<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494994
Report Date: 01/14/2022
Date Signed: 01/14/2022 11:07:02 AM

Document Has Been Signed on 01/14/2022 11:07 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:SALL FAMILY CHILD CAREFACILITY NUMBER:
197494994
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
01/14/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Sokhna Sall, Applicant TIME COMPLETED:
11:15 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 01/14/2022 at 08:00 AM, Licensing Program Analyst (LPA) Denise Miranda conducted an announced Pre-Licensing inspection at 12301 Greene Avenue, Los Angeles, CA, 90066. The purpose of the visit is to ensure that health, safety and personal rights, as required by Title 22 Regulations governing California Family Child Care Homes. This is an application for a Small Family Child Care Home. Per application, the facility hours will be from 09:00AM to 4:00 Monday - Friday and Applicant have applied to provide care for children ages (2) years old to 5 years old.

LPA Miranda met with applicant, Sokhna Sall, and was guided on a tour of the indoor and outdoor of the home. LPA did not observe any children in care during this inspection. Per applicant, the residents in the home include applicant and her roommate Priscila Robinson. LPA observed all adults obtained criminal record clearances and are associated to the facility.

The home is a one story dwelling with 3 bedrooms, 1 bathroom, living room, kitchen, front and back yard, detached garage with attached storage room. The primary childcare area of the home is the living room and bedroom#3 converted in nap room. Safe toys and play equipment are observed. The fireplace in the living room is screened and needs to be stable on the floor. LPA inspected the bathroom and did not observe any medications, toxins or cleaning compounds that would pose a risk to children in care. Outdoor play area was observed at the back yard and drive way that which was fully fenced. LPA observed on the drive area debris, and gaps on the cement area that would pose a risk to children in care.

The off-limit areas of the home area: bedroom#1 & 2, kitchen, storage area. LPA observed at the kitchen area two child safety gates making it inaccessible to the children in care. The two child safety gates were placed, one face to the living room and another face to the hallway by the bathroom
SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE: DATE: 01/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/14/2022
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 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SALL FAMILY CHILD CARE
FACILITY NUMBER: 197494994
VISIT DATE: 01/14/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. Hazardous materials in the kitchen and bathroom are inaccessible to children. According to the applicant, there are no weapons or firearms at the home; None were observed by LPA. Per Applicant she does not have any pets and LPA did not observe any pets. Per applicant the garage will be use only for activities, no sleep or eating are allow in the garage area. A declaration was obtained during this inspection.

Applicant was informed that all provider is required to wash hands after every diaper change and to never shake a baby to prevent the Shaken Baby Syndrome. Safe to Sleep Campaign:


https://safetosleep.nichd.nih.gov/materials19-02 CCP Safe Sleep Awareness Campaign
*Only children eating may be in highchairs and that car seats are utilized only for transportation.
*Requirements for fingerprint clearances and associations are discussed with the applicant. The applicant was informed that the presence of adults in the home without Criminal Record Clearance or Exemption will be cited and civil penalty assessed for $100 per day up to $500.00 (5 days) for the 1st offense and up to $3000.00 for the 2nd offense within a 12-month period. The applicant may find additional information and forms on the Department’s website at www.ccld.ca.gov including information on the Live Scan application (LIC 9163). Appointments can be made for Live Scan at 1-800-315-4507.

*LPA Miranda informed applicant how to obtain Quarterly Updates. Applicant was encouraged to read the Child Care Quarterly updates every season, as they come out, to stay informed of any changes or updates to statutes and regulations. The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on childcare licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed:
Phone number: (916) 654-1541
Email Address: childcareadvocatesprogram@dss.ca.gov
SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2022
LIC809 (FAS) - (06/04)
Page: 2 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SALL FAMILY CHILD CARE
FACILITY NUMBER: 197494994
VISIT DATE: 01/14/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
*The applicant was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and licensing within the time frame specified by the regulation.
*The "Notification of Parent's Rights" (PUB394) poster must be posted in an area accessible to parents.
*The applicants were advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. *LPA discussed AB633 and informed applicant that upon receipt of a Type A deficiency, the applicants shall post and provide copies of this licensing report (LIC 809 or LIC 9099 and copy of LIC 9224 to parent/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed.
*Complaints shall be reported by applicant/licensee and/or parents to the complaint hotline at (844) 538-8766 and for general information and incident reporting; contact their local childcare office.

*Commencing September 1, 2016, SB 792, prohibits a person from being employed or volunteering at a childcare facility or family day care if he or she has not been immunized against influenza, pertussis and measles.

*Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Website: www.mandatedreporterca.com Applicants were reminded of their responsibility to report suspected child abuse. *Incidental Medical Services Include: Blood-Glucose Monitoring for Diabetic Children, Administering Inhaled Medication, Administering EpiPen Jr. and EpiPen or other Epinephrine Auto-Injectors, Glucagon Administration, Gastrostomy Tube Care (G-tube care), Insulin Injections Administration, Anti-Seizure Administration, and Carrying out medical orders when the child’s physician has determined that a layperson can be trained and safely carry out the orders. Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department.

SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2022
LIC809 (FAS) - (06/04)
Page: 3 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SALL FAMILY CHILD CARE
FACILITY NUMBER: 197494994
VISIT DATE: 01/14/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
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: http://www.ada.gov/childqanda.html

*New Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment. *Applicant was informed of the following items that must be posted in visual site once licensed: (1) License (2) Emergency Disaster Plan (3) Children’s Roster (4) Parents Rights Poster PUB 394, Personal Rights LIC 613-A Recent regulatory changes were discussed.

LPA Miranda observed the following:


*Fire safety requirements: Fully charged fire extinguisher (Classification: 2A10BC), smoke and carbon monoxide detectors present and operable
*Applicant is currently certified in Pediatric CPR/First Aid and has completed and will expired on 05/20/23, the preventive health and safety training, childhood nutrition training and lead poisoning prevention training
* Mandated reported has completed and will expired on 11/11/2023.
*Toys and equipment are observed and in good repair
* The home is equipped with a first-aid kit: cleansing pads, band aid, bandages, gauze, and a digital thermometer
*All toxins and detergents are in locked/latched cabinets
*Electrical outlets have safety covers installed
**LPA Miranda did not observe bodies of water
The following items were thoroughly discussed with the applicant:
*Requirements for fire drills, earthquake drills, and documentation for both
*The necessity of earthquake safety and drills twice a year
*The role and responsibilities of being a mandated reporter
*Mandatory Forms for the children’s files and provider’s files
*Applicant was referred to LIC 311D (copy of provided): Records to be Maintained at The Facility - Family Child Care Home.
SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2022
LIC809 (FAS) - (06/04)
Page: 4 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SALL FAMILY CHILD CARE
FACILITY NUMBER: 197494994
VISIT DATE: 01/14/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
*Applicant was made aware that it is her responsibility, as well as anyone who assists in providing care, to know Title 22 Regulations.
*The applicant was advised on how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov

*The applicant was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must have the facility’s phone number at all times. If the phone number has changed, licensing must be notified.

*Regulation prohibits the smoking of tobacco on the premises.
*State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category
* All infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome)

Below are forms, found at www.ccld.ca.gov, that applicants shall use for record keeping and posting requirements:

LIC 9148 Earthquake Preparedness Checklist


PUB 394 Notification of Parent's Rights Poster 12/06 (issued & discussed)
LIC999A Facility Sketch (floor plan and yard)
LIC610A Emergency Disaster Plan for FCCH
LIC 9040 Child Care Facility Roster (Retain for 3 years) most recent must be posted
LIC 627 Consent for Medical Treatment
LIC 702 Child's Preadmission Health History-Parents Report
LIC 995 Notification of Parent's Rights
LIC 613-A Personal Rights
LIC 700 Identification and Emergency Information
LIC 282 Affidavit Regarding Liability for Family Child Care Homes
LIC 9224 Acknowledgement of Receipt of Licensing Reports 12/06 (issued & discussed)
SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2022
LIC809 (FAS) - (06/04)
Page: 5 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SALL FAMILY CHILD CARE
FACILITY NUMBER: 197494994
VISIT DATE: 01/14/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Title 22, Division 12 Regulations (access website: http://ccld.ca.gov).

Due to the COVID-19 pandemic and local and state ordinances, applicant was directed to the CCLD.CA.GOV website for important updates and PINS.

The following is needed priory to licensure:

  • Document shall be posted it – LIC610A Emergency Disaster, LIC9148 Earthquake Preparedness Checklist , PUB394 Notification of Parents Rights and LIC999A Facility Sketch (Floor plan and yard)
  • Drive way and back yard – gaps and debris were found on the cement area and need to be cover.
  • Bedroom #2 and #3 – Applicant will place a door knob safety cover or latch on the doors.
  • Fireplace – Fireplace screen needs to be stable on the floor.
  • At least one Playpen or crib
  • Applicant needs to revise and submit the IMS plan.

Applicant agreed to submit all plan of corrections via email to Licensing Program Analyst (LPA) Miranda no later than 01/28/2022.

A copy of this report and all other Licensing reports must be made available to the public for 3 years.

SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2022
LIC809 (FAS) - (06/04)
Page: 6 of 6