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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493605
Report Date: 03/27/2024
Date Signed: 03/27/2024 03:23:02 PM


Document Has Been Signed on 03/27/2024 03:23 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:AVALOS FAMILY CHILD CAREFACILITY NUMBER:
197493605
ADMINISTRATOR:AVALOS, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 283-2579
CITY:LOS ANGELESSTATE: CAZIP CODE:
90044
CAPACITY:14CENSUS: 5DATE:
03/27/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Maria AvalosTIME COMPLETED:
03:30 PM
NARRATIVE
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Licensing Program Analysts (LPA), V. Wheatley and LPA Cristina Castellanos conducted an unannounced inspection regarding the above allegation and met with licensee Maria Avalos. Licensee was observed supervising 5 day care children playing in the front yard upon arrival. The licensee's husband was also present.

LPAs toured the inside of the home and observed the main bathroom unlocked. This bathroom is not used for day care children however is to remain inaccessible to day care children. Licensee is being required to add a door knob cover to the bedroom next to the main bathroom and the closet in the bedroom used for the day care children.

During a previous inspection was conducted by IB Investigator Jose Santana. Based on his observations and interviews it was determined there were two adults (Adult #1 and Adult #2) on the premises during day care hours which did not have a fingerprint clearance. See LIC 809 D.

During an inspection on 11/30/23, LPA Wheatley informed licensee it is required to have a sleeping log for children under 2 years old and a fire drill log. This was not observed today. See LIC 809D
SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Veronica WheatleyTELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:
DATE: 03/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/27/2024
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 03/27/2024 03:23 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: AVALOS FAMILY CHILD CARE
FACILITY NUMBER: 197493605

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/27/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/28/2024
Section Cited
CCR
102370(d)(1)

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102370 (d)(1)-Criminal Record Clearance - 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:(1) Obtain a California clearance or a criminal record exemption as required by the Department
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Licensee understands that all adults living, working or visiting the home during day care hours must be fingerprint cleared through live scan. Also, if another adult is left with a child that they must also have current CPR and first aid. The licensee will submit a plan of correction that she understands by 3/28/24.
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This requirement was not met as evidenced by: During interviews with IB Investigator, Jose Santana it was disclosed that two adults (Adult 1 and Adult 2) have been on the premises without a fingerprint clearance. This is an immediate risk to the health and safety of children in care.
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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: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Veronica WheatleyTELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:
DATE: 03/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/27/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3


Document Has Been Signed on 03/27/2024 03:23 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: AVALOS FAMILY CHILD CARE
FACILITY NUMBER: 197493605

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/27/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/28/2024
Section Cited
CCR
102425(j)(2)(D)

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102425(j)(2)(D) -INFANT SAFE SLEEP
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following:Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:
a. Date. b.Infant’s name. c.Time of each 15-minute check.
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The licensee will ensure that infants are checked every 15 minutes while napping and document the napping on a log. This log must be kept for children under 2 years old for 3 years. Also licensee is required to have LIC 9227 to be signed by parents enrolling children under 1 year old.
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This requirement was not met as evidenced by: The licensee is not using a napping log for infant under 2 years old. This is a potential risk to the health and safety of children enrolled.
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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: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Veronica WheatleyTELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:
DATE: 03/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/27/2024
LIC809 (FAS) - (06/04)
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