197408252-3-8-2024-30-CC-RRID-D36M7B-20240308082115

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197408252
Report Date: 03/07/2024
Date Signed: 03/08/2024 08:21:36 AM

Document Has Been Signed on 03/08/2024 08:21 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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	LEWIS FAMILY CHILD CARE		FACILITY NUMBER:	197408252
ADMINISTRATOR:	CARRIE L. LEWIS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 777-2302
CITY:	INGLEWOOD	STATE: CA	ZIP CODE:	90305
CAPACITY:	14	CENSUS: 1	DATE:	03/07/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Carrie Lewis		TIME COMPLETED:	02:00 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	On 3/7/2024, Licensing Program Analyst (LPA) Ranita Richmond conducted an unannounced visit to the above-named Home to conduct the Required 3-year Annual Inspection. LPA was greeted by Licensee Carrie Lewis. LPA Richmond observed 1 toddler in care, being supervised and cared for appropriately by licensee. Hours of operation are Monday through Friday, 6:00am – 6:00pm. Licensee provides snacks and water. LPA Richmond toured the home inside and outside for a Health and Safety inspection. LPA Richmond confirmed that the home consists of living room, dining room, family room, kitchen, 2 bedrooms, 3 bathrooms, attached garage, and fenced backyard. The ON LIMIT AREAS are as follows: family room (Main day care area/napping room), dining room (eating area), bathroom #1, and fenced back yard. The OFF-LIMIT AREAS are as follows: kitchen, attached garage, living room, bedroom #1, bedroom #2, bathroom #2 and bathroom #3 all of which are inaccessible to children in care by safety gates, closed and/or locked doors and visual supervision. Licensee is aware that the children must nap and have meals in the home. LPA Richmond observed a fully charged 2A:10B:C Fire Extinguisher in the kitchen, a working smoke detector and carbon monoxide detector in the main daycare area (family room). There are no firearms or ammunition on the premises. There are no pools, ponds or other bodies of water on the premises.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Ranita Richmond	TELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

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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Document Has Been Signed on 03/08/2024 08:21 AM - 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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: LEWIS FAMILY CHILD CARE	FACILITY NUMBER: 197408252
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/07/2024

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 observation, interview, record review, the licensee did not comply with the section cited above, licensee does not possess a current updated mandated reporter training which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/14/2024
	Plan of Correction
1 2 3 4	Licensee will complete mandated reporter training and email to LPA Richmond.

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.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Ranita Richmond	TELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: LEWIS FAMILY CHILD CARE	FACILITY NUMBER: 197408252
	VISIT DATE: 03/07/2024

NARRATIVE

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LPA Richmond observed age-appropriate toys, books and furnishings. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts.

LPA reviewed 2 children’s files. Files are in need of immunization records, physician’s reports, authorization for medical treatment, and signed Parent’s Rights.

LPA Richmond observed the licensees updated CPR/First Aid taken 07/27/23.

LPAs reviewed staff file. Current Mandated reporter training is needed. Type B citation issued.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page 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) are not currently being provided. Licensee is open to taking children that need medication. Prescription medications shall be administered in accordance with the label directions as prescribed by the child’s physician. Medications should be in its original content with all necessary LIC forms completed.

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.

LPA Richmond reminded Licensee of the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

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.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Ranita Richmond	TELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: LEWIS FAMILY CHILD CARE	FACILITY NUMBER: 197408252
	VISIT DATE: 03/07/2024

NARRATIVE

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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&R) throughout California.

LPA provided and reviewed LIC311D and all necessary forms to help keep facility files up to date.

During the exit interview, Licensee Carrie Lewis confirmed that there are no Registered Sex Offenders living in the home.

Deficiencies were cited today, per Title 22 Regulations and Health and Safety Codes. See LIC 809D.

An exit interview was conducted, a copy of this report was read and provided to Licensee Carrie Lewis.

Notice of Site Visit was provided and required to be posted for 30 days.

Appeal rights were printed and provided to licensee Carrie Lewis.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Ranita Richmond	TELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

LIC809 (FAS) - (06/04)

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