Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018568
Report Date: 08/03/2017
Date Signed 08/03/2017 02:58:40 PM

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:DUNCAN FAMILY CHILD CAREFACILITY NUMBER:
198018568
ADMINISTRATOR:JAMISHA JENEE DUNCANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 326-2619
CITY:LOS ANGELESSTATE: CAZIP CODE:
90061
CAPACITY:14CENSUS: 0DATE:
08/03/2017
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Jamisha DuncanTIME COMPLETED:
02:55 PM
NARRATIVE
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Licensing Program Analyst (LPA) Warren Birks conducted an unannounced Annual Random inspection. LPA met with licensee, Jamisha Duncan who guided analyst on a tour of the facility. There were zero children present and there is currently one child enrolled. There is one adult residing in the home that has a clearance on file.

This is a single story home which consists of 3 bedrooms, 1 bathroom, kitchen, dining room, living room, play area, detached garage, backyard (fenced). LPA observed parked vehicles in the backyard. Child care takes place in the living room, dining room, bathroom in hallway, playroom and backyard. All areas used by children were inspected for safety, comfort, cleanliness, ventilation and heating (wall heater).

The licensee states that there are no poisons in the home. The licensee understands that any poisons must be locked with a key or combination lock. Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible. Per licensee, there are no weapons, firearms or bodies of water on the premises. There were toys observed for children. Posting requirements were observed to be posted at the time of visit. Children’s records were reviewed. The valve on the required 2A 10BC fire extinguisher indicates fully charged however the last date of service is unknown. Smoke and carbon monoxide detectors near the dining room and hallway were tested, and are in need of batteries. There are emergency supplies on the premises and a medical kit. The licensee understands that in her absence 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.

The licensee has taken 1st Aid and Pediatric CPR however she was unable to locate a current card. The following children’s records were available for review: Immunization Records, Notification of Parents’ Rights receipt for children and Identification and Emergency forms. ID/Emergency form needs physician information.
SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-2956
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2017
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 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: DUNCAN FAMILY CHILD CARE
FACILITY NUMBER: 198018568
VISIT DATE: 08/03/2017
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There were NO ZERO TOLERANCE deficiencies cited during this visit. Zero Tolerance includes:
Absence of Supervision; Accessible Bodies of Water. No bodies of water on the premises; Accessible Firearms, Ammunition or Both. No firearms or weapons in the home; Refused Entry to a Facility or Any Part of a Facility in Violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g)(2); The Presence of an Excluded Individual. No excluded individuals; Children are not left in parked vehicles.

POSTING REQUIREMENTS: Parent’s Rights Poster, Facility License and Emergency Disaster Plan is posted. SMOKING IS PROHIBITED IN A LICENSED FAMILY CHILD CARE HOME. No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility.

INFANT CARE: LPA advised the licensee to sleep infants where the infant can be directly supervised. If the licensee chooses to sleep infants in another room, the licensee is advised to conduct periodic checks. LPA discussed the following. 1) Safe Sleeping Poster (www.sidsandkids.org) 2) CCLD Fall and Winter/Spring 2015 Quarterly Update, Page 5 only.

Medication: 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. Licensee does not offer incidental medical services at this time.

LPA advised the licensee how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov. The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Licensee Duncan.

SUPERVISOR'S NAME: Katherine HarewoodTELEPHONE: (323) 981-2956
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2017
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: DUNCAN FAMILY CHILD CARE
FACILITY NUMBER: 198018568
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/03/2017
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/04/2017
Section Cited
1597.622
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Employees or volunteers at family day care home; immunization requirements; records; exemptions: (2) If a person meets all other requirements for employment or volunteering, as applicable, but needs additional time to obtain and provide his or her immunization records, the person may be employed or
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Licensee indicated she will provide proof of immunization records or Titers test for measles, pertussis. Licensee will provide inluenza declaration.
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Type B
08/24/2017
Section Cited
102417(g)(1)
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Fire extinguishers and smoke detectors shall meet State Fire Marshal standards.
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Licensee indicated she will have fire extinguisher serviced or purchase a new one.
Type B
08/07/2017
Section Cited
102417)g)(1)
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Fire extinguishers and smoke detectors shall meet State Fire Marshal standards.

smoke detector in need of batteries.
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Licensee indicated she will install batteries in smoke detector.
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: Katherine HarewoodTELEPHONE: (323) 981-2956
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2017
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: DUNCAN FAMILY CHILD CARE
FACILITY NUMBER: 198018568
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/03/2017
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/10/2017
Section Cited
102421(b)
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Childs Records. The licensee shall maintain, in each child’s record, a copy of the emergency information card required in Section 102417(g) (7).

Emergency form for child #1 needs current physician information.
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Licensee indicated she will update current physician information.
Type B
08/04/2017
Section Cited
102417(g)
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Operation of a Family Child Care Home. The home shall be free from defects or conditions which might endanger a child.

LPA observed vehicles parked in backyard play area. Licensee indicated that if children were here the cars would not be parked in tghe back.
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Licensee indicated she will make sure cars are not parked in backyard play area during childcare hours.
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No children were present.
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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: Katherine HarewoodTELEPHONE: (323) 981-2956
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2017
LIC809 (FAS) - (06/04)
Page: 4 of 4