197494080-7-19-2021-30-CC-LSTN-C53UQX-20210719154751

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494080
Report Date: 07/19/2021
Date Signed: 07/19/2021 03:49:12 PM

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:	AMADOR FAMILY CHILD CARE		FACILITY NUMBER:	197494080
ADMINISTRATOR:	AMADOR, JENNIFER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 701-6687
CITY:	HAWTHORNE	STATE: CA	ZIP CODE:	90250
CAPACITY:	14	CENSUS: 4	DATE:	07/19/2021
TYPE OF VISIT:	Office	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Jennifer Amador		TIME COMPLETED:	02:45 PM

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On July 19, 2021 a Supervisory Conference was held via Microsoft Teams with Licensing Program Managers (LPMs), Karren Starks and Maureen Neal, Licensing Program Analyst (LPA) Laticia Thompson and Licensee, Jennifer Amador.

The purpose of the Supervisory meeting was to discuss additional or continuous concerns regarding the operations of her licensed facility since the Non- Compliance Conference on 12/14/2020:

The areas listed were discussed with the licensee on 12/14/2020, at which time the licensee was advised that the facility must maintain substantial compliance. It was at this time the licensee was made aware that failure to maintain substantial compliance with Title 22 Regulations and/or Health and Safety Codes would result in the Department seeking to take legal action against the facility.

Criminal Record Clearance and/or Exemption: Prior to working in a licensed facility all adult individuals must obtain a criminal record clearance or request a transfer of a criminal record clearance. LPA Thompson observed 2 assistants caring for children without a criminal record clearance on 10/30/2020. Based on record review of 12/20/19 this is a repeat violation. The licensee was informed of the importance for obtaining a Criminal Record Clearance and/or exemption in order to provide a safe environment for children in care. The licensee is to ensure that all adults in the home have obtained a criminal background clearance and/or exemption when working/residing and assisting with child care in the facility.

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Laticia S Thompson	TELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2021

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: AMADOR FAMILY CHILD CARE	FACILITY NUMBER: 197494080
	VISIT DATE: 07/19/2021

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Licensee states she submitted criminal record transfer requests but was unable to produce copies upon requests. Licensee also admits she did not contact the Regional Office to confirm transfer was completed prior to employing staff.

Personal Rights: Each child shall be accorded safe, healthful and comfortable accommodations, furnishing and equipment; investigative findings show that licensee did not store sharp knives in an area that was inaccessible to children under care. LPA Thompson observed an unlocked cabinet that contained poisonous material (toilet bowl cleaner, Lysol solution and hair products) which are harmful to children in care. Licensee did not lock a door that is an off-limits room containing sharp needles and medication in an accessible area to children.

Records: LPA observed children's records with missing documents. Licensee was unable to provide a roster for children in care.

Since the Non-Compliance Conference the licensee has been found non-compliant in the following areas:

Personal Rights:

Children are allowed to fight while in care

Licensee inappropriately disciplines the children.

A child while in care at the facility was shoved against a wall by the licensee’s mother

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Laticia S Thompson	TELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2021

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: AMADOR FAMILY CHILD CARE	FACILITY NUMBER: 197494080
	VISIT DATE: 07/19/2021

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Records:

Licensee failed to provide LPA with current roster of children enrolled in the facility, failed to provide children’s records as requested, failed to provide proof of 1^st Aid/CPR and Mandated Reporter training for assistant that was initially alone supervising the children.

Therefore, based on the licensee’s failure to maintain substantial compliance since the time of the Non-Compliance Conference, the Regional Office (RO) is requesting our Legal Department to seek an Administrative Action against the facility.

A copy of this report will be provided to the licensee. The licensee will provide a copy of this report to the parents or authorized representative of each child in care. The parent or authorized representative will sign a LIC9224 – Acknowledgement of Receipt of Licensing Reports, which will be placed in the child’s file. This procedure will also be completed for any child who enrolls within the next 12 months. If this process is not followed the licensee will be cited and a penalty will be assessed.

Licensee has been instructed to reply to the email of this report acknowledging a copy was received.

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Laticia S Thompson	TELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2021

LIC809 (FAS) - (06/04)

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