197412111-10-22-2025-30-CC-SPOL-DMPNTE-20251022104435

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197412111
Report Date: 10/21/2025
Date Signed: 10/22/2025 10:47:13 AM

Document Has Been Signed on 10/22/2025 10:47 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	MITCHELL-MILLER FAMILY CHILD CARE		FACILITY NUMBER:	197412111
ADMINISTRATOR/ DIRECTOR:	MITCHELL-MILLER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 270-8434
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90056
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 3	CENSUS: 0	DATE:	10/21/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:10 AM
MET WITH:	Diedre Mitchell-Miller		TIME VISIT/ INSPECTION COMPLETED:	11:35 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Shandra Powell conducted an unannounced Annual Random inspection on 10/21/2025. A copy of the Entrance Checklist for Child Care homes form (LIC 126) was provided to the licensee upon entry.LPA observed Facility License, Notification of Parents Rights, Earthquake Preparedness posted on a cardboard located in the dining room area. LPA reviewed the Emergency Disaster Plan LIC610A, Disaster and Fire Drill Log per documentation. LIC9040 Facility Roster was observed with 3 children enrolled. Licensee stated the facility is operating 6 days a week and 24hrs a day. The licensee stated that she has 3 school age children enrolled in care at this time. LPA reminded licensee a assistant must be present when more than 8 children are in care. No assistant present during inspection. This is a one story home 2 bedrooms and 1 bathroom. Per Licensee one other adult resides in the Family Child Care Home. All Adults present, residing and working in the home are fingerprint cleared and associated to the facility. Licensee gave LPA a tour of the home inside and out. The home was inspected for safety, comfort, cleanliness, telephone service (Land line), heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines located in off limit room locked. and hazardous items that can pose a danger to children. The home is a one story home with 2 bedrooms (off limits) all bedrooms are made inaccessible by locked doors (with key locks) and a child proof gate which closes off the dining room from the hallway where bedrooms are located. 1 bathroom (on limits) children enter bathroom from kitchen/service porch area. LPA observed two entry doors for bathroom off hallway and off kitchen. The Living and Dining Room are the main child care areas and are ON LIMITS.

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Shandra Powell
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MITCHELL-MILLER FAMILY CHILD CARE	FACILITY NUMBER: 197412111
	VISIT DATE: 10/21/2025

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The kitchen and back yard are ON-LIMITS. During inspection LPA observed stairs to attached unit located in the back yard are under construction. Licensee completed declaration which states no children are allowed in back yard due to construction of stairs. When construction is completed children will be able to enter back yard. The kitchen is ON-LIMITS and is a walkway for children to enter back yard and bathroom. The children eat, nap(cots) and play in the day care room areas. LPA observed a play yard in living room of home. LPA reminded licensee when children bring food or drink items into the home during childcare hours they must be labeled and properly stored. Home utilizes central heat and ceiling fans and window air conditioner for a cooling and heating source. Hazardous materials in the kitchen and bathrooms are inaccessible to children. LPA observed a small dog in a kennel located in kitchen area.

The home has a fireplace that is barricaded. Licensee states she has age appropriate toys available for children. LPA discussed weapons in the home. The Licensee does not have any guns or weapons in the home or on the premises. All Kitchen drawers do not have latches but items which are hazardous were inaccessible, all sharp items are placed in cabinets above refrigerator.
LPA observed a fire extinguisher which is at least a 2A:10BC LPA reviewed receipt showing date of purchase within a year. LPA reminded licensee that the fire extinguisher must be serviced yearly and or a new fire extinguisher must be bought. Smoke/Carbon Monoxide detector was inspected and tested during inspection.
During inspection LPA observed a full complete First Aid Kit in the home. Current CPR/First Aid certification was available for review for licensee and assistant which expires 07/2026. LPA observed a updated Mandated Reporter Training Certificate for licensee dated 02/13/2025.
LPA reviewed 2 children's file during today's inspection and observed the following LIC 700 (Identification and Emergency Information), LIC 627 (Consent for Emergency Medical Treatment), LIC 995A (Notification of Parents' Rights). Files were complete.

There are no bodies of water at the home. The front yard of the home is off-limits. Licensee will visibly supervise children during outside play at all times. LPA observed a small black gate on side of home used for children to enter back yard.

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Shandra Powell
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MITCHELL-MILLER FAMILY CHILD CARE	FACILITY NUMBER: 197412111
	VISIT DATE: 10/21/2025

NARRATIVE

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LPA reminded licensee only drivers licensed for the type of vehicle to be operated shall be permitted to transport children in care.

The manufacturer's rated seating capacity of the vehicle shall not be exceeded.

Motor vehicles used to transport children in care shall be maintained in safe operating condition.

All vehicle occupants must be secured in an appropriate restraint system.

Children shall not be left in parked vehicles.
When transporting infants in any motor vehicle, the licensee shall secure the infants in a car seat, designed for infants, which is secured in the vehicle in accordance with manufacturer's instructions.

The following was thoroughly discussed with Licensee:
License was reminded that all adults 18 and over living or working in the home, 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.

Incidental Medical Services (IMS):
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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm.

Incidental Medical Services (IMS) are not currently being provided.

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Shandra Powell
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MITCHELL-MILLER FAMILY CHILD CARE	FACILITY NUMBER: 197412111
	VISIT DATE: 10/21/2025

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LPA thoroughly discussed Safe Sleep Practices: always place infants on their backs for sleeping; use only a tight-fitting sheet on the crib or play yard mattress; do not hang any items from the crib or above the crib; keep all items, including blankets, out of the crib or play yard; pacifiers may be used as long as they do not have items attached to them; infants should not be swaddled or have any items covering them while sleeping; the temperature of the room should be comfortable enough for an adult to wear a t-shirt and not be too hot or too cold.

During this inspection, LPA did observe an copy of a previous infants 15min sleep log. Licensee does not have in infants in care at this time.

The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot line at 1-800-540-4000. Also call the CCLD office within 24 hours of all Unusual Incidents and follow up with a written Unusual Incident/Injury Report (LIC 624B) within 7 business days.

Licensee was reminded that all infants must be placed on their backs when sleeping to prevent S.I.D.S. (sudden infant death syndrome), and that the Provider is required to wash hands after every diaper change and to never shake a baby to prevent the Shaken Baby Syndrome

LPA the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov. Licenses stated she has subscribed to receive Important updates during inspection.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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.

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Shandra Powell
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MITCHELL-MILLER FAMILY CHILD CARE	FACILITY NUMBER: 197412111
	VISIT DATE: 10/21/2025

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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your experienced. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding inspection tools and methods, please visit the Program website at www.cdss.gov/inforesouces/community-care-liceinsing/inspection-process .

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&R) throughout California.

Exit interview conducted and report was reviewed with the Licensee. Report, Appeal Rights and Notice of Site Visit were given to Licensee. The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Shandra Powell
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2025

LIC809 (FAS) - (06/04)

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