Pre-licensing visit·December 23, 2022

On 12/23/2022 Licensing Program Analyst (LPA) Judy Laureano conducted an announced inspection with applicant Anush Gevoryan for the purpose of a pre licensing inspection of 7263 Mason Avenue, Winnetka, CA 91306. The purpose of this inspection is to ensure the standards for a Family Child Care Home are being met in accordance to California Tittle 22 Regulations and California Health and Safety Codes. During today's inspection, applicant's children were present and providing translation. Applicant speaks Armenian and Russian but understand a little of English. The licensee is applying for a Small Family Child Care Home license for a max capacity of 8. Copy of Deed is on file, reflecting applicant as owner of the home. Currently living in the home is two adults and three minor children. Per the application, at this time, the ages the applicant wishes to provide services for are children 2 months to 13 years old with the hours of Monday through Friday from 7:00 a.m. to 7:00 p.m. Licensee was informed that any changes to ages, hours and days of operation shall be submitted to the department for approval prior to initiation of changes. The home is a 3 bedroom and 2 bathroom single story home with a living room, dining room, kitchen, extra family room, covered car port and detached garage. LPA observed an enclosed front yard that is designated as OFF LIMITS. Applicant confirmed that families will enter the home through the alley located in the back of the home. Applicant confirmed the following areas are OFF LIMITS to the children in care: Bedroom 1 with bathroom and bedroom 3. The kitchen is OFF LIMITS but will be used only as a walkway to access the back yard. Families will enter the home through the back alley behind the home. As you enter the facility, you are led to the enclosed back yard. LPA observed a covered car port and detach garage. Page 2 Detached garage has been designated as OFF LIMITS. The back yard was observed to have shaded area as well as a grassy area. LPA observed some outdoor age appropriate equipment and applicant confirmed that once licensed, she will purchase additional outdoor materials. LPA observed outside the home the washer and dryer and informed applicant to ensure that doors of equipment remain locked at all times and that all detergent needs to be inaccessible to the children in care. Applicant will fence/barricade all rose bushes located in the back yard and submit proof of correction to LPA. As you enter the home, you are guided to the kitchen. The kitchen area will be used as a walk way to access the outdoor space. All cabinets were observed. All sharp pointed object and knives were observed to be located in the top cabinet, made inaccessible to the children in care. Under the sink cabinet was observed and inspected- cabinet was empty. Applicant confirmed that facility will be providing meals and snacks and if children have any dietary restrictions and/or allergies, parents will be providing the meals and snacks. LPA advised applicant to contact CCR, local RR agency to request information regarding the different local food programs. LPA advised applicant to cover the stove as added precaution. Next to the kitchen, a small dining room area was observed with a dining room table. Applicant confirmed that older children will eat in the space. Next to the kitchen, living room area was observed. The living room area has been designated as the day care use. LPA observed children size table and chairs and age appropriate toys. A mounted television set was observed in the space and all electrical outlet are were observed to be covered. Next to the living room, LPA observed an extra family room. Family room is accessible through the sliding doors located in the living room. LPA observed two small steps that lead to the extra room. LPA inspected the space and observed two working fire extinguisher, one mounted by the wall and the other in the top cabinet of the space. LPA observed a large dinning room table with chairs. LPA observed all cabinets. LPA advised applicant to contact her assigned LPA as soon as she wishes to use the space. Page 3 Bedroom 1 with bathroom 1 have been designated as OFF LIMITS. Bedroom 1 and bathroom 1 are located outside the living room, next to the kitchen area. Across the living room, LPA observed a small hallway that leads to bedroom 2, bathroom 2, closet and bedroom 3. Bedroom 2 has been designated as day care space. Applicant confirmed that children will nap in the space and LPA observed napping cots in the area. The bathroom that children will use is located next to bedroom 2. LPA observed and inspected the sink, cabinets and toilet. LPA discussed using paper towels and displaying a handwashing sign for children to view. LPA instructed applicant to remove all items from the tub area, applicant removed all items before the end of the inspection. Bedroom 3 is located next to the bathroom has been designated as OFF LIMITS to the children in care. LPA observed the room and reminded applicant to maintain all doors closed during the hours of operation. LPA observed applicant test the carbon monoxide and smoke detector. LPA observed carbon monoxide and smoke detectors in living room, hallway and bedroom 2 and bedroom 3. LPA did not observed any bodies of water and did not observed any fire arms in the home. Applicant is pending Preventative Health and Safety Training and is currently in contact with instructor to register for a January 2023 class. Once class has been completed, applicant will submit proof of completion. The following areas are OFF LIMITS to the children in care: 1. Bedroom 1 with bathroom 1- doors will remain locked during the hours of operations. 