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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419932
Report Date: 03/14/2024
Date Signed: 03/14/2024 06:21:03 PM


Document Has Been Signed on 03/14/2024 06:21 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:STEVENS-CHANIN FAMILY CHILD CAREFACILITY NUMBER:
197419932
ADMINISTRATOR:STEVENS-CHANIN, SARAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 718-0777
CITY:CHATSWORTHSTATE: CAZIP CODE:
91311
CAPACITY:14CENSUS: 12DATE:
03/14/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Nehama Abecassis, AssistantTIME COMPLETED:
06:30 PM
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Licensing Program Analyst (LPA) Elicia Calvillo conducted an unannounced annual inspection to the above facility on 03/14/2024. LPA arrived at the facility at 10:30AM, identified self and met with Nehama Spritzer, Licensee’s Assistant who guided analyst on a tour of the facility. LPA provided Assistant with a copy of the LIC 126 (FCC) Entrance Checklist to help facilitate the inspection. LPA observed that also present during this inspection, was Sarit Grion, Assistant, Jessica Khoda, Assistant, and Stephanie Arrango, Volunteer. LPA observed 12 children upon arrival. Per Licensee’s Assistant, operation hours are 08:00AM to 05:00PM. There are 12 children that are currently enrolled. A current children’s roster was available for review.

Nehama Abecassis, Licensee’s Assistant stated Sara Stevins-Chanin, Licensee has been absent from the facility since Sunday, March 10, 2024. Per the case file, in 2017 the Licensee admitted they do not live orreside at this residence. The preponderance of evidence shows that more likely than not this Licensee does not live at this address. For a Family Child Care Home, child care needs to be provided on the premises of the licensed residence. Licensee’s Assistant stated the only adult living in the home is Sara Stevins-Chanin, Licensee and the other adult and minor child have moved out of the home. The licensee did not report a change to the household composition. A Type A citation will be assessed.

Because the licensee rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (UC9151) that the licensee assistan confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (UC 9149).

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SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Elicia CalvilloTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:
DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/14/2024
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 03/14/2024 06:21 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: STEVENS-CHANIN FAMILY CHILD CARE
FACILITY NUMBER: 197419932

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above that the Security Guard carries a firearm with ammunition in the presents of children when they are playing outside the facility. Firearms which pose a danger if readily available to children shall be stored where they are inaccessible to children. which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 03/15/2024
Plan of Correction
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Security Guard Victor Orellano will be removed from the facility site and an invoice to replace the fense by 3/20/2024 will be provided to LPA by 3/15/2024.
Type A
Section Cited
CCR
102370(d)
Criminal Record Clearance
(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, Guardian record review, the licensee did not comply with the section cited above in [count] out of two adults present who did not have a Criminal Record Clearance completed for Jessica Khonda and Stephanie Arrango and Victor Orellano prior to being present in the home which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 03/15/2024
Plan of Correction
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Licensee Assistant stated that a Criminal Record Clearance will be submitted for Jessican Knonda, a copy will be emailed to LPA by 3/15/2024. And Stephanie Arrango and Victor Orellano will be removed from the facility by 3/15/2024.
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: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Elicia CalvilloTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:
DATE: 03/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/14/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/14/2024 06:21 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: STEVENS-CHANIN FAMILY CHILD CARE
FACILITY NUMBER: 197419932

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.3(a)(6)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above that Licensee did not report alterations to the facility grounds as the property divider fence has been removed which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 03/15/2024
Plan of Correction
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An invoice to replace the fense by 3/20/2024 will be provided to LPA by 3/15/2024.
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: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Elicia CalvilloTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:
DATE: 03/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/14/2024
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: STEVENS-CHANIN FAMILY CHILD CARE
FACILITY NUMBER: 197419932
VISIT DATE: 03/14/2024
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Licensee’s Assistant was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. During today’s visit there were two adults present who did not have a Criminal Record Clearance completed for Jessica Khonda, Stephanie Arrango and Victor Orellano prior to being present in the home. A Type A citation will be assessed with a $500.00 Civil Penalty for each person.

