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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197410641
Report Date: 12/19/2024
Date Signed: 12/20/2024 08:23:19 AM

Document Has Been Signed on 12/20/2024 08:23 AM - 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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:PENALOZA FAMILY CHILD CAREFACILITY NUMBER:
197410641
ADMINISTRATOR/
DIRECTOR:		CECILIA PENALOZAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 591-9460
CITY:CULVER CITYSTATE: CAZIP CODE:
90230
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 8DATE:
12/19/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:44 AM
MET WITH:Cecilia PenalozaTIME VISIT/
INSPECTION COMPLETED:
11:04 AM
NARRATIVE
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On 12/19/24 Licensing Program Analyst (LPA) Ranita Richmond arrived at the above named home to complete and unannounced Case Management Deficiencies visit. LPA was greeted by licensee Cecilia Penaloza. LPA toured the home inside and outside for health and safety.

At approximately 9:44am during walk through, LPA observed cleaning compounds, detergents, medicines, razors, and other items that could pose danger to children in care stored in the following areas accessible to children in care: the shower (razors, cleaning compounds, beauty supplies), the middle medicine cabinet (medicines and beauty supplies), left medicine cabinet ( medicines, beauty supplies, and antiseptics), on the counter inside the classroom (clorox disinfectant wipes), on the table outside (lysol disinfectant wipes). Citation cited. At approximately 9:46am LPA observed toys attached to and hanging from side of crib. Citation cited.

LPA reviewed staff 1st aid/cpr. S1 taken 5/02/22, S2 taken 6/23/22, S3 taken 5/02/22. Citation issued.
LPA advised licensee that 1st aid/cpr must be renewed every two years. LPA advised licensee that at least one fingerprint cleared staff must be trained in and have current up to date pediatric cpr/1st aid.

Citations were cited today, per Title 22 Regulations and Health and Safety Codes. See LIC 809D.

An exit interview was conducted, a copy of this report, and appeal rights were discussed and provided to licensee Cecilia Penaloza.

Notice of Site Visit was provided and required to be posted for 30 days.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Ranita Richmond
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2024
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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Document Has Been Signed on 12/20/2024 08:23 AM - It Cannot Be Edited


Created By: Ranita Richmond On 12/19/2024 at 11:53 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: PENALOZA FAMILY CHILD CARE
FACILITY NUMBER: 197410641

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/06/2025
Section Cited
CCR
102417(g)(4)

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102417 Operation of a Family Child Care Home (g) The home shall be free from...conditions which might endanger a child.(4)..,cleaning compounds, medicines ,... and other items which could pose a danger... to children shall be stored where they are inaccessible to children.
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Licensee will make all cleaning compounds, medicines, and other items which pose a danger to children inaccessible by placing them on high shelves or locked cabinets.
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Based on observation, the licensee did not comply with the section cited above evidenced by cleaning compounds, medicines, and other items which could pose a danger to children were accessible to children in care in bathroom, daycare room, and outdoors.
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Type B
01/06/2025
Section Cited
CCR102425(b)(3)

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102425 Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects. (3) There shall be no objects hanging above or attached to the side of the crib.
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Licensee will ensure that all cribs and pack n plays are free from all loose items and no items will be attached to or hanging from the cribs or pack n plays at all times.
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Based on observation, the licensee did not comply with the section cited above as evidenced by toys attached to crib and hanging from the side of the crib.
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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:Claudia Escobedo
LICENSING EVALUATOR NAME:Ranita Richmond
LICENSING EVALUATOR SIGNATURE:
DATE: 12/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/19/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/20/2024 08:23 AM - It Cannot Be Edited


Created By: Ranita Richmond On 12/19/2024 at 12:11 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: PENALOZA FAMILY CHILD CARE
FACILITY NUMBER: 197410641

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/06/2025
Section Cited
CCR
102416(c)

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102416 Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.
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Licensee and staff will complete EMSA approved pediatric first aid/cpr training.
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Based on observation, the licensee did not comply with the section cited above evidenced by licensee and staff have expired pediatric cpr/1st aid trainings on file.
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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:Claudia Escobedo
LICENSING EVALUATOR NAME:Ranita Richmond
LICENSING EVALUATOR SIGNATURE:
DATE: 12/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/19/2024


LIC809 (FAS) - (06/04)
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