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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493882
Report Date: 09/15/2021
Date Signed: 09/20/2021 04:14:38 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 09/20/2021 04:14 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:CANN ACADEMY INFANT CENTERFACILITY NUMBER:
197493882
ADMINISTRATOR:CANN-DUAH, RONNIEFACILITY TYPE:
830
ADDRESS:3801 WEST 132ND STREETTELEPHONE:
(323) 541-7271
CITY:HAWTHORNESTATE: CAZIP CODE:
90250
CAPACITY: 12TOTAL ENROLLED CHILDREN: 0CENSUS: 3DATE:
09/15/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:07 AM
MET WITH:Ronnie Cann-duah-licenseeTIME COMPLETED:
03:15 PM
NARRATIVE
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On 9/15/2021 Licensing Program Analyst (LPA), Jillinda Chandler conducted an unannounced Annual Random/1 year required visit for Cann Academy Infant Center. Present in the center upon arrival were licensee and 3 infant children, prior to approaching the facility LPA observed 1 adult enter the facility, however the adult was not present when inside, the adult returned and it was disclosed that the adult was an associated employee. The facility has a preschool license # 197493883 which also was inspected during today visit. The preschool operation are conducted on the upper level of the two story church. The center was inspected inside and out for health and safety compliance per Title 22.

LPA observed the following:
Care and supervision were observed
The center capacity was within the scope of the license and ratios were met.
Appropriate size fire extinguisher carbon and smoke detector present & operable.
pg. 1 of 4
SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE: DATE: 09/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/15/2021
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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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: CANN ACADEMY INFANT CENTER
FACILITY NUMBER: 197493882
VISIT DATE: 09/15/2021
NARRATIVE
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Detergents were accessible to children in care, LPA observed cans of disinfecting sprays within children's reach inside of the infant activity area
Per licensee cell phones are used for communication, licensee disclosed to LPA that she did not have her cell phone during todays visit. A phone was not present until assistant arrived.
Emergency Disaster Plan & Notification of Parent’s Rights Poster and California Safety Seat Law were present, however the license, menus and Complaint hot line poster shall be added to parent board.
Pediatric CPR and First Aid Card for licensee expires 2023
No bodies of water on the premises
Children records were not readily available or found to be incomplete
Staff files were not available during todays available
Roster was not readily available
Toys, equipment, and materials observed in fair condition, LPA advised licensee that toys shall be sanitized after use during Covid 19
Sign in and out sheets were observed parents used their original signatures to sign children in.
LPA observed three cribs for napping infants, one crib was not operable due to a broken wheel, there were no emergency cribs present during todays visit
Water dispenser and pitchers were used for indoor and outdoor water sources.
shading and benches for resting were observed. pg. 2 of 4
SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021
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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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CANN ACADEMY INFANT CENTER
FACILITY NUMBER: 197493882
VISIT DATE: 09/15/2021
NARRATIVE
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Central air and heating was provided throughout the center
LPA observed blankets in each crib.
LPA observed napping materials on stored cots
Cubbies for children's belongings were observed, children foods and formulas were stored in there individual back packs.
The facility has a full kitchen, the kitchen was not locked during todays visit, toxins and detergents were observed in an unlocked cabinet. Kitchen was observed in poor condition.
Refrigeration was available for foods capable of rapid contamination, LPA did not observe any contaminating foods during today visit.
Restrooms were clean, toilets and sinks were operable
LPA observed changing table without padding that were within arms reach of sinks.
The outdoor activity area was observed in fair condition. LPA observed slats in the gate were missing this is a potential risk of a wandering away.
Toys and equipment were in fair condition.
Artificial grass was observed under climbing apparatus




pg 3 of 4
SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021
LIC809 (FAS) - (06/04)
Page: 6 of 8
Document Has Been Signed on 09/20/2021 04:14 PM - It Cannot Be Edited


Created By: Jillinda Chandler On 09/15/2021 at 01:34 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CANN ACADEMY INFANT CENTER
FACILITY NUMBER: 197493882

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/17/2021
Section Cited
CCR
101438.1(g)

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101438.1(g)All disinfectants, cleaning solutions and other hazardous materials shall be removed immediately and stored as specified in Section 101238. this standard was not met as evidence by: LPA observed
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Licensee was instructed to remove the cans of Lysol. Licensee shall obtain a key or a safety knob for the kitchen door by. In the intrim licensee shall ensure the childs saftey gate is secured at all times.
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2 cans of Lyson spray on the childrens activity tabel and in an unlocked kitchen,toxins and detergents were oberved in an unlocked cabinet, this poses an immediate risk to children in care and a type A citation was issued
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Licensee must inform the parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months via form LIC-9224 Acknowledgement of Receipt of Licensing Reports.
Type A
09/15/2021
Section Cited
CCR101224(a)

