197493175-7-11-2022-30-CC-SORS-CG8ULR-20220711154109

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197493175
Report Date: 07/11/2022
Date Signed: 07/11/2022 03:41:22 PM

Document Has Been Signed on 07/11/2022 03:41 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:	MEGIDESH FAMILY CHILD CARE		FACILITY NUMBER:	197493175
ADMINISTRATOR:	MEGIDESH, IFAT		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 720-7763
CITY:	WINNETKA	STATE: CA	ZIP CODE:	91306
CAPACITY:	14	CENSUS: 10	DATE:	07/11/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:28 PM
MET WITH:	MEGIDESH, IFAT - Licensee		TIME COMPLETED:	04:00 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 07/11/2022 Licensing Program Analyst (LPA), Suzette Ornelas conducted an unannounced Annual Required Inspection and was met by Licensee, MEGIDESH, IFAT. Also present were Staff #1 (S1), Staff #2. Days and hours of operation are Monday through Thursday 8:30a to 4p and Friday 8:30a to 3p. LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed and Licensee confirmed that the living room is on limits all other rooms in the home are off limits to children in care by the use of closed doors and supervision. The detached garage in the front of the property has certificate of occupancy and is being used for recreational purposes only for child care children. Children eat and sleep in the living room in the main house. Children occasionally eat outdoors. LPA inspected the home for safety, comfort, and cleanliness. The bathroom was inspected for chemicals/toxins and potential hazards to children. The kitchen cabinets were inspected for the inaccessibility of toxins/chemicals, knives and other sharp objects that may be dangerous to children in care. LPA observed age appropriate toys in good repair. There are working smoke and carbon monoxide detectors installed in children's playroom. LPA provided licensee with information on creating a written disaster plan along with a copy of the regulation. Licensee will submit plan to LPA via email. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible. There are no fireplaces or open face heaters in the home. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no stairs in this home. The home has working telephone service and LPA confirmed the phone number is (818) 720-7763.

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Suzette Ornelas	TELEPHONE: 424-301-3008
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 7

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: MEGIDESH FAMILY CHILD CARE	FACILITY NUMBER: 197493175
	VISIT DATE: 07/11/2022

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
26
27
28
29
30
31
32

There is currently one infant in care over 12 months old. LPA discussed Safe Sleep Regulations with licensee. There is one crib or play yard for each infant in care, cribs and play yards are kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping. LPA observed an Infant Sleep Log for the infant in care and the assistants monitoring the children and documenting sleep.

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. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. LPA observed form LIC 995A was missing for 5 out of 10 children, the bottom portion was observed missing. Licensee will provide proof via email to LPA.

Licensee’s Mandated Reporter Training was completed in 2022. LPA observed 1 staff file to be missing the mandated reporter training certificate. Licensee will ensure staff completes the training and will provide LPA with a copy of the certificate via email. Licensee’s pediatric CPR/First Aid expires on 2024. A review of records indicates that all employees and/or volunteers do not have immunization records on file for influenza, pertussis and measles. LPA observed 2 employee immunization records to be incomplete. Licensee will submit proof to LPA via email.

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.

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Suzette Ornelas	TELEPHONE: 424-301-3008
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2022

LIC809 (FAS) - (06/04)

Page: 2 of 7

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: MEGIDESH FAMILY CHILD CARE	FACILITY NUMBER: 197493175
	VISIT DATE: 07/11/2022

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
26
27
28
29
30
31
32

Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: HSC 1596.8662(b)(1) – Mandated Reporter Training Certificate of Completion

(see next page, 809 D) Licensee was provided a copy of appeal rights.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Suzette Ornelas	TELEPHONE: 424-301-3008
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2022

LIC809 (FAS) - (06/04)

Page: 3 of 7

Document Has Been Signed on 07/11/2022 03:41 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: MEGIDESH FAMILY CHILD CARE	FACILITY NUMBER: 197493175
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/11/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

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 observation, interview, record review, the licensee did not comply with the section cited above in 1 out of 3 employees did not have a current Mandated Reporter Training Certificate which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/18/2022
	Plan of Correction
1 2 3 4	Licensee will provide proof of correction via email 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: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Suzette Ornelas	TELEPHONE: 424-301-3008
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2022

LIC809 (FAS) - (06/04)

Page: 4 of 7