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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197415798
Report Date: 03/15/2023
Date Signed: 03/15/2023 04:35:44 PM


Document Has Been Signed on 03/15/2023 04:35 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:LOVELESS FAMILY CHILD CAREFACILITY NUMBER:
197415798
ADMINISTRATOR:LOVELESS, SASHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 567-3763
CITY:HAWTHORNESTATE: CAZIP CODE:
90250
CAPACITY:14CENSUS: 9DATE:
03/15/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:SASHA LOVELESSTIME COMPLETED:
04:45 PM
NARRATIVE
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On 3/15/2023, Licensing Program Analyst (LPA) Loyce Phillips, conducted a case management inspection to follow up on an Unusual Incident reported to the department by telephone on 12/7/2022. LPA met with Licensee, Sasha Loveless and toured the facility and took a census of the children. Upon arrival, there were 9 children and 2 staff present today at the facility.

Description of the incident: On 12/7/2022, Licensee reported C1 stated C2 try to pull down her pants and look at her private area. Licensee immediately spoke with both parents regarding the incident. Licensee contacted CPS and CCLD to report incident. Licensee suspended C2 from the program until further notice.

Based on the information obtained and interviews conducted; C1 personal rights were violated, when C2 disclose to S2 that he asked to look at C1 private area. Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: (See 809-D).

An exit interview was conducted and a copy of this report, appeal rights and Notice of Site Visit was provided to Licensee.

SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3063
LICENSING EVALUATOR NAME: Loyce PhillipsTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:
DATE: 03/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/15/2023
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 03/15/2023 04:35 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: LOVELESS FAMILY CHILD CARE
FACILITY NUMBER: 197415798

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/24/2023
Section Cited

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102423(a)Each child receiving services from a family child care home shall have certain rights that shall......(1) To be treated with dignity in his/her personal relationship with staff and other persons. This requirement was not met as evidenced by: Based on interview statement from S2; C2 ask to see C1 private area. If not corrected this poses a potential health, safety,
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Licensee will meet with staff to discuss personal rights and submit a written statement of understnding to LPA by plan of correction date.
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or personal rights 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: Peter FloresTELEPHONE: (424) 301-3063
LICENSING EVALUATOR NAME: Loyce PhillipsTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:
DATE: 03/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/15/2023
LIC809 (FAS) - (06/04)
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