198005835-7-29-2025-54-CC-ACAN-DK2RKK-20250729130540

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198005835
Report Date: 07/29/2025
Date Signed: 07/29/2025 01:06:03 PM

Document Has Been Signed on 07/29/2025 01:06 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	CONNER-LEWIS FAMILY CHILD CARE		FACILITY NUMBER:	198005835
ADMINISTRATOR/ DIRECTOR:	CONNER-LEWIS, MONIQUE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(213) 595-2870
CITY:	CARSON	STATE: CA	ZIP CODE:	90746
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 7	CENSUS: 4	DATE:	07/29/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:58 AM
MET WITH:	Licensee Monique Conner-Lewis,		TIME VISIT/ INSPECTION COMPLETED:	01:10 PM

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	Licensing Program Analyst (LPA) Ashley Calderon conducted an unannounced annual / random inspection at the above facility on 7/29/25 at 09:58AM. LPA met with Staff Assistant Desari Lewis who allowed LPA entrance into the facility. LPA upon entrance met with Licensee Monique Conner-Lewis who LPA disclosed the purpose of today's visit. LPA upon entrance observed (4) children in care (2 were infants). Individuals residing in the home, employee and/or volunteers have been discussed and noted. All adults present in the home are fingerprinted cleared. Facility capacity is in compliance for a Large Family Child Care Home- Capacity of 14. Hours of operation are Mon-Fri 7:00 AM - 6:15PM. This is a 2 story home which consists of 3 bedrooms, 2 1/2 bathroom, kitchen, dining room, living room, family room (fireplace locked), garage and backyard (fenced). On limit: Living room, bathroom near the living room, dining room, kitchen area , family room and backyard as noted in the facility sketch. The LPA toured all areas that would be used by children during the visit. Off limit: all upstairs bedrooms, upstairs bathrooms, and garage. There are weapons, firearms on the premises in off limit area. LPA observed the firearms to be securely locked within Title 22 regulations. Currently, no Ammunition stored in the home. LPA informed gun holder and Licensee when Ammunition is brought into the home must be separated from the firearm. (Pg 1/ Cont...)

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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Document Has Been Signed on 07/29/2025 01:06 PM - It Cannot Be Edited

Created By: Ashley Calderon On 07/29/2025 at 11:41 AM

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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CONNER-LEWIS FAMILY CHILD CARE	FACILITY NUMBER: 198005835
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/29/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review Staff Assistant ( Staff #2) file did not have Mandated reporter training, Licensee stated Staff #3 certficate expired, the licensee did not comply with the section cited above in [1] out of [2] Staff assistant mandated reporter which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/15/2025
	Plan of Correction
1 2 3 4	Staff Assistant ( Staff #2) will take Child Care Provider Mandated Reporter Training and will send certificate to LPA Calderon .

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Denise Gibbs
NAME OF LICENSING PROGRAM MANAGER:

	Ashley Calderon
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2025

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CONNER-LEWIS FAMILY CHILD CARE	FACILITY NUMBER: 198005835
	VISIT DATE: 07/29/2025

NARRATIVE

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All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection:

LPA reviewed required posted documentation's located by the stairs. Prominent Posted was observed: Facility License and Publication (PUB) 394- Notification of Parent Rights. LPA printed out Licensing Form (LIC) 9148- Earthquake Preparedness form. Facility records were reviewed for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster/Fire drill log, last drill conducted on 06/18/2025.

Kitchen was observed, chemicals and cleaning compounds are found inaccessible with a baby latch in place under the sink cabinet. Knives are placed on the kitchen counter towards the very back , inaccessible to children. LPA informed Licensee to observe the scenario when taller and older children are present in the home place knives in a high to reach cabinet for inaccessibility. Per Licensee, poisons are stored in locked garage. Carbon Monoxide is interconnected with the Smoke Alarm detector, during visit it was tested and found operable. Fire extinguisher was observed with service tag 6/6/2025. Licensee has a pet cat, kept in off limit up stairs area(s) when children are present. Facility has stairs and at the bottom of the stairs there is a baby gate in place. Per Licensee, currently no children on medication. There is a secured fireplace in the family room. Family room is used for infants. Infant napping equipment in family room observed (2) play yards. LPA gave consultation on mattress must be firm with fitted sheets for cribs and play yards.

Outdoor was observed, there is age appropriate toys for the children in care. No bodies of water was observed.

LPA reviewed required documentation's for Licensee, Staff Assistants and children in care. Children records were reviewed children had Emergency Information form, Immunization records , Affidavit regarding Liability Insurance- LIC282 and additional documents required by Title 22. Licensee Mandated Reporter (M.R) expires 4/27' and Pediatric 1st aid and cpr expires 1/27'. Staff Assistant (Staff #2- S2) Pediatric 1st aid and cpr expires- 1/2027 and Mandated Reporter was not provided, Per Licensee informed LPA Calderon S2 needs to retake training and certificate has expired, deficiency cited. Staff #3- S3 M.R expires- 5/19/25 and Per Licensee does not stay alone with children therefore does not require Pediatric first aid/cpr.

(Pg 2/Cont..)

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2025

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CONNER-LEWIS FAMILY CHILD CARE	FACILITY NUMBER: 198005835
	VISIT DATE: 07/29/2025

NARRATIVE

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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, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. A Notice of Site visit was given and must remain posted for 30 days. Based on today’s visit, Per California Code of Regulations Title 22, the facility was given (1) deficiency, Type B, provided on LIC 809-D. An exit interview was conducted with Licensee Monique Connor Lewis. (Pg3 /End of Report)

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2025

LIC809 (FAS) - (06/04)

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