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101224(a) All child care centers shall have working telephone service on the premises. This standard was not met as evidence by: per licensee Mobile phones are used and she did not have her phone during todays visit. Licensee
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Licensee shall provide proof of purchase for a additional mobile unit to be left on premises at all time or provide a land line service. Assistant was obseved going to lunch with the cell.
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was alone upon arrival of LPA with three infant children without a working telephone. Licenssees assistant arrived during visit with a cell phone This poses an immediate risk to children in care.
A type A citation was issued
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Licensee must inform the parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months via form LIC-9224 Acknowledgement of Receipt of Licensing Reports.
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:Peter Flores
LICENSING EVALUATOR NAME:Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:
DATE: 09/15/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2021


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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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CANN ACADEMY INFANT CENTER
FACILITY NUMBER: 197493882
VISIT DATE: 09/15/2021
NARRATIVE
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The licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If facility was cited type A violations or complaint is found to be substantiated or unsubstantiated, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Licensee must inform the parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months via form LIC-9224 Acknowledgement of Receipt of Licensing Reports.

Based on todays inspection LPA shall recommend an informal supervisory meeting to be conducted .

An exit interview was conducted, a copy of this report was provided along with the appeal rights.

















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SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021
LIC809 (FAS) - (06/04)
Page: 5 of 8
Document Has Been Signed on 09/20/2021 04:14 PM - It Cannot Be Edited


Created By: Jillinda Chandler On 09/15/2021 at 02:06 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CANN ACADEMY INFANT CENTER
FACILITY NUMBER: 197493882

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/22/2021
Section Cited
CCR
101217(c)

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101217(c) All personnel records shall be available to the Department to inspect, audit, and copy upon demand during normal business hours. Records may be removed if necessary for copying. This standard was not met by evidence of; no files were
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Licensee shall prepare staff files with the required documents per title 22 section 101217. Forms shall be completed no later than 9/22/2021.
A subsequent visit will be conducted for review of corrections
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readily available upon request by LPA, licensees nor the assistants files were availble. This is a potential health and safety risk to children in care. A type B citation was issued.
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Type B
09/17/2021
Section Cited
CCR101439

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101439 Infant Care Center Fixtures, Furniture... all such equipment and furniture shall be assembled or installed according to the manufacturer's instructions, and shall be maintained in good
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Licensee shall provided a photo of repaired crib no later than 9/17/2021
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repair and safe condition. This standard was not met by evidence of LPA observed a crib for napping missing a wheel. This is a possible safety risk to children in care. A type B citation was issused.
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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:Peter Flores
LICENSING EVALUATOR NAME:Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:
DATE: 09/15/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2021


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Page: 7 of 8
Document Has Been Signed on 09/20/2021 04:14 PM - It Cannot Be Edited


Created By: Jillinda Chandler On 09/15/2021 at 02:40 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CANN ACADEMY INFANT CENTER
FACILITY NUMBER: 197493882

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/22/2021
Section Cited
CCR
101221(a)

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101221(a)Child's Records A separate, complete and current record for each child is maintained in the child care center. This standard was not met by evidence of; files provided to LPA for review were incomplete and missing required documents
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Licensee shall ensure that all required forms are complete and readily available for review no later than 9/22/2021 or upon childs next day in attendance. A subsequent visit will be conducted to review files
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 Child # 3 did not have a file on file at the center and licensee could not provid, or had access to childs emergency contacts.this is an immediate health and safety risk to 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:Peter Flores
LICENSING EVALUATOR NAME:Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:
DATE: 09/15/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2021


LIC809 (FAS) - (06/04)
Page: 8 of 8
Document Has Been Signed on 09/20/2021 04:14 PM - It Cannot Be Edited


Created By: Jillinda Chandler On 09/15/2021 at 02:53 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CANN ACADEMY INFANT CENTER
FACILITY NUMBER: 197493882

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/17/2021
Section Cited
HSC
1596.841

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§1596.841 Current roster of children provided care in facility required Each child day care facility shall maintain a current roster of children who are provided care in the facility... This standard was not met as evidence by: per licensees statement
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Licensee shall prepare an partial roster reflecting children in on todays visit no later than 9/17/2021 a copy shall be emailed to LPA. A complete roster shall be prepared no later than 9/22/2021
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there was no roster availble for review.
this poses an possible health and safety risk to children in care. A type B was issued
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Type B
09/22/2021
Section Cited
CCR101238.2(g)

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101238.2(g) The playground shall be enclosed by a fence to protect children and to keep them in the outdoor activity area. The fence shall be at least four feet high. This standard was not met as evidence by
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Licensee shall provided added supervison beyond ratios when infants are using the out door activity space, until repairs or alternate solutions are made. No later than 9/22/2021
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LPA observed slants missing from gate, large enough for a small child to wander away through. This is an immediate health and safety risk to children in care. Type B citation was issued
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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:Peter Flores
LICENSING EVALUATOR NAME:Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:
DATE: 09/15/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/15/2021


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