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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197415331
Report Date: 04/27/2023
Date Signed: 04/27/2023 01:46:56 PM


Document Has Been Signed on 04/27/2023 01:46 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:STEWART FAMILY CHILD CAREFACILITY NUMBER:
197415331
ADMINISTRATOR:STEWART, MONIQUEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 815-0852
CITY:LOS ANGELESSTATE: CAZIP CODE:
90008
CAPACITY:14CENSUS: 12DATE:
04/27/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:21 PM
MET WITH:Aviance Kelly, AssistantTIME COMPLETED:
02:00 PM
NARRATIVE
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On 04/27/23 at 9:25 AM, Antonio Almanza, Licensing Program Analysts (LPA), were at the licensed facility conducting an alternate inspection when the deficiencies listed below were observed. LPA observed 12 children in care, five infants and 7 preschool children being supervised by 4 staff, one of whom does not have a criminal record clearance.

The following 2 Type A deficiencies are being cited during today's inspection (see LIC 9099D). Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit. 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.

1. LPA observed Staff 2 providing care to 3 infant children in the infant room (living room) without a criminal record clearance. After obtaining statements from Staff 2 and Staff 3, it was determined that Staff #2 has been at the facility since August 2022 but turned 18 years in January 2023, works Monday - Friday from 7:00 AM - 5:00 PM. This will result in a Type A citation. A civil penalty will also be issued.


2. LPA observed an infant inside of a swing/rocker and 6 bouncer/rockers in the infant room. This will result in a Type A citation.

A copy of this Report, Notice of Site Visit, and Appeal Rights were explained and provided to Aviance Kelly, Assistant Director.

SUPERVISOR'S NAME: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:
DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/27/2023
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 04/27/2023 01:46 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: STEWART FAMILY CHILD CARE
FACILITY NUMBER: 197415331

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/28/2023
Section Cited

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102370 Criminal Record Clearance (d) All individuals subject to a criminal record review... shall prior to working, residing, or volunteering in a licensed facility: (1) Obtain a California clearance... as required by the Department or
This Requirement is not met as evidenced by:
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Facility will not allow staff 3 to return to work until Staff 3 has received a criminal record clearance.
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Based on observation, interview and record review, Staff 2 has been working since January 2023 and does not have a criminal record clearance, which poses an immediate or Health and Safety, and personal rights risk to persons in care.
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Facility will provide LPA a written statement acknowledging understanding of regulations pertaining to criminal record clearance by 04/28/23.
Type A
04/27/2023
Section Cited

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102417 Operation of a Family Child Care Home (g)(10) A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Section 1596.846(b) and (c).
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Facility will remove prohibited items from the FCCH and provide LPA with a written statement of understanding that bouncers, swings, and walkers are prohibited items in family child care homes by 04/28/23.
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Based on observation, interview and record review, LPA observed an infant in a swing and 7 bouncers in the infant room, which poses an immediate or Health and Safety, and 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: Betty BellTELEPHONE: (424) -301-3063
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:
DATE: 04/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/27/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2