197408812-1-29-2025-30-CC-VWHY-DDE4N2-20250129181426

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197408812
Report Date: 01/29/2025
Date Signed: 01/29/2025 06:14:43 PM

Document Has Been Signed on 01/29/2025 06:14 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	ALEXANDER FAMILY CHILD CARE		FACILITY NUMBER:	197408812
ADMINISTRATOR/ DIRECTOR:	ALEXANDER, CAROLYN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 532-8298
CITY:	GARDENA	STATE: CA	ZIP CODE:	90249
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 13	DATE:	01/29/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:45 PM
MET WITH:	Carolyn Alexander		TIME VISIT/ INSPECTION COMPLETED:	06:00 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 January 29, 2025, Licensing Program Analyst (LPA), Veronica Wheatley and conducted an unannounced Annual Inspection and was met by Licensee daughter Amira. The licensee Carolyn Alexander arrived during the inspection. Licensee's daughter Kathy is also present. Days and hours of operation are currently Monday through Saturday at 5:30am through 10:30pm. LPA toured the home inside and a census was taken. LPA observed 10 children on the premises upon arrival. The licensee arrived with two children and later one more child arrived at 4PM. The majority of the children are school aged children. Current facility sketch reviewed and confirmed that the family room is used for child care and napping. All bedrooms are off-limits and made inaccessible by use of locks. There are no firearms or ammunition on the premises per licensee. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible. There is a working fire extinguisher, smoke detector, and carbon monoxide detector. The home is equipped with central heating and ventilation is adequate for safety and comfort. There are no stairs in the home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number. The backyard is fenced. There is no swimming pool or other bodies of water on the premises. LPA discussed Safe Sleep Regulations with licensee. Cribs and play yards will be 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. 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 at all times. Individual Infant Sleeping Plan is completed for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping. A sleeping / napping log is required for all children under 2 years old age. The log will be kept until 3 years after the child is dis-enrolled. Children under 1 years old will require LIC 9227 (Sleeping Plan). There are no infants on the premises.

Maureen Neal	TELEPHONE: (424) 301-3042
Veronica Wheatley	TELEPHONE: (424) 301-3051
	DATE: 01/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ALEXANDER FAMILY CHILD CARE	FACILITY NUMBER: 197408812
	VISIT DATE: 01/29/2025

NARRATIVE

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Licensee ensures that children in care are supervised at all times and is aware 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. Capacity as specified on the license is being

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporter Training expired January 2, 2025. Licensee’s pediatric CPR/First Aid expires on May 2024. A review of records indicates that all employees and/or volunteers 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. Incidental Medical Services (IMS) are not 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.

LPA discussed with the licensee the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

Exit interview conducted. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Veronica Wheatley	TELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:	DATE: 01/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025

LIC809 (FAS) - (06/04)

Page: 2 of 3

Document Has Been Signed on 01/29/2025 06:14 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ALEXANDER FAMILY CHILD CARE	FACILITY NUMBER: 197408812
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/29/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited

CCR

102416(c)

Personnel Requirements

(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA's observance and record review, the licensee did not comply with the section cited above in that the licensee and daughter's pediatric CPR and first aid has expired. This poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/11/2025
	Plan of Correction
1 2 3 4	Licensee will complete Pediatric CPR/first aid class and submit certification to Department by 2/11/25.

Type B

Section Cited

CCR

102417(g)(7)

Operation of A Family Child Care Home

(7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care. 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 in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/11/2025
	Plan of Correction
1 2 3 4	Licensee will complete Mandated Reporter Training and submit to Department by 2/11/25.

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

Maureen Neal	TELEPHONE: (424) 301-3042
Veronica Wheatley	TELEPHONE: (424) 301-3051
	DATE: 01/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025

LIC809 (FAS) - (06/04)

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