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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494930
Report Date: 10/23/2024
Date Signed: 10/23/2024 11:58:14 AM

Document Has Been Signed on 10/23/2024 11:58 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:GREEN FAMILY CHILD CAREFACILITY NUMBER:
197494930
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
10/23/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:15 AM
MET WITH:MONICA GREEN, LICENSEETIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On 10/23/2024, Licensing Program Analyst (LPA) Lisa Clayton made an unannounced visit to the Green Family Child Care Home to conduct the Required 3-year inspection. LPA was greeted by Licensee Monica Green. LPA Clayton observed 6 children being supervised and cared for appropriately by the licensee and her fingerprint cleared husband. Per Licensee the hours of operation are Monday through Thursday, 9am – 4:00pm, Friday 9am – 1pm. Licensee provides am snack, lunch and afternoon snack, milk and water.

LPA Clayton toured the home inside and outside for a Health and Safety inspection. The home has working telephone and LPA Clayton confirmed the number is (310) 755-1581.

LPA Clayton confirmed that the single-family home consists of the following: living room, dining room, kitchen, 3 bedrooms, 2 bathrooms, fenced back yard, and fenced front yard and detached garage.

The ON LIMIT AREAS are as follows: living room, dining room (classroom), bedroom #3 (nap room), bathroom #2 and the fenced backyard. The ISOLATION AREA will be in the napping room.

The OFF-LIMIT AREAS are as follows: bedroom #1, bedroom #2, bathroom #1, kitchen, laundry room, detached garage all of which are inaccessible to children in care by closed and/or locked doors and visual supervision.

Furniture and equipment are in good condition and free of sharp, loose, or pointed parts.


SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Lisa Clayton
LICENSING EVALUATOR SIGNATURE: DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/23/2024
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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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: GREEN FAMILY CHILD CARE
FACILITY NUMBER: 197494930
VISIT DATE: 10/23/2024
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There are no pools, ponds or any other bodies of water on the premises. LPA Clayton observed a firearm stored in the closet in bedroom #1. LPA Clayton observed it to be locked in an appropriate lock box and the ammunition is stored separately.

The home has a fully charged 3A40BC fire extinguisher in the laundry room, a working carbon monoxide detector in the kitchen and a working smoke detector in the classroom (dining room).

LPA Clayton reviewed 6 children’s files and observed them to be in compliance as they contain current contact information for authorized representatives and/or relatives who can assume responsibility for the child, immunization records, and signed Parent’s Rights.

LPA Clayton reviewed a facility roster and an up to date disaster drill log.

Both licensee and her husband (assistant) have current CPR/First Aid certificate that expire in 2025 and Mandated Reporter training that expire 2025. Licensee and staff have immunizations records and are in compliance with immunizations required for childcare providers.

LPA Clayton observed Sleep Logs for children in care under 2 years of age. LPA Clayton reminded Licensee of the Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and­resources/safesleep as an additional resource. LPA Clayton informed applicant of the importance of checking for recalled infant devices on the United States Consumer Products 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 the purchased equipment.

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Lisa Clayton
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
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: GREEN FAMILY CHILD CARE
FACILITY NUMBER: 197494930
VISIT DATE: 10/23/2024
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LPA reminded Licensee of the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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


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

Per Title 22 Regulations and Health and Safety Codes, no deficiencies were cited today.

An exit interview was conducted, a copy of this report was read and provided to licensee Monica and will be made available to the public upon request.

LPA Clayton posted a Notice of Site Visit which is required to be posted for 30 days.

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Lisa Clayton
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
LIC809 (FAS) - (06/04)
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