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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400907
Report Date: 12/05/2025
Date Signed: 12/05/2025 03:38:12 PM

Document Has Been Signed on 12/05/2025 03:38 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:DICKERSON FAMILY CHILD CAREFACILITY NUMBER:
198400907
ADMINISTRATOR/
DIRECTOR:		DICKERSON, ANITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(424) 200-8647
CITY:CARSONSTATE: CAZIP CODE:
90746
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
12/05/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:56 PM
MET WITH:Licensee - Anita DickersonTIME VISIT/
INSPECTION COMPLETED:
03:52 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
On December 05, 2025 at 12:56Pm; Licensing Program Analyst (LPA) Ashley Calderon conducted an unannounced annual/random inspection visit. LPA met with Licensee Anita Dickerson who allowed LPA entrance into the facility. LPA disclosed the purpose of the inspection.

Per Licensee, hours of operation are Monday through Friday, 6:30am to 6:00pm. Per Licensee, overnight care and weekend care can be provided if needed and will notify licensing if any changes. Licensee states she cares for children 0 months to 13 years of age. This is a single story home consisting 3 bedrooms, 2 bathrooms, kitchen, dining area, living room, garage, office, backyard and front yard. Areas used by children include: Living room, dining area, kitchen, bathroom, office room and part of back yard. Areas off limits include: 3 bedrooms, 1 bathroom, garage and right side/back yard (gated).

Upon arrival LPA Calderon observed (4) children in care (2 were infants) and three individuals present who were noted and all are fingerprinted cleared. LPA observed Licensee and assistant staff (Licensee's family member) caring for children. (1) infant observed napping during arrival, baby had a pacifier with no attachment and crib was clear of any risk.

LPA conducted a guided tour of the facility alongside Licensee A.Dickerson. The home was inspected for safety, cleanliness, telephone service (via cellphone), heating and ventilation (central), detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. Per Licensee, one child is on medication and medication is kept in a locked box in licensee off limit locked personal bedroom. Medication was reviewed during today's visit, observed to be over the counter and per Licensee it is over the counter medication and LPA reviewed medication found in original container and not expired, LPA reviewed child on medication file and this child arrived after for after school care. Required postages to post in a prominent area was observed by the entrance door of the home.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/05/2025
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 4
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)
Page: 2 of 4
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: DICKERSON FAMILY CHILD CARE
FACILITY NUMBER: 198400907
VISIT DATE: 12/05/2025
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
LPA observed knives are located in high cabinet above the oven in the kitchen. Cleaning products are made inaccessible in high shelf cabinet near the sink. Licensee stated provides food for children in care. The home is observed to be clean and orderly, there are outlet covers throughout the home. Smoke detector and carbon monoxide detector were observed and tested, interconnected. Per Licensee, fire alarm system is through the American District Telegraph (ADT) system. Per Licensee, does a test monthly and contacts ADT before doing testing. LPA observed Fire Alarm pull system, per Licensee interconnected with Carson Fire Department. LPA observed Fire and Earthquake Drill record documentation drill date: 11/02/24. The required (2A10BC) fire extinguisher was observed in the kitchen, LPA observed extinguisher was charged and had a service date inspection tag dated 11/02/2025. Per Licensee, the isolation area for a sick child waiting to be picked up will be in the isolation office room. The office room does have a door that leads to the off limit garage, LPA observed a chime alarm on the door and two locks ( that can be opened from the inside) therefore LPA informed Licensee recommends installing a latch to provide better inaccessibility. LPA observed (2) cribs for infant in care placed in the living room with firm mattress and fitted sheets. The off limit rooms are kept locked and have baby safety knobs. LPA observed age appropriate toys and learning materials inside and outside in the back yard. No bodies of water were observed at the facility. Per Licensee, stated no poisons stored in the home. Licensee stated additional cleaning supplies are stored in the locked shed. LPA observed locked shed located in the backyard. Per Licensee, there are no weapons or firearms in the facility, none were observed by LPA Calderon during the tour. The facility has a dog that was observed in the back / side yard that is off limit and is gated off.

LPA reviewed records. LPA reviewed Licensee and staff assistant record. Licensee Mandated Reporter certificate exp 6/18/26 and Pediatric CPR and First Aid expires 9/27'. Staff assistant during visit went to pick up after school children, staff assistant file was reviewed and is full qualified to care for children alone. Licensees temporary absent may not exceed 20% of hours of operations. LPA reviewed records for (5) children, (4) whom were present in the home during today's visit, and record for (1) child who is taking medication at the facility, total (5) files. Infants had 15 min sleep log due to their ages they do no required the LIC9227 Infant Individual Sleep Plan as they are not in the 0-12 month age group. LPA Calderon reviewed LIC282 Affidavit Regarding Liability Insurance for child records, each child had the form in their files due to home does not carry liability insurance. LPA reviewed current Child Roster. LPA interviewed Licensee. At approx 2:44pm, (5) children after-school children arrived at the day care, making census 9. At approx. 2:51pm individual who resides in the home arrived at the home, who is fingerprinted cleared. At 3:10 pm 1 additional child arrived making census 10.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: DICKERSON FAMILY CHILD CARE
FACILITY NUMBER: 198400907
VISIT DATE: 12/05/2025
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
  • 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 child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
  • During the exit interview, the Licensee Anita Dickerson, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
  • 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.


During today's visit according to California Code of Regulations Title 22, the facility was found in compliance and not citations were given.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee Anita Dickerson.
NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025
LIC809 (FAS) - (06/04)
Page: 4 of 4