198020093-1-27-2026-54-CC-ACAR-DQQT9P-20260127133216

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020093
Report Date: 01/23/2026
Date Signed: 01/27/2026 01:32:55 PM

Document Has Been Signed on 01/27/2026 01:32 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:	ALLEN FAMILY CHILD CARE		FACILITY NUMBER:	198020093
ADMINISTRATOR/ DIRECTOR:	KEISHA M. ALLEN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 710-7324
CITY:	NORWALK	STATE: CA	ZIP CODE:	90650
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 13	CENSUS: 1	DATE:	01/23/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:58 PM
MET WITH:	Keisha Allen		TIME VISIT/ INSPECTION COMPLETED:	04:00 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	ANNUAL/RANDOM INSPECTION CONDUCTED On January 23, 2026, at 12:58 PM, Licensing Program Analyst (LPA) A. Carter conducted an Unannounced Annual / Random Inspection and met with Keisha Allen, the licensee. LPA disclosed the purpose of the inspection and was granted entry into the facility. LPA was taken on a guided tour of the facility and provided licensee with a copy of the Facility Entrance Checklist. Adults in the home were discussed, and all have criminal record clearance. At the initial start of today’s inspection there was 1 infant in care and currently 12 children are enrolled. The children's roster is current and was reviewed by LPA. The facility’s hours of operation are 24 hours Monday through Thursday and Friday from 3:00 AM to 10:45 PM. Licensee was reminded that care cannot be provided for any one child for a continuous 24 hour period. Licensee provides transportation and overnight care as needed. This is a single story home which consists of (3) bedrooms and (2) bathroom. Areas accessible to children are: daycare room, one (1) bathroom, living room, kitchen, family room, and backyard. Areas off-limits to children and parents are: (3) bedrooms, one bathroom, and attached garage. LPA observed a safety gate separating areas used by children and off-limits making them inaccessible to children in care. The licensee does understand that licensing staff may have access to off-limit areas during inspection visit if necessary. All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. The facility has central air and heating and maintains telephone service via landline and cell phone. Report Continues- Page 1 of 5

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Andrea Carter
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2026

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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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: ALLEN FAMILY CHILD CARE	FACILITY NUMBER: 198020093
	VISIT DATE: 01/23/2026

NARRATIVE

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Facility License, Emergency Disaster Plan, and Parents’ Rights were posted and observed at time of inspection. Disaster drill log was also available during today’s inspection, with last disaster drill conducted on 01/06/26. LPA observed the required 2A10BC fire extinguisher with service tag dated 10/6/25. Smoke and carbon monoxide detectors are in operable condition at time of inspection. First Aid kit is mounted on the wall in the main care area observed by LPA.

At 1:10 PM, LPA observed age appropriate toys, and other age-appropriate material available such as learning charts, circle time area, toddler size tables and chairs, books for reading, blocks, play kitchen all free of loose and sharp parts. LPA observed 2 cribs in the day care room not blocking entrances or exits. Napping cots are available and there is a changing table against the wall. and adjacent sink. Children use the bathroom located in the hallway. LPA observed bathroom to have operable toilet/sink and adequate toileting supplies for children in care. All cabinets under the sink are secured with safety latches. No hazards observed. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible stored in off-limit areas of the home. Detergents and cleaning supplies are stored in the off-limits garage, and personal medications are stored in a lock box in the refrigerator inaccessible to children in care. The Licensee states that there are no poisons in the home and understands that poisons must be locked.
Per licensee, the children have access to the backyard for outside play. LPA observed age appropriate toys such as slides, and games. LPA observed yard has adequate perimeter fencing through-out the property. Play area is free of loose and sharp articles or objects and all trees, shrubs, and plants are maintained. LPA did not observe a pool, spa, or any other bodies of water on the premises.

· Beginning at 2:10 PM, Licensee left facility to pick up day care children from school. LPA continued inspection report inside vehicle. Licensee returned to the facility at 3:32 PM with 6 school-age children.

Food is provided for children in care. LPA reminded licensee that any food brought from the children’s homes shall be labeled with child’s name and properly stored or refrigerated. Per the Licensee, there are no children enrolled that requires medication administered or any children with allergies. The isolation area for sick children waiting to be picked up is in the living room, supervised and away from the other children in care.

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Andrea Carter
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2026

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

FACILITY NAME: ALLEN FAMILY CHILD CARE	FACILITY NUMBER: 198020093
	VISIT DATE: 01/23/2026

NARRATIVE

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Infant Care: Currently, there are (2) infants under 12 months enrolled. LPA observed sleep log for enrolled infants. The Licensee was advised that infants shall not be swaddled in care. Car seats shall only be used for transportation purposes and shall not be used for sleeping. LPA discussed the Safe sleep regulation, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0 -24 months.
—Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization's Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, and documentation of 15-minute Infant Sleep Check (0-24 months).

Staff records were reviewed for approved Pediatric First Aid & CPR certification, Criminal Record Statement, Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate.
—CPR Card valid until: 10/06/27
—Mandated Reporter AB1207 valid until: 09/04/27

The following was discussed:
· Rooms that are off-limits need to be made inaccessible during operating hours. NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers, or any other item that falls into that category are permitted in the facility. Effective January 1, 2010, Licensees of family childcare homes are required to ensure that at least one staff member with current training in Pediatric First Aid & CPR is on site at all times when children are present.
· Reporting Requirements: Changes should be reported to the Department as soon as they occur, such as construction, remodeling, telephone number changes and/or if you move from your home. Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.

During the inspection, children present were observed to be treated with dignity and respect, observed to be receiving safe, healthful, and comfortable accommodations, furnishings, and equipment, and free from corporal and/or unusual punishment.

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Andrea Carter
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2026

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

FACILITY NAME: ALLEN FAMILY CHILD CARE	FACILITY NUMBER: 198020093
	VISIT DATE: 01/23/2026

NARRATIVE

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The Licensee confirms there are no pets in the home, there are no smokers in the home, there are no weapons or firearms in the home, and there are no pools, spas or other bodies of water on the premises.

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 and removing any 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 childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Andrea Carter
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2026

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

FACILITY NAME: ALLEN FAMILY CHILD CARE	FACILITY NUMBER: 198020093
	VISIT DATE: 01/23/2026

NARRATIVE

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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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

No deficiencies will be cited today 01/23/26. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Licensee Keisha Allen.
Appeal Rights Given

...............................Report End Page 5 of 5...............................

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Andrea Carter
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2026

LIC809 (FAS) - (06/04)

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