Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419054
Report Date: 06/29/2015 12:00:00 AM
Date Signed 07/01/2015 01:49:38 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME:MALHEUDE FAMILY CHILD CAREFACILITY NUMBER:
197419054
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
06/29/2015
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
07:50 AM
MET WITH:Vaina MalheudeTIME COMPLETED:
10:15 AM
NARRATIVE
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Licensing Program Analyst (LPA) Silva Garibyan conducted a site visit for the purpose of an Annual Random visit. The licensee has applied for capacity increase. LPA met with the licensee and toured the home inside and outside. There were 5 children present at the time of the visit ( one infant). LIcensee's home is a single story, 3 bedroom, 2 bathroom home with a living room and kitchen. Family members residing at facility are: 3 adults (licensee and her fiance, and her sister). Main care is provided primarily in the master bedroom/play room, small bedroom adjacent to the play room, and kitchen.. Off limit areas include 2 bedrooms and the living room.. Children utilize the bathroom located in the playroom. Children play in the back yard which is fenced.
The home was found to be clean and orderly with proper ventilation for safety and comfort. The bathroom was inspected for inaccessibility of chemicals/toxins and other potential hazards to children in care.. Cabinets and drawers in the kitchen were inspected for inaccessibility of toxins/chemicals, knives and other sharp objects which may be harmful to children in care. The Fire Extinguisher (2A-10-BC) is mounted on the wall in the bedroom inaccessible to children in care. There is a working smoke detector located in the play room. Licensee was unable to demonstrate current proof of CPR/First Aid Certificates. LPA did not observe the Parent's Rights poster to be posted in a prominent area of the home
LPA observed toys and furniture that were age appropriate and in good repair. LPA toured the backyard and found it to be fully fenced. There is no pool, spa or other bodies of water on the premises.. Children's outdoor play equipment and toys are age appropriate and in good repair. There is a bunny in the cage in the back yard.
Capacity and Ratios: The licensee has applied for a capacity increase for a large family . The Max capacity is 12 with no more than 4 infants and a qualified assistant. Without a qualified assistant the license reverts back to the requirements for a small family childcare. Optional care may be provided for a maximum capacity of 14 children with no more then 3 infants, 2 school age children and a qualified assistant. School age children must be 1 age 6 yrs and 1 in Kindergarten.
Exit interview conducted and a copy of the report provided.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (310) 337-4826
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (310) 337-3754
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2015
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, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME: MALHEUDE FAMILY CHILD CARE
FACILITY NUMBER: 197419054
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/29/2015
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/06/2015
Section Cited
102416(c)
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:Licensee is required to maintain current Pediatric CPR and First Aid certifications at all times.

Licensee was unable to demonstrate current proof of CPR/First Aid Certificates.
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Licensee has misplaced both cards and will submit proof of current cards to LPA Garibyan as soon as possible or on or before 07/06/15

Type B
07/06/2015
Section Cited
102419 (b)
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Parents Rights. The Licensee shall post the PUB 394, Family Child Care Home Notification of Parents’ Rights Poster in an accessible area in the family child care home at all times children are in care. LPA did not observe the Parent's Rights poster to be posted in a prominent area of the home
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Licensee will ensure the Parent's Rights poster is posted in a prominent area of the home immediately and will submit proof to the Department. via photo no later than 7/06/2015 to clear the deficiency.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (310) 337-4826
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (310) 337-3754
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2015
LIC809 (FAS) - (06/04)
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