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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417027
Report Date: 03/20/2025
Date Signed: 03/20/2025 12:54:17 PM

Document Has Been Signed on 03/20/2025 12:54 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:ALGOSO FAMILY CHILD CAREFACILITY NUMBER:
197417027
ADMINISTRATOR/
DIRECTOR:		ALGOSO, CARMENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 263-7430
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 2DATE:
03/20/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:10 AM
MET WITH:Carmen Algoso, LicenseeTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
NARRATIVE
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On 03/20/2025, Licensing Program Analyst (LPA) Elicia Calvillo conducted an unannounced 3 Year Required Annual inspection at 15843 Blackhawk Street, Granada Hills, CA. 91344. LPA arrived at the facility at 08:10 AM, identified self and met with Carmen Algoso, Licensee who guided analyst on a tour of the inside and outside of the facility. There were 2 children and 1 Assistant present at arrival. LPA provided Licensee with a copy of the LIC126 Entrance Checklist -Family Child Care Homes to help facilitate the inspection. Licensee cares for children from ages 3 months to 13-year-olds. Facility hours of operation are Monday to Friday from 07:00AM to 06:00PM.

Because the licensee rents/leases the home, proof of landlord notification is required. LPA observed the Property Owner/Landlord Notification form (LIC 9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

The family child care home is a one-story dwelling, includes living room, dining room, kitchen, laundry nook, play room #1, playroom #2, 4 bedrooms, 2 bathrooms, and an attached garage converted to a bedroom. There is a front yard that is used for children to enter and exit the facility. There is a fenced outdoor play area in the back of the house.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The children use the combination playroom #1 and playroom #2 for child care activities, sleeping, and eating. There are tables and chairs, toys and play items that are safe, clean, and appropriate for the ages of the children. LPA observed there are cribs (pack n’ play) and bed linens available for children. The attached garage is used as an extra sleeping area and to store extra cribs, cots, and bed linens.
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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2025
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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Document Has Been Signed on 03/20/2025 12:54 PM - It Cannot Be Edited


Created By: Elicia Calvillo On 03/20/2025 at 11:16 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: ALGOSO FAMILY CHILD CARE
FACILITY NUMBER: 197417027

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in that the play yard used by children has two (2) trampolines which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/21/2025
Plan of Correction
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Licensee stated that they will remove the two (2) trampolines from the play yard and email LPA photos of the play yard by the plan of correction due date 04/21/2025.
Type B
Section Cited
CCR
102425(j)(1)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in that 3 out 3 infant children's records did not contain a documentation of a physical check every 15 minutes while sleeping which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/21/2025
Plan of Correction
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Licensee stated that they will physically check on an infant every 15 minutes while sleeping and keep a sleep log for each child and email LPA a copy of the 15 minute sleep log by the plan of correction due date 04/21/2025.
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:Rita Ramos
LICENSING EVALUATOR NAME:Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:
DATE: 03/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/20/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/20/2025 12:54 PM - It Cannot Be Edited


Created By: Elicia Calvillo On 03/20/2025 at 11:16 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: ALGOSO FAMILY CHILD CARE
FACILITY NUMBER: 197417027

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in that the Licensee and Staff #1 did not have proof of Immunization record and TB clearance or risk assessment readily available upon request which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/21/2025
Plan of Correction
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Licensee stated they will obtain proof of immunizations and tuberculsis clearance or risk assessment for Licensee and Staff #1 and email LPA a copy of the records by the plan of correction due date 04/21/2025.
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in that 3 of 3 children's files did not contain the LIC9227 Individual Sleep Plan readily available upon request which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/21/2025
Plan of Correction
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Licensee stated the will obtained the LIC 9227 Individual Infant Sleep Plan and email LPA a copy of the forms by the plan of correction due date 04/21/2025.
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:Rita Ramos
LICENSING EVALUATOR NAME:Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:
DATE: 03/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/20/2025


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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: ALGOSO FAMILY CHILD CARE
FACILITY NUMBER: 197417027
VISIT DATE: 03/20/2025
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The children use the bathroom #1 located in the hallway near the kitchen. The vanity cabinet holds hand soap and paper products, and LPA observed cleaning products stored in the vanity without a child proof latch. Licensee stated the will install child proof latches for hazardous items stored in the bathroom vanity cabinet. LPA observed that the bathroom that children use was sanitary.

Per Licensee, when a child shows signs of illness they will be separated from other children and isolated in the living room.

