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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197411822
Report Date: 11/03/2022
Date Signed: 11/03/2022 04:11:56 PM


Document Has Been Signed on 11/03/2022 04:11 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:PADILLA FAMILY CHILD CAREFACILITY NUMBER:
197411822
ADMINISTRATOR:PADILLA, SONIA I.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 290-5366
CITY:LOS ANGELESSTATE: CAZIP CODE:
90016
CAPACITY:14CENSUS: 7DATE:
11/03/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:31 PM
MET WITH:Licensee Sonia PadillaTIME COMPLETED:
04:20 PM
NARRATIVE
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On 11/03/22 at 8:37 AM Licensing Program Analysts (LPA) Antonio Almanza were at the licensed facility conducting an alternate inspection when the deficiencies listed below were observed. LPAs observed 7 children in care, five infants and 2 toddlers being supervised by Licensee Sonia Padilla and Assistant. Assistant guided LPA on a tour of the facility and assisted LPA during the visit.

Deficiencies observed:

Type A Violations issued under California code of Regulations, Title 22, Division 12 & Chapter 1:

1. At 8:49 AM, LPA observed Infant/Child (C6) being dropped of and Licensee taking C6 under their care and supervision. LPA question the age of the child and the Assistant stated that the child was under 2 but was not sure of the Date of Birth. License called child’s mother over the phone and mother verified the child is still an Infant putting the facility at 5 Infants and 2 toddlers in care.

2. At 9:30 AM, LPA asked the Assistant for Pediatric First Aid CPR cards and the Assistant reported that they expired for both Licensee and Assistant in September of last year. LPA requested copies to verify expiration date and Assistant was unable to provide LPA with copies.

Type B Violations issued under California code of Regulations, Title 22, Division 12 & Chapter 1:

4. AT 8:55 AM, LPA requested a copy of facility Roster to verify the children’s ages and the Assistant was unable to provide a current roster for children in the facility

5. At 8:59 AM LPA requested children’s files for 7 children in care; LPA was not provided children’s files for Child 1, 4, 6, and 7.

6. At 2:55 PM, LPA asked the Assistant for Mandated Reporter Training Certificate and the Assistant reported that they do not have it.

SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:
DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/03/2022
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 5


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: PADILLA FAMILY CHILD CARE
FACILITY NUMBER: 197411822
VISIT DATE: 11/03/2022
NARRATIVE
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Type A deficiencies were cited during today's inspection (see LIC 809Ds). Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection).

**In addition; A copy of this report must be provided to the authorized representatives of all currently enrolled children and any newly enrolled child for the following 12 months. The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC9224) shall be signed and kept in each of the children’s records. The report shall be provided no later than the next business day or the next day the child is in care.

A copy of this report, Appeal Rights and Notice of Site Visit were reviewed and provided to the Licensee Sonia Padilla and Assistant Villma Avila.

SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
LIC809 (FAS) - (06/04)
Page: 5 of 5
Document Has Been Signed on 11/03/2022 04:11 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: PADILLA FAMILY CHILD CARE
FACILITY NUMBER: 197411822

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/03/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/04/2022
Section Cited

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102416.5(d)(1) Staffing Ratio and Capacity - Twelve children, no more than four of whom may be infants; or

This Requirement is not met as evidenced by:
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Based on observation, and interview, The Licensee did not had 5 infants in care, which poses an immediate or Health and Safety, and personal rights risk to persons in care.
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Type A
11/07/2022
Section Cited

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102416(C)(1)(b) Personnel Requirements - A licensee of a large family day care... at least one person has a current certificate in pediatric first aid... when children are present at the facility...
This Requirement is not met as evidenced by:
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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: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:
DATE: 11/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/03/2022
LIC809 (FAS) - (06/04)
Page: 4 of 5


Document Has Been Signed on 11/03/2022 04:11 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: PADILLA FAMILY CHILD CARE
FACILITY NUMBER: 197411822

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/03/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/11/2022
Section Cited

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02417(g)(8) Operation of a Family Child Care Home - 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:
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Based on observation, interview and record review, The Licensee does not have current facility roster, which poses a potential Health or Safety, or personal rights risk to persons in care.
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Type B
11/11/2022
Section Cited

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Operation of a Family Child Care Home - 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...

This Requirement is not met as evidenced by:
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Based on observation, interview and record review, The Licensee does not have files for children 1, 4, 6, and 7, which poses a potential Health or Safety, or personal rights risk to persons in care.
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LPA provided Licensee with LIC 311D.
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: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:
DATE: 11/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/03/2022
LIC809 (FAS) - (06/04)
Page: 3 of 5


Document Has Been Signed on 11/03/2022 04:11 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: PADILLA FAMILY CHILD CARE
FACILITY NUMBER: 197411822

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/03/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/11/2022
Section Cited

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(2) Provide training including statewide guidance on the responsibilities of a mandated reporter who is a licensed day care provider or an applicant for that license, administrator, or employee of a licensed child day care facility...
This Requirement is not met as evidenced by:
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Based on observation, interview and record review, The Licensee and assistant do not have current mandated reporter certification, which poses a potential Health or Safety, or personal rights risk to persons in care.
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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: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:
DATE: 11/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/03/2022
LIC809 (FAS) - (06/04)
Page: 2 of 5