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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419417
Report Date: 11/20/2023
Date Signed: 11/21/2023 08:03:34 AM

Document Has Been Signed on 11/21/2023 08:03 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:LIZARDI FAMILY CHILD CAREFACILITY NUMBER:
197419417
ADMINISTRATOR:LIZARDI, MARTHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(424) 287-9922
CITY:SAN PEDROSTATE: CAZIP CODE:
90731
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
11/20/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Licensee, Martha LizardiTIME COMPLETED:
12:55 PM
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On 11/20/2023 at 9:40am Licensing Program Analyst (LPA), Sarah Garcia conducted an unannounced Annual Required Inspection at the above-mentioned facility. LPA was greeted by staff, Geraldine Romero (S1). Licensee was not present during initial inspection. S1 called licensee, Martha Lizardi (D1). D1 arrived at the facility at 9:50am. During the initial inspection, LPA observed 5 children in care.

Facility operates 7 days a week, 24 hours a day Sunday through Saturday. Currently licensee is available to care for children seven months old to 12 years old. Facility is Large Family Child Care Home with a max capacity of 14. Licensee provides transportation to the children.

LPA toured the home inside and outside. The home is a duplex home with 3 bedrooms and 1 bathroom, the living room, kitchen area, and outdoor area. Licensee confirmed the following areas are designated for day care only: living room, bedroom #1, bathroom #1, outdoor area including garage. LPA observed the parent board with all the necessary posting. LPA inspected bedroom #1 and observed cots to utilize for sleep. The bathroom that children use is located outside of the kitchen. LPA inspected the bathroom #1 and observed toilet paper under the bathroom sink. There are no medications, toxins or cleaning compounds accessible to the children in care in bathroom #1. LPA inspected the living room and observed the space to be clean and orderly. LPA observed age-appropriate toys, materials, children's tables and books. LPA observed a fish tank on top of the cabinet out of reach to children in care. LPA inspected the kitchen and observed the knives and sharp objects to be in the top cabinet out of reach to the children. LPA observed the poisons, detergents, cleaning compounds, medications and other items on the top shelf above the washer and dryer which can pose a risk to children in care made inaccessible. LPA observed the bedroom #2 to be empty. LPA observed the bedroom #3 to be empty. Per the licensee, the licensee is currently in the process of relocating and submitted an application to the Department.


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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LIZARDI FAMILY CHILD CARE
FACILITY NUMBER: 197419417
VISIT DATE: 11/20/2023
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The following areas are OFF LIMITS to the children in care: Bedroom #2 and bedroom #3.

LPA inspected the outdoor area and observed safe toys and play equipment. Outdoor area is clean and free from debris. LPA observed a washer and dryer in the outdoor area. LPA instructed licensee to remove the washer and dryer to ensure it is inaccessible to children in care. Per the licensee, there are no weapons or firearms on premises. There are no bodies of water on the premises.

All electrical outlets were observed to be covered. LPA reminded licensee to ensure all areas that have been designated as OFF LIMITS need to have doors closed, locked, and made inaccessible when children are present.



LPA observed licensee test the smoke detector in the home. LPA observed the carbon monoxide detector was not functioning. LPA instructed licensee to purchase batteries and repair carbon monoxide detector. One charged fire extinguisher was observed, 2:A10:BC. Licensee confirmed program provides meals and snacks. LPA discussed the importance of maintaining a system where allergies and food restrictions are noted. LPA observed a first aid kit with a working thermometer.

Licensee currently does not administer medication. Adequate heating and ventilation for safety and comfort were observed in the space. The home has ceiling fans and portable heaters. The home has working telephone service and LPA confirmed the phone number (424) 287-9922.

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

Capacity as specified on the license is being maintained during today’s inspection.

LPA reviewed 5 children’s files and observed files to be complete. LPA observed the earthquake and fire drill log. LPA discussed all necessary forms needed in each children’s file and provided licensee with the LIC 311D- Records to be maintain in the facility and provided licensee with a current copy to use as a reference when auditing files.

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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2023
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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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LIZARDI FAMILY CHILD CARE
FACILITY NUMBER: 197419417
VISIT DATE: 11/20/2023
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LPA reviewed Licensee’s Pediatric CPR and First certification and observed certification with an expiration date of 08/2024. LPA reviewed licensee’s Mandated Reporter training and observed certification with an expiration date of 10/2024.

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.



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.

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: 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.

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

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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2023
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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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LIZARDI FAMILY CHILD CARE
FACILITY NUMBER: 197419417
VISIT DATE: 11/20/2023
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Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809D) Licensee was provided with a copy of appeal rights.

LPA Sarah Garcia informed licensee, Martha Lizardi, that this report dated 11/20/2023 document(s) (1) Type A citation and (1) Type B Citation which shall be posted for 30 consecutive days as there are immediate and potential risk(s) to the health, safety, or personal rights of children in care.
Also, LPA Garcia informed the licensee to provide a copy of this licensing report dated 11/20/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report along with appeal rights was reviewed with the licensee.

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 inspection experience. If you have any questions regarding the process or tools, please send them by email 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.

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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2023
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Document Has Been Signed on 11/21/2023 08:03 AM - It Cannot Be Edited


Created By: Sarah Garcia On 11/20/2023 at 12:13 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: LIZARDI FAMILY CHILD CARE
FACILITY NUMBER: 197419417

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1597.543
Licensure Requirements
Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee does not have a functioning carbon monoxide detector which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/21/2023
Plan of Correction
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Licensee will purchase batteries and repair the carbon monoxide detector by 11/21/2023. Licensee will send proof with a picture of the functioning carbon monoxide detectors to LPA email sarah.garcia@dss.ca.gov by 5pm on 11/21/2023. LPA will conduct a Plan of Correction visit to verify the functioning carbon monoxide detector.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Maureen Neal
LICENSING EVALUATOR NAME:Sarah Garcia
LICENSING EVALUATOR SIGNATURE:
DATE: 11/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/20/2023


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Document Has Been Signed on 11/21/2023 08:03 AM - It Cannot Be Edited


Created By: Sarah Garcia On 11/20/2023 at 12:13 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: LIZARDI FAMILY CHILD CARE
FACILITY NUMBER: 197419417

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/20/2023

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 does not have immunization records (measles, pertussis, influenza) in facility records which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/27/2023
Plan of Correction
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Licensee will provide proof of immunization records (measles, influenza, pertussis) to LPA via email sarah.garcia@dss.ca.gov by 5pm on 11/27/2023.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Maureen Neal
LICENSING EVALUATOR NAME:Sarah Garcia
LICENSING EVALUATOR SIGNATURE:
DATE: 11/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/20/2023


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