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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417712
Report Date: 06/19/2019
Date Signed: 06/19/2019 12:22:31 PM

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: 9DATE:
06/19/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:18 AM
MET WITH:LicenseeTIME COMPLETED:
12:39 PM
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On 6/19/2019 Licensing Program Analyst, Jillinda Chandler conducted an unannounced Annual Random visit for the Algutria FCCH. Present in the home were licensee, licensees spouse, their two adult children and nine day care children. All adults were identified and have criminal back ground clearances. The home was inspected inside and out for health and safety compliance per Title 22. Day care was being conducted in the homes living room where children eat and sleep. There was an unattached garage that is used for dramatic play. The garage is divided to include a sleeping quarters for the licensees adult son. Both areas were inspected. The family has one large dog. The dog was observed in a gated area in the rear of the home.
LPA observed the following:
Care and supervision were observed
The homes capacity was within the scope of the license
Appropriate size fire extinguisher carbon and smoke detector present & operable.
Detergents, and knives were inaccessible, Toxins were locked and inaccessible.
No guns or weapons present as stated by the Licensee, no weapons observed by LPA.
Properly working telephone
License, facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2019
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: 06/19/2019
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Poster and California Safety Seat Law are posted
Pediatric CPR and First Aid Card expires 3/2021
No bodies of water were observed on the premises
Children records available and in good order.
Toys, equipment and materials available and in good order
Children have access to the homes back yard for out door activities
Both licensee and licensees spouse has completed the required Mandated Reporter Training
Incidental Medical Services were discussed. There were no children in need of theses services during todays inspection.
Licensee receives quarterly updates from the department

There were no deficiencies cited during todays inspection.

A copy of this report was discussed and left with the licensee.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2019
LIC809 (FAS) - (06/04)
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