LPA upon arrival went to enter the property gate and observed a Security Guard sitting in the yard where children were playing. LPA observed the fence that divides the two properties was removed and there was no division between the facility and 20735 Devonshire Street, Chatsworth, CA 91311. LPA confirmed with that the Security Guard carries a firearm with ammunition in the presents of children when they are playing outside the facility. Firearms which pose a danger if readily available to children shall be stored where they are inaccessible to children. A Type A citation will be assessed with a $500.00 Civil Penalty.

As drawn on the facility sketch and observed during the tour. This is a single-story dwelling, Living room, 4 Bedrooms, 2 Bathrooms, Dining Room, and Kitchen. LPA observed the following areas used for child care are Living Room is the main area for child care activities, playing, eating, and circle time, 2 bedrooms are for the napping area, 1 bedroom is used as the main entrance to the child care, 1 bathroom located in the hallway near the living room is used for children. The outdoor area includes a partial fenced on 3 sides and the fence dividing the property line has been removed, there is a play area includes toys and other materials for children to play with and has a covered shaded area and grass and dirt covering. The Licensee did not report alterations to the grounds as the property divider fence has been removed. A Type A citation will be assessed.

LPA did not observe any pools, spas, hot tubs, fish ponds, or similar bodies of water during the inspection.


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SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Elicia CalvilloTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
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: STEVENS-CHANIN FAMILY CHILD CARE
FACILITY NUMBER: 197419932
VISIT DATE: 03/14/2024
NARRATIVE
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additional resource. LPA also informed licensee’s assistant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at http://www.cpsc.gov and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on XXXXX. There are first aid supplies available. LPA advised that if a child shows signs of illness they shall be separated from other children.


The licensee does not have proof of immunization against influenza, pertussis, and measles.

LPA observed that the Sara Stevens-Chanin, Licensee do not have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file.

Children’s records were reviewed, including emergency information, and were observed to be complete.



LPA issued a LIC 811 Confidential Names List to the licensee which documents staff and children’s files reviewed during this inspection.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.

All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. Last drill documented was conducted on 11/23/2023.

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility.

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SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Elicia CalvilloTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
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: STEVENS-CHANIN FAMILY CHILD CARE
FACILITY NUMBER: 197419932
VISIT DATE: 03/14/2024
NARRATIVE
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The licensee facility is observed to be operating within the license capacity limitations. LPA did not observe any children left in parked vehicles. Car seats shall only be used for transportation. LPA did not observe any children sleeping in car seats.

There are no pets on the premises.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/resources/child-care-centers/.

Licensee’s Assistant was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee’s Assistant, Nehama Abecassis confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.



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SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Elicia CalvilloTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
LIC809 (FAS) - (06/04)
Page: 6 of 7
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: STEVENS-CHANIN FAMILY CHILD CARE
FACILITY NUMBER: 197419932
VISIT DATE: 03/14/2024
NARRATIVE
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At this time, the licensee is not in compliance with California Code of Regulations Title 22 and deficiencies were cited. At 10:30AM, LPA confirmed Jessica Khonda has worked since 6/8/2023 as an Assistant at the facility and did not have an Criminal Record Clearance associated with facility. Licensee stated they did not request a transfer of a criminal record clearance for those individuals subject to a criminal record review per regulation102370 Criminal Record Clearance.

As a result of today's visit, the following deficiencies listed on the attached deficiency page are being cited in accordance with California Code of Regulations Title 22; 102370 Criminal Record Clearance, a Type A citation will be assessed with a $1500.00 Civil Penalty for three individuals present in the home without a Criminal Record Clearance; 102416.3(a)(6) Alterations to existing building or grounds, a Type A citation will be assessed for not reporting alterations to the facility grounds; 102417(g)(4) Operations to a family child care home, a Type A citation will be assessed with a $500.00 Civil Penalty for Security Guard carries a firearm with ammunition in the presents of children when they are playing outside the facility. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent.) During this visit, the Licensee/Director was provided with a copy of LIC 9224 Acknowledgement of Receipt of Licensing Reports Form and LIC 995A Notification of Parents’ Rights.

A notice of site visit was given and must remain posted for 30 days.



Exit interview conducted and report was reviewed with the Licensee’s Assistant Nehama Abecassis. LPA will address additional citations in a continuation visit for the remainder of citations for 102423 Personal Rights and 102416.2 Reporting Requirements.
SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Elicia CalvilloTELEPHONE: (424) 301-3016
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
LIC809 (FAS) - (06/04)
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