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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197403031
Report Date: 02/08/2023
Date Signed: 02/08/2023 04:40:57 PM


Document Has Been Signed on 02/08/2023 04:40 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:EPPS FAMILY DAY CAREFACILITY NUMBER:
197403031
ADMINISTRATOR:EPPS, ANDREAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 937-7325
CITY:LOS ANGELESSTATE: CAZIP CODE:
90016
CAPACITY:14CENSUS: 7DATE:
02/08/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:19 AM
MET WITH:Andrea Epps, LicenseeTIME COMPLETED:
04:47 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 02/28/23 at 9:30 AM, Antonio Almanza, Licensing Program Analyst (LPA), conducted an unannounced Annual Required Inspection and met with Andrea Epps, Licensee. Also present were Staff #1 (S1). Days and hours of operation are Monday through Friday, 7:30 PM to 5:30 PM. The home has working telephone service and LPA confirmed the phone number is 323-937-7325. During today’s visit there are 7 children in care.

The home is a 2 story 5 bedroom (located upstairs), 3 bathroom home (one toilet and one sink downstairs) with kitchen, service porch (with laundry area), living room, dining room, library room, and a breakfast room. The garage has been converted into a 2 story ADU (2 bedroom/2 bathroom) with separate child care room (with bathroom). Licensee is reporting that Staff 1 resides in the ADU. Licensee did not notify the Department of the of the ADU construction that took place and does not have Certificate of Occupancy.

Facility sketch from the file was reviewed and Licensee and S1 are reporting that primary child care is conducted in the ADU. Licensee is stating that children use the living room and breakfast room for sleeping. Licensee is reporting that the second floor, library and ADU dwelling are off limits to children in care. There is a child safety gate that makes the stairs to the second floor inaccessible. There is fireplace with screen in the living room and will not be in use during daycare hours.

There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible to children in care.

There is a working smoke detector, carbon monoxide detector in the breakfast room, adequate heating and ventilation for safety and comfort, and First Aid Kit. LPA observed a Fire Extinguisher in the laundry room area that was serviced on 01/24/2022.

There are currently 2 infants in care. LPA discussed Safe Sleep Regulations with licensee. There is one crib or play yard for each infant in care, cribs and play yards are kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Pg 1 of 4

SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:
DATE: 02/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/08/2023
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 8


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: EPPS FAMILY DAY CARE
FACILITY NUMBER: 197403031
VISIT DATE: 02/08/2023
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
Infants are not swaddled while in care. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

Licensee was reminded that children in care are supervised at all times and children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. There is a grass area, large shade tree with a raised deck (5 stairs) and concrete area for active play.

Licensee does not have a current roster of the children or fire/disaster drill completed and documented within the last 6 months. Licensee and Staff1 Mandated Reporter Training was completed on 01/19/22. Licensee and Staff1 pediatric CPR/First Aid expires on 01/26/22. A review of records indicates that Staff 1 does not have immunization records on file for influenza, pertussis and measles. All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

Licensee does not have required posting for the Familiy Child Care License in an area accessible to parents.

Incidental Medical Services (IMS) are currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.



To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process. pg 2 of 4
SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 02/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023
LIC809 (FAS) - (06/04)
Page: 2 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: EPPS FAMILY DAY CARE
FACILITY NUMBER: 197403031
VISIT DATE: 02/08/2023
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, 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.

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 [facility representative] 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. LPA provided Licensee with PIN 20-24-CCP.

The following was discussed with the applicant:
- Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. The family day care home shall maintain documentation of the required immunization's or exemptions from immunization, as set forth in this section, in the person’s personnel record that is maintained by the family day care home.
- A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.
- The fire extinguisher type 2A-10BC must be serviced annually. Smoke and carbon monoxide detectors should be checked, and batteries should be replaced.