2. Bedroom 3- door will remain locked during hours of operations. 3. Kitchen- only used as a walk way and applicant will add stove knob covers. 4. Detached Garage- door will remain closed and locked during hours of operations. The following corrections will need to be completed by 1/13/2022. 1. Safety gate/barricade all rose bushes in the back yard. 2. Safety covers for stove located in the kitchen. 5. Proof of completion of Preventative Health and Safety Training. Exit interview was conducted with applicant, Anush Gevorgyan. The licensing determination of this application will be reviewed with Licensing Program Manager for final resolution. Page 4 The following was discussed with the applicant: Applicant was made aware of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State\342\200\231s licensing role, provide information to the public and parents on childcare licensing, and provide many other helpful resources to the licensees and the public. CCAP\342\200\231s direct contact information is as followed: Phone number: (916) 654-1541 Email Address: childcareadvocatesprogram@dss.ca.gov Immunizations: Commencing September 1, 2016, SB 792, prohibits a person from being employed or volunteering at a childcare facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the inspection. Mandated Reporter Training: Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com . Licensee was reminded of their responsibility to report suspected child abuse. LPA reviewed with the LIC 311D, Forms/Records To Keep In Your Family Child Care Home, children\342\200\231s forms/records, family forms/records, and information to be posted. CHILDREN'S FORMS/RECORDS Children's files must contain the following documents/information: \342\200\242 Parent Notification, Additional Children in Care (LIC 9150), if you plan to care for more than 6 children for a Small Family Child Care Home, or more than 12 for a Large Family Child Care Home. \342\200\242 Copy of document verifying child\342\200\231s enrollment in Kindergarten or K-T. (22 CCR 102421(c)) Page 5 \342\200\242 Affidavit Regarding Liability Insurance (LIC 282) - This form is required to be signed by each parent of a child in care if you do not have either liability insurance or a bond. \342\200\242 Consent for Medical Treatment (LIC 627) - This document gives you permission by the parent to seek emergency medical or dental care for their child if needed. \342\200\242 Consent/Verification for Nebulizer Care (LIC 9166) - Before a child care licensee or staff person can administer inhaled medication to a child in care, this form must be completed and filed in the child's record and in the personnel file. A separate form must be filled out for each person who administers inhaled medication to the child. \342\200\242 Identification and Emergency Information (LIC 700) - This form must be kept for each child in care and identifies whom to call in an emergency. \342\200\242 Notification of Parents' Rights (LIC 995A) - This form must be given to each parent at the time a child is accepted for care, along with the LIC 995E. \342\200\242 Caregiver Background Check Process (LIC 995E) - This form must be given to each parent at the time a child is accepted for care, along with the LIC 995A. \342\200\242 Family Child Care Consumer Awareness Information (LIC 9212) - This form must be given to the parents of each child in care. \342\200\242 California School Immunization Record (PM 286) or Confirmation of required immunization for children not enrolled in a public or private elementary school - For every infant, toddler, or preschool age child admitted into a Family Child Care Home, the provider must maintain current immunization records. PM 286 can be downloaded from the following website: http://www.cdph.ca.gov NOTE: Personal beliefs statement no longer applies (2015 SB 277). \342\200\242 Acknowledgement of Receipt of Licensing Reports (LIC 9224), if applicable. \342\200\242 Blood Glucose Testing Consent (LIC 9222) Must be signed by parent prior to administering test. \342\200\242 Individual Infant Sleeping Plan (LIC 9227) \342\200\223 Must be kept for infants up to 12 months of age. \342\200\242 Sleep Logs \342\200\223 must be kept for infants up to 24 months of age. Page 6 FACILITY FORMS/RECORDS \342\200\242 Facility files must contain the following documents/information: \342\200\242 Personnel Records as required in Title 22, Division 12, Chapter 3, Section 102416.1, including but not limited to, proof of current pediatric first aid, CPR and preventive health practices certificate, lead poisoning training, mandated reporter training (2015 