197494524-11-27-2023-30-CC-SGAA-CXYTJ3-20231127134540

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494524
Report Date: 11/27/2023
Date Signed: 11/27/2023 01:45:53 PM

Document Has Been Signed on 11/27/2023 01:45 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	PEREZ FAMILY CHILD CARE		FACILITY NUMBER:	197494524
ADMINISTRATOR:	PEREZ, JOHANA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 304-6887
CITY:	WILMINGTON	STATE: CA	ZIP CODE:	90744
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 4	DATE:	11/27/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Licensee, Johana Perez		TIME COMPLETED:	02:00 PM

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On 11/27/2023 at 11:35am, Licensing Program Analyst (LPA), Sarah Garcia conducted an unannounced Annual Required Inspection at the above-mentioned facility. LPA was greeted by licensee, Johana Perez. Present during time of inspection was licensee's daughter.

During the initial inspection, LPA observed 4 children in care.

Facility operates Sunday through Saturday, 24 hours, 7 days a week. Currently licensee is available to care for children 2 years old to 11 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 single-family home with 3 bedrooms and 2 bathrooms, living room, kitchen area, outdoor area, and garage. LPA observed the parent board with all the necessary posting outside. Licensee confirmed the following areas are designated for day care only: master bedroom, bathroom #1, bedroom #2, and outdoor area. The bathroom #1 that children use is located inside the master bedroom. LPA inspected the bathroom #1 and observed a safety latch on the mirror cabinet to ensure medications, toxins or cleaning compounds are inaccessible to the children in care. LPA observed the cabinet under the sink in bathroom #1 to be bolted and locked to ensure inaccessible to children. LPA observed a safety gate at the entrance of the master bedroom. LPA inspected the master bedroom and observed the space to be clean and orderly. LPA observed age appropriate toys, materials, and child size tables and chairs. LPA inspected the storage room in the master bedroom to have mats to utilize for sleeping. The storage room has a door knob cover to ensure inaccessible to children. LPA observed a safety gate at the entrance of bedroom #2. LPA inspected the bedroom #2 and observed age-appropriate toys and children's cubbies. LPA observed the wall heater to be properly barricaded. Per licensee, the wall heater is non-operational. LPA inspected the living room and observed the space to be clean and orderly. LPA inspected the kitchen and observed the knives and sharp objects to be out of reach to the children. LPA observed a safety latch under the kitchen sink cabinet to ensure all poisons, detergents, cleaning compounds, medications and other items which can pose a risk to children in care made inaccessible. LPA observed safety latches on all the lower cabinets in the kitchen.

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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 11/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023

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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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: PEREZ FAMILY CHILD CARE	FACILITY NUMBER: 197494524
	VISIT DATE: 11/27/2023

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The following areas are OFF LIMITS to the children in care: Bedroom #3, kitchen, and garage. All the off-limits areas have door knob covers to ensure inaccessible to children in care.

LPA inspected the outdoor area and observed safe toys and play equipment. Outdoor area is clean and free from debris. Outdoor area has wood chips for cushioning. Per the licensee, there are no weapons or firearms on premises. There are no pools or bodies of water on the premises. Licensee has 4 dogs and 3 guinea pigs. The 4 dogs are kept locked on the side of the house. The 4 guinea pigs are kept in a cage in the master bedroom. Per the licensee, parents are aware of pets in the home.

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, made inaccessible when children are present.

LPA observed licensee test the carbon monoxide and smoke detector in the home. One charged fire extinguisher was observed, 3:A40:BC. Licensee confirmed program provides meals and snacks. LPA discussed the importance of maintaining a system where allergies and food restrictions are noted. When a child is ill, the licensee will isolate them in the living room. 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 working telephone service and LPA confirmed the phone number (323) 304-6887.

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 4 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: 11/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: PEREZ FAMILY CHILD CARE	FACILITY NUMBER: 197494524
	VISIT DATE: 11/27/2023

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LPA reviewed Licensee’s Pediatric CPR and First certification and observed certification with an expiration date of 11/2025. Licensee’s Mandated Reporter was available for review with an expiration date of 05/2024.

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, Johana Perez, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

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

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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 11/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: PEREZ FAMILY CHILD CARE	FACILITY NUMBER: 197494524
	VISIT DATE: 11/27/2023

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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: 11/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023

LIC809 (FAS) - (06/04)

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