LPA observed the kitchen is not made inaccessible with the use of child proof latches or gates. Licensee stated they will install child proof latches for hazardous items in the kitchen stored in the cabinets. The licensee provides food for children in care. Licensee stated when food is brought to the facility it is labeled with child’s name and stored properly.

There is telephone service via a landline.

The outdoor play area is located at the back yard of the house, is fenced and there are no hazards to children present. LPA observed appropriate toys, climbing structure, and other play equipment for children in care. The outdoor play yard is covered with cement and artificial grass to absorb falls. LPA observed adequate shade with a portable umbrella.

Per Licensee, areas off limits to children and parents include 4 bedrooms and are made inaccessible by use of door locks.

LPA did observe a front yard, per Licensee, the front yard is not used for child care activities and is used for dropping off and picking up children.

Per Licensee, there are no firearms, ammunition, or poisons on the premises. LPA did not observe any firearms, ammunition, or poisons during the inspection. Poisons, detergents, medicines, and other items which could pose a danger if readily available to children are stored where they are inaccessible to children.

Per Licensee, there are no pets on the premises. LPA did not observe any pets on the premises.
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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ALGOSO FAMILY CHILD CARE
FACILITY NUMBER: 197417027
VISIT DATE: 03/20/2025
NARRATIVE
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Per Licensee, there are no bodies of water. LPA did not observe any swimming pool, wading pools, hot tubs, spas, fish ponds, fountains or other similar bodies of water.

LPA did observe a fireplace and it has a metal screen enclosure to prevent access by children. LPA did not observe an open face heater during the inspection. There is a working fire extinguisher, the valve on the 3A 10BC fire extinguisher indicates fully charged and Licensee was not able to confirm last service date. There is a smoke detector in playroom #1 room and was tested and operable. The carbon monoxide detector located in the kitchen and was tested and operable.

There is currently three (3) infant enrolled with the facility. LPA discussed the safe sleep regulations with Licensee 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 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.

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs and/or any other item that fall into these categories are not permitted in a family child care facility. LPA did observe two (2) trampolines in the outdoor play area located in the backyard, which are not permitted in a family child care facility. Licensee stated that they will have the two (2) trampolines removed from the outdoor play area.

Licensee was reminded that children in care are to be supervised at all times and made aware that children shall not be left in parked vehicles. Car seats shall only be used for transportation purposes and shall not be used for sleeping.

Capacity as specified on the license is being maintained.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
LIC809 (FAS) - (06/04)
Page: 5 of 8
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: ALGOSO FAMILY CHILD CARE
FACILITY NUMBER: 197417027
VISIT DATE: 03/20/2025
NARRATIVE
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LPA reviewed a sample of children’s files and observed files were not complete and documented on the LIC857. There were 3 of 3 children’s files missing LIC 9227 Sleeping Plan and 3 of 3 children’s file missing 15-minute sleep log documentation.

An emergency fire/disaster drill has been completed and documented within the last 6 months on 03/18/2025. Licensee Mandated Reporter Training was completed on 11/14/2024. Licensee’s pediatric CPR/First Aid expires on 07/2026.

LPA reviewed one (1) personal record and observed that the file was not complete and documented on the LIC 859. The personnel record was missing immunization record for proof of tuberculosis clearance or risk assessment.

LPA reviewed with licensee the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children's forms/records, facility forms/records, and information to be posted.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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:
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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
LIC809 (FAS) - (06/04)
Page: 6 of 8
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: ALGOSO FAMILY CHILD CARE
FACILITY NUMBER: 197417027
VISIT DATE: 03/20/2025
NARRATIVE
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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: https://www.ada.gov/resources/child-care-centers/.

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

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 platforms.

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.

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

During today's visit, per Title 22, Division 12, Chapter 3, of the California Code of Regulations, there are four (4) Type B citations being cited for sections 102417 (g) Operation of Family Child Care Home, 102425(j)(1) Infant Safe Sleep, 1597.622(c) Administration of Child Day Care Licensing and 102425(c) Infant Safe Sleep and a plan of correction for the four (4) Type B citations will be due 04/21/2025.

A Notice of Site Visit was given and must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to comply with posting requirement will result in an immediate civil penalty of $100.00.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
LIC809 (FAS) - (06/04)
Page: 7 of 8
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: ALGOSO FAMILY CHILD CARE
FACILITY NUMBER: 197417027
VISIT DATE: 03/20/2025
NARRATIVE
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Exit interview was conducted with Carmen Algoso, Licensee including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
LIC809 (FAS) - (06/04)
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