AB 1207), TB test results, measles, pertussis and influenza/may decline influenza, and documentation of either a criminal record clearance or a criminal record exemption. Unusual Incident/Injury Report (LIC 624B) - You must use this form and submit it to your local licensing office when reporting any incidents or injuries occurring during day care hours. \342\200\242 Child Care Facility Roster (LIC 9040) - It is required that each child care facility maintain a current roster of children who are provided care. \342\200\242 Notice of Employee Rights (LIC 9052) - This form must be filled out by all employees working in the Family Child Care Home. \342\200\242 Statement Acknowledging Requirement to Report Suspected Child Abuse (LIC 9108) -This form is the Child Care Custodian's acknowledgement of the requirement to report suspected child abuse. \342\200\242 Property Owner/Landlord Consent Form (LIC 9149), if you plan to care for more than 6 children for a Small Family Child Care Home or more than 12 for a Large Family Child Care Home. \342\200\242 Property Owner/Landlord Notification Form (LIC 9151). \342\200\242 Proof of control of property, including but not limited to a copy of your deed, mortgage statement or property tax bill, or lease/rental agreement. \342\200\242 Verification that fire drills and disaster drills are conducted every six months. \342\200\242 Emergency Disaster Plan (LIC 610A) - Evidence satisfactory to the department that there is a fire escape and disaster plan for the facility and that fire drills and disaster drills will be conducted at least once every six months. \342\200\242 Earthquake Preparedness Checklist (LIC 9148) or equivalent, must be attached to the LIC 610A and available to the public. Page 7 INFORMATION TO BE POSTED IN YOUR FAMILY CHILD CARE HOME You are required by law to post the following in your home: \342\200\242 Facility Sketch (LIC 999A) or equivalent sketch \342\200\242 Notification of Parents' Rights Poster (PUB 394) - This poster must be placed in an area of the home where all parents can see it. \342\200\242 Facility License (LIC 203)-Your Family Child Care Home License must be posted in an area of the home where it can be easily seen. \342\200\242 Notice of Site Visit (LIC 9213) must remain posted for 30 days (during the hours that children are in care) after each site visit by a licensing representative. \342\200\242 Any licensing report documenting a type \342\200\234A\342\200\235 citation must be posted for 30 days during the hours that children are in care. \342\200\242 Any licensing report or other document verifying compliance or non-compliance with the Department\342\200\231s order to correct a Type \342\200\234A\342\200\235 deficiency must be posted for 30 days during the hours that children are in care. Licensee was made reminded that it is the licensee\342\200\231s, as well as anyone who assists in providing care responsibility to know the regulations. Licensee was also encouraged to read the Child Care quarterly updates every season as they come out to stay informed of any changes or updates to statutes and regulations. Applicant was advised that regulation prohibits the smoking of tobacco in a private residence licensed as a family childcare home during the hours of operation. Applicant was made aware that state law prohibits baby walkers, bouncy seats, exer-saucers and any other items that fall into that category. Applicant was also reminded that only children who are eating may be in highchairs and that car seats are utilized only for transportation. Applicant was also informed that the provider is required to wash hands after every diaper change and to never shake a baby to prevent the Shaken Baby Syndrome. Page 8 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. 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. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides 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 Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed. 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 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 no longer are attending the facility. Annual fees must be paid promptly and by the due date or a late fee shall be assessed, and/or the License shall be terminated. (If paying by check please make sure to write facility number on check to ensure that payment is applied to your facility number) Page 10 The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked, and batteries should be replaced. Changes should be reported the to the Department as soon as they occur such as construction and remodeling, telephone number changes and/or if you move from home. Reporting requirements: Applicant must report any unusual incident or injuries to the Child Care Regional office by telephone within 24 hours and in writing within 7 days. Applicant was provided with LIC 624 as a reference. Fire and safety drills must be performed every six months and documented for review by the Department. All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation. LPA advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov 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.