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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417712
Report Date: 01/12/2023
Date Signed: 01/12/2023 05:39:04 PM


Document Has Been Signed on 01/12/2023 05:39 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:ALGUTRIA FAMILY CHILD CAREFACILITY NUMBER:
197417712
ADMINISTRATOR:ELIZABETH ALGUTRIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 674-2076
CITY:INGLEWOODSTATE: CAZIP CODE:
90303
CAPACITY:14CENSUS: 7DATE:
01/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:38 PM
MET WITH:Elizabeth Algutria-LicenseeTIME COMPLETED:
05:45 PM
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On 1/12/2023 Licensing Program Analyst (LPA), Jillinda Chandler conducted an unannounced one year required visit for Algutria Family Child Care Home. Present in the home was licensee Elizabeth Algutria,Carlos Algutria, licensees husband and 7 day care children.The home is a single family, single story home. Child care is conducted in the living-room, kitchen,and dining room,the home has one bathroom, there are two bedrooms in the home which are designated as off limits. The home was inspected inside and out for Health and Safety compliance.

LPA observed the following:
Proper care and supervision were observed during todays inspection
The homes capacity was within the scope of the license
Appropriate size fire extinguisher carbon and smoke detector's were present & operable.
Detergents, and knives were inaccessible, Toxins were locked and inaccessible.
Per the licensee there were no guns or weapons present LPA did not observe any weapons during todays inspection.
The home has a properly working telephone LPA observed the homes parent notification board; the license, facility sketch, Emergency Disaster Plan, Notification of Parent’s Rights Poster, Lead Poison Awareness, Safe Sleep and California Safety Seat Law were posted. A first aid kit was observed containing the required supplies: scissors, tweezers, bandages, medical ointment and a thermometer. Licensee’s Pediatric CPR and First Aid Card expires 4/2023
SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:
DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/12/2023
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ALGUTRIA FAMILY CHILD CARE
FACILITY NUMBER: 197417712
VISIT DATE: 01/12/2023
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No bodies of water were observed on the premises
Children records available and in good(need of updating) order.
Personal records were reviewed, LPA did not observe; immunization records for licensee and licensees husband, licensee was advised to provide immunization's for; Pertussis and Measles, per licensee she does not take the Influenza vaccination.
Licensees Mandated Reporter certificate expires 3/24/2024
A roster was readily available and current.
Per licensee parents are recorded via home camera as verification of signing in and out. LPA advised licensee a plan shall devised to have parents sign children in and out
Licensee does not provide Individual Medical Services (IMS). IMS was discussed with licensee.
All adults in the home cleared a criminal background clearance.
Toys, equipment and materials were available and in good order
Children napped in the living room using play pens or cots. Infant safe sleep was discussed with licensee. LPA reminded licensee that children are only to use car seats during transportation, and appropriate children’s feeding chairs shall only be used during mealtime. Outdoor activities were conducted in the back yard, LPA did not observe any hazardous conditions in this area. The family has two dogs, children are allowed to interact with the animals.
SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ALGUTRIA FAMILY CHILD CARE
FACILITY NUMBER: 197417712
VISIT DATE: 01/12/2023
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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.

Exit interview conducted and report was reviewed with the licensee Elizabeth Algutria

SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 01/12/2023 05:39 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: ALGUTRIA FAMILY CHILD CARE
FACILITY NUMBER: 197417712

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above immunization records were not readily available for Elizabeth Algutria-licensee andCarlos Algutria- husband which poses a potential health risk to persons in care.
POC Due Date: 01/26/2023
Plan of Correction
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Licensee shall provide immunization records for the licensee and husband no later than the due date of 1/26/2023. Proof can be provided via mail or email.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:
DATE: 01/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/12/2023
LIC809 (FAS) - (06/04)
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