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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197410345
Report Date: 04/03/2024
Date Signed: 04/03/2024 04:15:48 PM


Document Has Been Signed on 04/03/2024 04:15 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:SMITH FAMILY CHILD CAREFACILITY NUMBER:
197410345
ADMINISTRATOR:SMITH, JANET F.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 292-4300
CITY:LOS ANGELESSTATE: CAZIP CODE:
90043
CAPACITY:12CENSUS: 0DATE:
04/03/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Janet Smith, LicenseeTIME COMPLETED:
04:30 PM
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On 04/03/2024 at 12:45pm, Licensing Program Analyst (LPA) Brittanee Cleveland conducted an unannounced annual inspection to the above facility at. LPA was greeted by Licensee, Janet Smith, who guided LPA on a tour of the facility. LPA provided licensee with a copy LIC 126 Entrance Checklist to facilitate inspection. This is an a Large Family Child Care Home of 12 children-ages 3 to 5 years of age. Upon arrival, Licensee told LPA that she has been inactive with the daycare since 2020. There were no children in care.

Home is a 1-story dwelling with 3 bedrooms and 3 bathrooms. Children would only have access to the rear living room space, a playroom and restroom. The kitchen, bedrooms and bathrooms are off limits to children. The valve on the 2A 10BC fire extinguisher indicates to be fully charged and purchased in 2023. Smoke and carbon monoxide detectors were tested and operable.

Individuals who reside in the home were noted and discussed. Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

Licensee states that there are no firearms stored in home.

All areas identified on the Facility Sketch were inspected for safety, comfort, and cleanliness. There is a telephone line that is used and stays within facility. The ventilation and heating observed to be screened.

Licensee states she does not care for infants.

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SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Brittanee ClevelandTELEPHONE: 424-301-3050
LICENSING EVALUATOR SIGNATURE:
DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/03/2024
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 2


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: SMITH FAMILY CHILD CARE
FACILITY NUMBER: 197410345
VISIT DATE: 04/03/2024
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Licensee stated she will remain in inactive until she completes projects around her home. LPA provided licensee with Request for Inactive Child Care Licensing Status (LIC9211) to complete and turn in to the regional office.

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.

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 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.

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, Janet Smith, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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

Exit interview conducted and report was reviewed with the licensee, Janet Smith. -- Page 2
SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Brittanee ClevelandTELEPHONE: 424-301-3050
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2