA observed safety knobs on stove, cleaning compounds and knives and other sharp utensils are located in overhead cabinets in the kitchen. There are outlet covers throughout the home.

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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE: DATE: 07/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/27/2022
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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ALLEN FAMILY CHILD CARE
FACILITY NUMBER: 198400595
VISIT DATE: 07/27/2022
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There is a wall heater in the living room that is not barricaded. Per applicant, the gas to the wall heater will be shut off by The Gas Company. The applicant will use portable heaters and fans to maintain home comfortable.

LPA observed the required 3A10 BC fire extinguisher in kitchen, with purchase receipt dated 4/1/22. Applicant was reminded that fire extinguishers need to be purchased or serviced yearly. Smoke and carbon monoxide detectors were tested and are operable.

The home was observed to be clean and orderly. LPA observed age appropriate toys and learning materials in the daycare area. First Aid and emergency supplies are available located in the kitchen.

The applicant states that parents will provide meals from home. Applicant understands that any food brought from the children’s homes must be labeled with child’s name and properly stored or refrigerated.

The applicant has completed the required Health and Safety Training, Nutrition, and Lead Training, Mandated Reporter Training and Pediatric First Aid/CPR expire on 8/22. Applicant was reminded to completed the Pediatric First Aid and CPR every 2 years. Required immunization's are current.

Per Applicant, there are no weapons or firearms in the facility, none were observed by LPA. Applicant has no pets at this time.

Per applicant, the back yard will be used as outdoor play area. The yard is enclosed with shade and grassy play area. LPA observed an inflatable Little Tykes bounce house. Applicant was advised to supervised children at all times while playing and ensure to follow the manufacturer age recommendations. Safe and age appropriate toys were available. There are no bodies of water on the premises.

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

LPA discussed the Safe Sleep Regulation and provided PIN 20-24-CCP and Infant Sleep Plan LIC 9227 for when Applicant is ready to enroll infants. Children will nap in the dining, mats and a play yard are available.

LPA discussed the safe sleep regulations with applicant 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.


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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: ALLEN FAMILY CHILD CARE
FACILITY NUMBER: 198400595
VISIT DATE: 07/27/2022
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LPA also informed applicant 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 may provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual -
Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 Provided COVID-19 Technical Assistance by emailing applicant COVID-19 resources and self-assessment prior to visit. LPA discussed self-assessment and answered question regarding COVID-19 recommendations. LPA advised applicant to ensure they are following the guidance from the local health authorities in order to prevent and reduce the transmission of diseases.

Per applicant parents will drop off/pick up at the side gate. Daily temperature checks and health screenings are done at the entrance. COVID-19 posters and resources have been posted in the entrance visible to parents. Parents will be made aware of the COVID-19 policies and exclusion procedures in writing and verbal. Per applicant, high touched areas, bathroom and toys will be disinfected at the end of the day or as needed.
Per applicant children will be encouraged to was their hands for 20 seconds throughout the day as needed. A hand washing poster is located in the bathroom used by children in care. Per applicant personal items will be placed in an individual cubby. Children will bring their own blanket and sheet for nap. Bedding will be washed weekly by parents or as needed.

The isolation area for a sick child waiting to be picked up will be in the dining room away from other children.

Per applicant, there are no dual licenses at this address. Applicant’s email address was obtained during this inspection. The applicant was advised that email may be public information.



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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: ALLEN FAMILY CHILD CARE
FACILITY NUMBER: 198400595
VISIT DATE: 07/27/2022
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The following was discussed with the applicant:
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.

-In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR & Pediatric First Aid certification, TB clearance, immunization, Mandated Reporter training certificate www.mandatedreporterca.gov, and a valid criminal record clearance associated to the facility license.

-A current roster of children enrolled must be available and maintained for a period of three years, even after children are no longer attending the facility.


-Unusual incident or any changes will be reported to Licensing within 24 hours and an LIC 624B will be submitted within 7 days.

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 licensed-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.

The following correction needs to be made prior to obtaining a large family child care license.


Proof of corrections are due by 8/1/22
1. The wall heater in the living room is not barricaded. Per applicant, the gas to the wall heater will be shut off by The Gas Company. Proof will be submitted to department by email.

A large family childcare license will be granted upon completion of all required documentation and corrections. Once licensed, the applicant is required to comply with the terms and limitations stated on the license.

Exit interview conducted and report was reviewed with Eboni Allen, applicant

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4