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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493537
Report Date: 05/21/2024
Date Signed: 05/21/2024 03:37:57 PM


Document Has Been Signed on 05/21/2024 03:37 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:YAISH FAMILY CHILD CAREFACILITY NUMBER:
197493537
ADMINISTRATOR:YAISH, RAKEFETFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 212-8250
CITY:CANOGA PARKSTATE: CAZIP CODE:
91304
CAPACITY:14CENSUS: 12DATE:
05/21/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:47 PM
MET WITH:Rakefet YaishTIME COMPLETED:
03:55 PM
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Licensing Program Analyst (LPA) Tatiana Bickham conducted an unannounced annual required inspection at the above facility on 05/21/2024 at 1:20 PM. LPA met with Rakefet Yaish, Licensee who guided analyst on a tour of the facility. LPA provided Licensee with a copy of the LIC 126 Entrance Checklist to help facilitate the inspection. Family members residing at facility are: 4 adults (licensee, spouse and licensee two adult children). There were 12 children and 3 adults present when LPA arrived. Facility capacity is in compliance for a large Family Child Care Home. Hours of operation are Mon-Thur 8:00 AM - 4:30 PM and Fri 8:00 AM- 3:00 PM.

LPA toured the home inside and outside. This is a one-story home which consists of 4 bedrooms, 3 bathrooms, kitchen, dining room/living room, laundry room, detached garage (day-care), front yard and backyard (fenced).

Per Licensee, areas off limits to children and parents include: Main house which includes, 4 bedrooms, 2 bathrooms, kitchen, dinning room/living room, laundry room, and front yard.

Per Licensee, areas that are accessible to children include: Detached garage (day care), bathroom, and backyard. The bathroom that children use is located inside of the day-care room and was observed to be clean and free of hazards.

Food is provided by Licensee. Licensee was reminded if children bring food from home, it must be labeled with the child’s name and properly stored or refrigerated.

Individuals residing in the home have been discussed and noted. All adults present in the home have obtained a criminal record clearance or exemption. --Page 1 of 4
SUPERVISOR'S NAME: Raul NavarroTELEPHONE: (424) -30-3072
LICENSING EVALUATOR NAME: Tatiana BickhamTELEPHONE: (424) 301-3023
LICENSING EVALUATOR SIGNATURE:
DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/21/2024
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 5


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: YAISH FAMILY CHILD CARE
FACILITY NUMBER: 197493537
VISIT DATE: 05/21/2024
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All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection:

LPA reviewed required posted documentation for Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. Facility records were reviewed for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster drill log, last drill conducted on January 2024.

Smoke and carbon monoxide detectors are operable. Fire extinguisher indicated fully charged and was purchased within the year. The home maintains telephone service cell phone. The home is observed to be clean and orderly. There are toys and other age-appropriate materials available for children. LPA observed that detergents, cleaning compounds are stored in the home (off limits) and medication is stored in bathroom under the sink, inaccessible to children by lock on cabinet. Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, not only inaccessible to children. Isolation area for sick children waiting to be picked up is either outside or in the day-care room, away from the other children. Per Licensee there are no firearms or weapons stored in the home.

Infant Care: Per Licensee, no infants are enrolled. Only children ages 3-5.

Overnight Care: Per Licensee, no overnight care is provided.

Currently, children are using the back yard for outdoor play. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that could be hazardous to children in care. The home has a swimming pool in the backyard. Swimming pool is fenced per regulation. The fence is 5 ft high and the fence does not obscure the pool from view. The pool gate is self-latching, self-closing and opens away from the swimming pool.



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 immunization's 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. Both staff members were missing proof of current Mandated Reporter Training Certificate.
--Page 2 of 4
SUPERVISOR'S NAME: Raul NavarroTELEPHONE: (424) -30-3072
LICENSING EVALUATOR NAME: Tatiana BickhamTELEPHONE: (424) 301-3023
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2024
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: YAISH FAMILY CHILD CARE
FACILITY NUMBER: 197493537
VISIT DATE: 05/21/2024
NARRATIVE
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During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful, and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.

Incidental Medical Services (IMS): Per Licensee, no children enrolled require Incidental Medical Services.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm

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.

Licensee was reminded of their responsibility to report suspected child abuse. Mandatory Forms for the children’s files and provider’s files were discussed. Licensee was made aware that state law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category. Licensee was reminded that all infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome), and that the Provider is required to wash hands after every diaper change and to never shake a baby to prevent the Shaken Baby Syndrome. Licensee was also reminded that only children eating may be in highchairs and that car seats are utilized only for transportation.


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

The licensee was advised the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, (Type A violation), a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. -Page 3 of 4
SUPERVISOR'S NAME: Raul NavarroTELEPHONE: (424) -30-3072
LICENSING EVALUATOR NAME: Tatiana BickhamTELEPHONE: (424) 301-3023
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: YAISH FAMILY CHILD CARE
FACILITY NUMBER: 197493537
VISIT DATE: 05/21/2024
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If these requirements are not met, civil penalties in the amount of $100 perviolation will be assessed. The applicant was made aware that a licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment.

During the exit interview, the LICENSEE, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No deficiencies were cited during todays visit.

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.

Exit interview was conducted and report was reviewed with the Licensee.


















--Page 4 of 4
SUPERVISOR'S NAME: Raul NavarroTELEPHONE: (424) -30-3072
LICENSING EVALUATOR NAME: Tatiana BickhamTELEPHONE: (424) 301-3023
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5