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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197412075
Report Date: 10/26/2022
Date Signed: 10/26/2022 02:17:49 PM


Document Has Been Signed on 10/26/2022 02:17 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:CHICA FAMILY CHILD CAREFACILITY NUMBER:
197412075
ADMINISTRATOR:INGRID CHICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 491-6021
CITY:INGLEWOODSTATE: CAZIP CODE:
90304
CAPACITY:14CENSUS: 10DATE:
10/26/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Ingrid ChicaTIME COMPLETED:
02:00 PM
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On 10/26/2022 Program Analyst (LPA), Judy Laureano conducted an unannounced Annual Required Inspection and was met by Ingrid Chica. Inspection was conducted in Spanish. Present during today’s inspection was licensee and assistant Maritza Maeda.

Days and hours of operation are 8:00 am to 5:00 p.m., Monday through Friday. Currently applicant cares for children ages 2 months to 4 years old. Licensee confirmed that she does not provide overnight care or weekend care.

LPA toured the home inside and outside and a census was taken; 10 children were present with licensee and assistant providing care and supervision. The home is a single-family home with 5 bedrooms and 2 ½ bathrooms, living room, dining room, kitchen. The home has a front yard that is off limits and enclosed back yard with a detached garage. Licensee confirmed the following areas are used for day care: living room, dining room area, bedroom 1 and bathroom outside the kitchen. The backyard is enclosed and designated as daycare space.

The backyard was inspected and Licensee confirmed children play in the tent area.

Licensee confirmed the following areas are off limits: bedroom 2 with bathroom, bedroom 3, bedroom 4 and bedroom 5 with ½ bathroom and detached garage. Doors were observed to be closed and licensee confirmed that doors will remain closed during the hours of operations.

There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents and cleaning compounds are kept locked in the bottom kitchen cabinet. LPA observed a magnet safety latch on cabinet, making the content inaccessible to the children in care. Sharp object and knives were observed in a locked drawer- safety magnet latch, making the content inaccessible to the children in care.

SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:
DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/26/2022
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 4


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: CHICA FAMILY CHILD CARE
FACILITY NUMBER: 197412075
VISIT DATE: 10/26/2022
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LPA observed 4 high chairs and children size table and chairs in the dining room area. Licensee confirmed the area is used for the day care and children eat and nap in the area. LPA observed a barricaded fireplace in the dining room area, making inaccessible.

The home was observed having a working fire extinguisher mounted outside the kitchen area. The Fire pull station was observed outside the bathroom by the dining room area. LPA observed licensee test the carbon monoxide and smoke detector in the home.

Adequate heating and ventilation for safety and comfort were observed in the space. LPA did no to observe any stairs in the home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number as 310-491-6021.

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. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were incomplete. LPA issued an advisory and discussed the LIC 311D with licensee. LPA provided a copy of forms via email.

Mandated Reporter Training was taken on 10/22/2022 by both licensee and assistant. Licensee’s pediatric CPR/First Aid was completed on 9/11/2022. Assistant’s pediatric CPR and First Aid was completed on 7/20/2022.

Licensee is available to care for infants. 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. 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.

SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4
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: CHICA FAMILY CHILD CARE
FACILITY NUMBER: 197412075
VISIT DATE: 10/26/2022
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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.

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.

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 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.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Ingrid Chica

SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022
LIC809 (FAS) - (06/04)
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