197418715-5-5-2025-58-CC-JLIY-DGDUGV-20250505153459

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197418715
Report Date: 05/05/2025
Date Signed: 05/05/2025 03:35:12 PM

Document Has Been Signed on 05/05/2025 03:35 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	MOR FAMILY CHILD CARE		FACILITY NUMBER:	197418715
ADMINISTRATOR/ DIRECTOR:	MOR, LIAT		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 654-6188
CITY:	RESEDA	STATE: CA	ZIP CODE:	91335
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 12	CENSUS: 12	DATE:	05/05/2025
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:15 PM
MET WITH:	Licensee Liat Mor		TIME VISIT/ INSPECTION COMPLETED:	03:40 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 5/5/25 at 1:15PM Licensing Program Analyst (LPA), Jeanine Lipsey conducted an unannounced Requires 3 year Annual Inspection and was met by Licensee Liat Mor. An Entrance checklist was provided. LPA observed 12 children, 2 of them were infants, in care being supervised by 3 staff. Capacity as specified on the license is being maintained. Days and hours of operation are Monday through Thursday 8am to 4:40pm, Friday to 3 PM. LPA observed the following required postings: License, PUB 394 Notification of Parents’ Rights Poster, and LIC 9148 Earthquake Preparedness Checklist. LPA advised all LIC9213 Notice of Site Visits shall be posted for 30 days after each site visit. LPA advised, any licensing report documenting a Type A citation must be posted for 30 days. LPA advised LIC610A Emergency Disaster Plan, and a disaster/fire drill log shall be available to view with disaster drills completed at lease every six months. The last disaster drills were conducted on 4/09/25. Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunizations Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, LIC 9227- Infant sleep form (0-12 months, and documentation of 15-minute Infant Sleep Check (0-24 months). Child #1 was missing immunizations. Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC-501: Personnel Record, LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. Licensee’s pediatric CPR/First Aid was completed on 3/19/24. Mandated Reporter Training expired in 2020. Due to time constraints, the inspection and report will be completed at a later date. Based on LPA's observations, the following deficiencies listed on the attached LIC809D (deficiency page) are being cited in accordance with Title 22, Division 12, Chapter 3, of the California Code of Regulations. Deficiencies that are being cited need to be cleared to protect the children's health & safety. Exit interview conducted and report was reviewed with the assistant Luz Cruz. A notice of site visit was given and advised Licensee that it must remain posted for 30 days. page 2

Betty Bell	TELEPHONE: (424) 301-3063
Jeanine Lipsey	TELEPHONE: (424) 301-3077
	DATE: 05/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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Document Has Been Signed on 05/05/2025 03:35 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MOR FAMILY CHILD CARE	FACILITY NUMBER: 197418715
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/05/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in that 3 staff memebers are missing Mandated reporter training which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/19/2025
	Plan of Correction
1 2 3 4	Licensee will have staff complete traning and send to LPA via email.

Type B

Section Cited

HSC

1597.622(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in that 2 staff missing MMR, 1 staff missing TB which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/19/2025
	Plan of Correction
1 2 3 4	Licensee will send proof of immunizations and send to LPA via email.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Betty Bell	TELEPHONE: (424) 301-3063
Jeanine Lipsey	TELEPHONE: (424) 301-3077
	DATE: 05/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2025

LIC809 (FAS) - (06/04)

Page: 3 of 5

Document Has Been Signed on 05/05/2025 03:35 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MOR FAMILY CHILD CARE	FACILITY NUMBER: 197418715
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/05/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited

CCR

102418(a)

Immunizations

(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in that Child #1 missing immunizations which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/19/2025
	Plan of Correction
1 2 3 4	Licensee will send proof of immunizations and to LPA via email.

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.

Betty Bell	TELEPHONE: (424) 301-3063
Jeanine Lipsey	TELEPHONE: (424) 301-3077
	DATE: 05/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2025

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: MOR FAMILY CHILD CARE	FACILITY NUMBER: 197418715
	VISIT DATE: 05/05/2025

NARRATIVE

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Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC-501: Personnel Record, LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. Licensee’s pediatric CPR/First Aid was completed on 3/19/24. Mandated Reporter Training expired in 2020. 2 staff missing MMR, 1 staff missing TB.

Due to time constraints, the inspection and report will be completed at a later date. Based on LPA's observations, the following deficiencies listed on the attached LIC809D (deficiency page) are being cited in accordance with Title 22, Division 12, Chapter 3, of the California Code of Regulations. Deficiencies that are being cited need to be cleared to protect the children's health & safety.

Exit interview conducted and report was reviewed with Licensee Liat Mor. A notice of site visit was given and advised Licensee that it must remain posted for 30 days.
page 2

SUPERVISOR'S NAME: Betty Bell	TELEPHONE: (424) 301-3063
LICENSING EVALUATOR NAME: Jeanine Lipsey	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2025

LIC809 (FAS) - (06/04)

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