197416878-5-25-2023-58-CC-JLAO-CS6SP8-20230525140244

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197416878
Report Date: 05/25/2023
Date Signed: 05/25/2023 02:03:58 PM

Document Has Been Signed on 05/25/2023 02:03 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:	MINWALLA FAMILY CHILD CARE		FACILITY NUMBER:	197416878
ADMINISTRATOR:	MINWALLA, SHAMA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 801-8155
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90019
CAPACITY:	14	CENSUS: 3	DATE:	05/25/2023
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Shama Minwalla and Karina Castro		TIME COMPLETED:	01:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 5/24/2023 at approximately 10:25 am Program Analyst (LPA), Judy Laureano conducted an unannounced Annual Required Inspection at 1609 Carmona Avenue, Los Angeles, CA 90019. LPA was greeted by Assistant Karina Castro who stated licensee is currently out and will call licensee. Asssitant K. Castro contacted Licensee and Licensee arrived at facility at approximately 11:08 a.m. During the initial inspection, LPA observed 3 children and Asssitant K. Castro providing care and supervision outside. Facility operates Monday through Friday from 8:30 a.m. to 5:00 p.m. Currently licensee is available to care for children 15 months to 5 years old. Facility is a Large family child care home with a max capacity of 12. LPA toured the home inside and outside. The home is a one story dwelling with 2 bedrooms, 1 office/napping room, living room, dining room, kitchen area with a family room and two bathrooms. Licensee confirmed the following areas are used for day care purposes: Living room, dining room, kitchen area with a family room, office and bathroom located across the kitchen area. The following area are OFF LIMITS to the children in care: Master bedroom with bathroom and bedroom 2. LPA observed door knob covers on all doors; making the areas inaccessible to the children in care. Safe toys and play equipment are observed. LPA observed a barricaded fireplace in the living room. Bathroom that children use is located next to the office/napping room. LPA inspected the bathroom and did not observe any medications, toxins or cleaning compounds that would pose a risk to children in care. Outdoor play area is conducted in the back yard which is fully fenced. LPA observed age appropriate outdoor toys. All electrical outlets were observed to be covered. LPA reminded licensee to ensure all areas that have been designated as OFF LIMITS need to have doors closed doors and made inaccessible when children are present.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: 424-301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023

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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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: MINWALLA FAMILY CHILD CARE	FACILITY NUMBER: 197416878
	VISIT DATE: 05/25/2023

NARRATIVE

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LPA observed licensee test the carbon monoxide and smoke detector in the home. One working fire extinguisher was observed outside the kitchen area. Licensee confirmed that families bring meals and snacks in appropriate containters and stored in the refrigerator when needed.

LPA discussed the importance of maintaining a system where allergies and food restrictions are noted.

No swimming pools or bodies of water were observed in the space. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. LPA observed a barricaded fire place in the living room area. LPA observed cleaning compounds locked in the hallway closet and under the kitchen cabinet- content made inaccessible to the children in care.

LPA discussed administering medication and licensee confirmed that currently program does have any child that needs medication administered. Licensee confirmed that medication is stored in a locked cabinet in the kitchen area.
Adequate heating and ventilation for safety and comfort were observed in the space. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number 310- 801-8155.

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 during today’s inspection.

LPA reviewed 3 children’s files and observed files to be complete. LPA discussed all necessary forms needed in each children’s file and provided licensee with the LIC 311D- Records to be maintain in the facility and provided licensee with a current copy to use as a reference when auditing files.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: 424-301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023

LIC809 (FAS) - (06/04)

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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: MINWALLA FAMILY CHILD CARE	FACILITY NUMBER: 197416878
	VISIT DATE: 05/25/2023

NARRATIVE

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LPA reviewed Licensee’s Pediatric CPR and First certification and observed certification is not valid “Adult, Child and Baby First Aid/CPR/AED online only completed on 5/10/2022. Licensee’s Mandated Reporter training was taken on 4/30/2022. LPA discussed with licensee the importance of completing EMSA approved training. LPA emailed licensee the approved EMSA vendor list for reference.

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/inspection-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.mExit interview conducted and report was reviewed with the licensee Shama Minwalla.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: 424-301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/25/2023 02:03 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: MINWALLA FAMILY CHILD CARE	FACILITY NUMBER: 197416878
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/25/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102416(c)

Personnel Requirements

(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above in having valid CPR and First Aid certificaiton, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 06/08/2023
	Plan of Correction
1 2 3 4	Licensee will enroll and complete a valid training for licensee and assistant by due date and email completion to LPA.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: 424-301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023

LIC809 (FAS) - (06/04)

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