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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700079
Report Date: 04/20/2023
Date Signed: 04/20/2023 01:40:21 PM

Document Has Been Signed on 04/20/2023 01:40 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:ALEXANDI FAMILY CHILD CAREFACILITY NUMBER:
195700079
ADMINISTRATOR:RAMONA ALEXANDIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 561-0144
CITY:BURBANKSTATE: CAZIP CODE:
91504
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
04/20/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Licensee Ramona Alexandi TIME COMPLETED:
02:00 PM
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On 4/20/2023, Licensing Program Analyst (LPA) Dalicia Adkins conducted an announced pre-licensing/ re-location inspection. LPA met with applicant Ramona Alexandi, who guided LPA on a tour of the inside and outside of the home. There were no other adults and no children present during the inspection. The hours of operation will be 7:00am- 7:00pm. Applicant is requesting for a relocation with a capacity of 14. Fire clearance granted, dated, 04/10/2023.

On 3/24/23 LPA conducted the initial pre-licensing/relocation visit. LPA Adkins conducted physical visit and LPM joined virtually via Facetime. The following corrections discussed: gapping in mesh pool gate/ opening on side of mesh gate, gapping under wrought iron gate and property permit. LPM discussed in detail with applicant about ADU conditions. Notarized statement of acknowledgment submitted, 04/17/2023. Refer to LIC 812 dated, 3/24/2023 for further details. Today's visit is a follow up visit to the pre-licensing visit conducted on 3/24/23. LPA observed wrought iron gate correction; the gate was lowered closing gap from the bottom of the gate and the ground. LPA observed the mesh pool gate corrections, the mesh gate gapping closed. Alarm installed on window that over looks the pool. LPA observed applicant opening the window and the alarm sounding. LPA took pictures of the home inside and outside.

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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Dalicia Adkins
LICENSING EVALUATOR SIGNATURE: DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/20/2023
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ALEXANDI FAMILY CHILD CARE
FACILITY NUMBER: 195700079
VISIT DATE: 04/20/2023
NARRATIVE
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This is a one bedroom ADU single story one bedroom home. The home has one bathroom, kitchen, dining room, living room and backyard.

The layout is an open floor plan; areas are identified by placement of furniture. There are two entrances/exits; one front of the home and another on the side of the home near the open space area.

There is an in-ground pool on premises; pool is located behind a wrought iron rolling gate. The wrought gate separates the backyard and the pool. The wrought gate extends from the side of the home to the brick wall on the opposite side of the yard. Addition to the wrought gate the pool has a mesh fence. The mesh fence is over 5 ft high with mesh type material that is transparent. The mesh fence is supported by metal beams anchored to the cement. The pool gate swings away from the pool, self-closes and has a self-latching device located at the top of the gate. This gate has a lock on top of the gate door, key is needed to open and lock the gate. Per applicant the gate will remain locked. Applicant demonstrated how to operate the two-step mechanism of opening the latch. First, the latch located at the very top of the gate must be pulled upward and then the key needed to open the gate. There is a small device on top of the latch with a red light. Red light is an alert that the gate is locked. The mesh gate extends around the entire perimeter of the pool.

The kitchen is off limits and is made inaccessible by child security gate. LPA observed knives and sharps stored in cabinet. Food preparation area adequately equipped, clean and free of hazards. Applicant will be providing breakfast, lunch and snacks. Per licensee, the facility will be participating in the local food program.

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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Dalicia Adkins
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ALEXANDI FAMILY CHILD CARE
FACILITY NUMBER: 195700079
VISIT DATE: 04/20/2023
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LPA Adkins observed operable refrigerator which will be used for storing food. Applicant will provide water and will be easily accessible for children.
LPA observed one hallway that leads form the main living room area to the bedroom and bathroom. This is a wide hallway and will be used as the isolation area. Per applicant a cubby with individual baskets will be utilized for children personal belonging.

LPA observed bathroom to be clean and safe. LPA observed one operable toilet and one sink. LPA observed stepping stool and one non-touch trashcan will be placed in bathroom. LPA observed paper towels, hand soap and toilet paper available to meet children hygiene needs. Cabinet underneath the sink is inaccessible to children, closed with child safety lock.

Per licensee children will use the main living room area for napping. children will use cots. LPA observed cots in the hallway area. LPA did not observe any cribs or high chairs. Per licensee, there will be no infants in care at this time.

LPA observe the outdoor area. The outdoor area will be used for playtime and activity time. LPA observed children furniture and age-appropriate toys. LPA observed artificial grass and tree located in center of yard providing shade.

All required licensing devices observed. Fire extinguisher (2A 10BC) located in hallway. Carbon Monoxide and smoke detector located in hallway and bedroom. LPA confirmed with applicant that cell phone will be use as primary contact (818) 561-0144. Applicant will use landline service (818) 507-5639 for emergencies. No fireplace or screened heaters in the home.

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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Dalicia Adkins
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ALEXANDI FAMILY CHILD CARE
FACILITY NUMBER: 195700079
VISIT DATE: 04/20/2023
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LPA observed the home to be well ventilated and adequate lighting. Applicant will use wall near front door to post all licensing forms.

Parents will park on the residential street and walk to the front gate. Parents will enter premises through wrought gate near the front door. There is a latch and door bell on the gate. Per licensee, a ring will be installed on the gate.

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.

LPA discussed the safe sleep regulations with applicant or facility 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, licensee, or facility representative] 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.

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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Dalicia Adkins
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ALEXANDI FAMILY CHILD CARE
FACILITY NUMBER: 195700079
VISIT DATE: 04/20/2023
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Incidental Medical Services (IMS) policy was discussed. For IMS information, see PIN 22-02-CCP. 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

LPA reviewed form LIC 311 D and copy provided. Entrance Checklist discussed and copy was provided to the applicant.

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.



An exit interview was conducted, and a copy of this report was provided to the Applicant was informed that licensing determination of this application will be reviewed with the Licensing Program Manager for final approval.

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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Dalicia Adkins
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023
LIC809 (FAS) - (06/04)
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