- Changes should be reported the to the Department as soon as they occur such as construction and remodeling.
- Fire and safety drills must be performed every six months and documented for review by the Department.
- Children and Staff records must be maintained and updated as needed and must be available for review by the Department.
Pg 3 of 4
SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 02/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023
LIC809 (FAS) - (06/04)
Page: 3 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: EPPS FAMILY DAY CARE
FACILITY NUMBER: 197403031
VISIT DATE: 02/08/2023
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
-Facility License, Notification of Parent’s Rights Poster PUB394, and Earthquick Preparedness LIC9148 are required to be posted in a prominent, publicly accessible area at the facility.

*** Licensee was instructed to cease the use of the ADU, until documentation for the ADU has been received, and the Department can verify that it is safe for use by children in care.

*** Licensee was instructed to submit an updated facility sketch for the indoor and outdoor space.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, Type B deficiencies are being cited (see next page, 809 D). Licensee was provided a copy of appeal rights.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Andrea Epps, licensee.

LPA left the facility premises at 11:05 AM and returned at 2:59 PM.

Pg 4 of 4

SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 02/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023
LIC809 (FAS) - (06/04)
Page: 4 of 8
Document Has Been Signed on 02/08/2023 04:40 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: EPPS FAMILY DAY CARE
FACILITY NUMBER: 197403031

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/08/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)1
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. 1. The licensee shall document the drills, including the date and time of each drill. This documentation shall kept at the family child care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in that there is no documentation for Drills conducted within the last 6 months, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/08/2023
Plan of Correction
1
2
3
4
Licensee will complete Drill Log and provide LPA a copy.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:
DATE: 02/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/08/2023
LIC809 (FAS) - (06/04)
Page: 5 of 8


Document Has Been Signed on 02/08/2023 04:40 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: EPPS FAMILY DAY CARE
FACILITY NUMBER: 197403031

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/08/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the licensee did not comply with the section cited above in that staff immunization records are not on file, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/08/2023
Plan of Correction
1
2
3
4
License will get the required records and provide LPA a copy.
Type B
Section Cited
CCR
102416.1(a)
Personnel Records
(a) Personnel records shall be maintained on each employee and shall contain the following information:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the licensee did not comply with the section cited above in that the Licensee does not have required staff records on file, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/08/2023
Plan of Correction
1
2
3
4
License will get the required records and provide LPA a copy.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:
DATE: 02/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/08/2023
LIC809 (FAS) - (06/04)
Page: 6 of 8


Document Has Been Signed on 02/08/2023 04:40 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: EPPS FAMILY DAY CARE
FACILITY NUMBER: 197403031

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/08/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.3(a)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview and record review, the licensee did not comply with the section cited above in that the licensee did not notify the Department of the ADU construction, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/08/2023
Plan of Correction
1
2
3
4
Licensee will provide copy of certificate of occupancy.
Type B
Section Cited
CCR
102419(b)
Admission Procedures and Authorized Representatives Rights
(b) The licensee shall post the PUB 394 (8/02), Family Child Care Home Notification of Parents’ Rights Poster in a prominent, publicly accessible area in the family child care home at all times children are in care.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview and record review, the licensee did not comply with the section cited above in that the facility does not have required postings in a prominent area accessible to parents, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/08/2023
Plan of Correction
1
2
3
4
Licensee will put required postings in a locations accessible to parents.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:
DATE: 02/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/08/2023
LIC809 (FAS) - (06/04)
Page: 7 of 8


Document Has Been Signed on 02/08/2023 04:40 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: EPPS FAMILY DAY CARE
FACILITY NUMBER: 197403031

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/08/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in that the facility does not have a current Roster on file, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/08/2023
Plan of Correction
1
2
3
4
Facility will complete and provide a Roster to LPA.
Type B
Section Cited
CCR
102423(a)(2)
Personal Rights
(a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview and record review, the licensee did not comply with the section cited above in that the ADU room is being used for day care children but LPA is unable to verify if it has been aproved by the city and is safe, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/08/2023
Plan of Correction
1
2
3
4
Licensee will not use ADU room until the Deparmtnet approves the use of this room. And Licensee will provide Certificate of Occupancy.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:
DATE: 02/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/08/2023
LIC809 (FAS) - (06/04)
Page: 8 of 8