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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494870
Report Date: 11/20/2024
Date Signed: 11/21/2024 09:10:40 AM

Document Has Been Signed on 11/21/2024 09:10 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:AYALA FAMILY CHILD CAREFACILITY NUMBER:
197494870
ADMINISTRATOR/
DIRECTOR:		JACQUELINE AYALAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 897-7008
CITY:CULVER CITYSTATE: CAZIP CODE:
90232
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
11/20/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:10 PM
MET WITH:Jacqueline AyalaTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On 11/20/24 Licensing Program Analyst (LPA) Ranita Richmond and Brittany Lovest arrived at the above named home to conduct a Plan of Correction visit and was met by Licensee Jacqueline Ayala. LPA observed 12 children in care being supervised and cared for by licensee and 1 fingerprint cleared assistant.

On 11/14/2024, Licensee was cited for the following:
1. Licensee will ensure that current mandated reporter training is completed for all employees.
2. Licensee will ensure storage areas for poisons, firearms and other dangerous weapons shall be locked.
3. Licensee will ensure that all detergents, cleaning compounds, etc. are inaccessible to children in care.
4. Licensee will ensure that all off limits areas are secured and made inaccessible to children in care by locked doors.

During visit LPA Richmond and Lovest observed the following:
1. LPAs observed a lock on the bathroom cabinet making cleaning products and detergents inaccessible to children in care.
2. LPAs observed a certificate that shows on 11/19/24, S2 completed mandated reporter training.

2 of 4 Citations issued on 11/14/2024 has been cleared.

An exit interview was conducted. A copy of this report, notice of site visit, deficiencies clearance letters were discussed and provided to Licensee.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Ranita Richmond
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2024
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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