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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419269
Report Date: 02/04/2025
Date Signed: 02/06/2025 08:10:33 AM

Document Has Been Signed on 02/06/2025 08:10 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:PONCE FAMILY CHILD CAREFACILITY NUMBER:
197419269
ADMINISTRATOR/
DIRECTOR:		PONCE, LILIANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 837-7836
CITY:CULVER CITYSTATE: CAZIP CODE:
90232
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
02/04/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Liliana PonceTIME VISIT/
INSPECTION COMPLETED:
02:41 PM
NARRATIVE
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On 02/04/2025 Licensing Program Analyst (LPA) Ranita Richmond arrived at the above named home for an unannounced Case Management Deficiencies visit and was met by Licensee Liliana Ponce. LPA observed 7 children in care being supervised and cared for by licensee and 1 fingerprint cleared assistant.

LPA Richmond toured the home inside and outside for a Health and Safety inspection.

During walk through LPA observed an open-faced heater in the living room that has a screen that is propped against the heater, but not installed to prevent access by children in care. Repeat citation issued. See LIC 809D. See LIC 421FC. LPA observed detergents, cleaning compounds, medication, etc. were readily available and stored where accessible to children in care in the dining room, laundry room, and bathroom. Repeat citation issued. See LIC 809D See LIC 421FC.. LPA observed cribs with items connected to the side of the crib. Citation issued. See LIC 809D. Licensee observed one infant sleeping on stomach inside of crib with loose items inside. Citation issued. See LIC 809D. LPA observed that licensee does not have present for viewing infant sleep log. Repeat citation issued. See LIC 809D. See LIC 421FC

LPA reviewed 7 children’s files and observed them to be missing affidavits of liability insurance. Repeat citations issued. See LIC 809D. See LIC 421 FC. LPA reviewed file of sleeping infant and observed section D of LIC 9227 incomplete by provider. Infant should be placed on back for sleeping and remain on back for sleeping. Citation issued. See LIC 809D.

LPA reviewed employees files and observed employees rights (LIC 9052) missing for assistant. Repeat citation issued. See LIC 809D. LPA observed TB clearance missing for assistant. Citation issued. See LIC 809D.



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.

Nine Type B citations issued during this visit per Title 22 Regulations and Health and Safety Codes. See LIC 809D. Civil Penalties Assessed. See LIC 421FC.
An exit interview was conducted, a copy of this report and appeal rights was read and provided to Licensee Liliana Ponce.
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: 02/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/04/2025
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 5
Document Has Been Signed on 02/06/2025 08:10 AM - It Cannot Be Edited


Created By: Ranita Richmond On 02/04/2025 at 11:44 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: PONCE FAMILY CHILD CARE
FACILITY NUMBER: 197419269

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/18/2025
Section Cited
CCR
102417(g)(1)

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Operation of A Family Child Care Home 102417(g) ... Safety precautions shall include but not limited to: (1)...heaters shall be screened to prevent access by children....
This requirement is not met as evidenced by:
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Licensee will install a screen to cover the open faced heater on all sides making it inaccessible to children in care.
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Based on observation the licensee did not comply with the section cited above in 1 out of 1, which poses/posed a potential health, safety or personal rights risk to persons in care. LPA observed screen propped in front of heater.
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Type B
02/18/2025
Section Cited
CCR102425(j)(2)

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Infant Safe SleepThe provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following:

This requirement is not met as evidenced by:
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Licensee will ensure that infant sleep logs are completed daily for all infants 24 months and under.
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Based on observation, the licensee did not comply with the section cited above in 4 out of 4 which poses/posed a potential health, safety or personal rights risk to persons in care. LPA observed no infant sleep logs for infants in care.
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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: 02/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/04/2025


LIC809 (FAS) - (06/04)
Page: 2 of 5
Document Has Been Signed on 02/06/2025 08:10 AM - It Cannot Be Edited


Created By: Ranita Richmond On 02/04/2025 at 11:54 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: PONCE FAMILY CHILD CARE
FACILITY NUMBER: 197419269

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/18/2025
Section Cited
CCR
102416.1(a)(10)

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Personnel Records 102416.1 (a) Personnel records shall be maintained on each employee... (10) A signed and dated copy of the Notice of Employee Rights [LIC 9052...
This requirement is not met as evidenced by:
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Licensee will ensure that all employees complete employees rights for file.
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Based on record review the licensee did not comply with the section cited above in 1 out of 1 which poses/posed a potential health, safety or personal rights risk to persons in care. LPA observed personnel files missing LIC 9052.
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Type B
02/18/2025
Section Cited
CCR102417(m)(3)

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Operation of A Family Child Care Home 102417(3) A file of affidavits signed by each parent... the family child care home does not carry liability insurance...
This requirement is not met as evidenced by:
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Licensee will ensure that LIC 282 is signed by authorized representative and placed in children's file for review.
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Based on record review the licensee did not comply with the section cited above in 7 out of 7 which poses/posed a potential health, safety or personal rights risk to persons in care. LPA observed children's files missing LIC 282.
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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: 02/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/04/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/06/2025 08:10 AM - It Cannot Be Edited


Created By: Ranita Richmond On 02/04/2025 at 12:05 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: PONCE FAMILY CHILD CARE
FACILITY NUMBER: 197419269

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/18/2025
Section Cited
HSC
1597.622(c)

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1597.622 Employees or volunteers at family day care home; immunization requirements; records; exemptions(c) The family day care home shall maintain documentation of the required immunizations...This requirement is not met as evidenced by:
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Licensee will ensure that all staff have current immunizations on file, including TB clearance.
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Based on record review the licensee did not comply with the section cited above in 1 out of 1 which poses/posed a potential health, safety or personal rights risk to persons in care. LPA reviewed staff files and observed missing TB.
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Type B
02/18/2025
Section Cited
CCR102425(b)

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102425 Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects.
This requirement is not met as evidenced by:
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Licensee will ensure that all cribs are free from all loose articles and objects.
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Based on observation the licensee did not comply with the section cited above in 1 out of 1 which poses/posed a potential health, safety or personal rights risk to persons in care. LPA observed cribs with loos articles and objects.
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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: 02/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/04/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/06/2025 08:10 AM - It Cannot Be Edited


Created By: Ranita Richmond On 02/04/2025 at 12:15 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: PONCE FAMILY CHILD CARE
FACILITY NUMBER: 197419269

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/18/2025
Section Cited
CCR
102425(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.This requirement is not met as evidenced by:
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Licensee will remove and ensure all cribs are free from hanging or attatched items to the sides of cribs at all times.
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Based on observation the licensee did not comply with the section cited above in 1 out of 1 which poses/posed a potential health, safety or personal rights risk to persons in care. LPA observed toys attached to side of crib.
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Type B
02/18/2025
Section Cited
CCR102425(d)(3)(A)

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102425 Infant Safe Sleep(d)... place infants up to 12 month of age on their backs for sleeping.(3) ... that has Section C of the form completed and signed...A. Upon the provider’s observation... the provider... Section D ...This requirement is not met as evidenced by:
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Licensee will ensure all infant children under 24 months in age are placed on their backs for sleeping. If a signed LIC 9227, for sections C and D are completed if an infant changes positions they are able to remain in the changed position.
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Based on record review the licensee did not comply with the section cited above in 1 out of 1 which poses/posed a potential health, safety or personal rights risk to persons in care. LPA observed infant sleeping on stomach. LIC 9227, Section D missing signature of provider.
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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: 02/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/04/2025


LIC809 (FAS) - (06/04)
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