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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494225
Report Date: 02/03/2023
Date Signed: 02/03/2023 11:35:29 AM


Document Has Been Signed on 02/03/2023 11:35 AM - 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:LEIVA FAMILY CHILD CAREFACILITY NUMBER:
197494225
ADMINISTRATOR:LEIVA, YEMILIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 961-1592
CITY:INGLEWOODSTATE: CAZIP CODE:
90303
CAPACITY:14CENSUS: 8DATE:
02/03/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:21 AM
MET WITH:Yemili Leiva-LicenseeTIME COMPLETED:
11:45 AM
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On 2/3/2023 Licensing Program Analyst (LPA) Jillinda Chandler made an unannounced visit to the Leiva Family Day Care for the purpose conducting a Required - 1 Year annual inspection. Present in the home were the licensee, licensees husband, 7 day care children and the licensee's minor child who was included in today's capacity. LPA toured the home for Health and Safety Compliance. The home is a two story home with an off limits living quarters on top and day care operations conducted on the lower level.

The following were observed during todays inspection:

Proper care and supervision was observed. Children were observed during meal time, children in high chairs were immediately removed after eating.
The homes capacity was within the scope of the license, there was no assistant so the capacity was reduced to a small family home's capacity. The home was clean and orderly.
During the inspection licensee's husband provided limited assistance, LPA informed licensee that if her husband will be assisting with children, he will be required to complete the Mandated Reporter Training, all other requirements were provided; TB and Immunization records.
Appropriate size fire extinguisher (last serviced 5/17/2022), carbon and smoke detector present & operable. Home is also equipped with fire alarm.
SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:
DATE: 02/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/03/2023
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: LEIVA FAMILY CHILD CARE
FACILITY NUMBER: 197494225
VISIT DATE: 02/03/2023
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Detergents, and knives were inaccessible, Toxins were locked and inaccessible.
The homes kitchen was inaccessible to children in care No guns or weapons present as stated by the Licensee, no weapons observed by LPA.
The home has a properly working telephone LPA observed the homes parent notification board; the license, facility sketch, Emergency Disaster Plan, Notification of Parent’s Rights Poster, Lead Poison Awareness, Safe Sleep and California Safety Seat Law were posted.
A first aid kit was observed containing the required supplies: scissors, tweezers, bandages, medical ointment and a thermometer. Licensee’s Pediatric CPR and First Aid Card expires 4/2023 No bodies of water were observed on the premises
Children records were readily available and in good order, containing required documentation.
Licensee's records were reviewed, LPA observed immunization records for licensee.
Licensees Mandated Reporter certificate expires 4/23/2024
A current roster was current and readily available for review.
Parents and authorized adults sign children in and out using their original signatures. Licensee was informed, sign in sheets shall be retained for a minimum of 30 days.
Licensee does provide Individual Medical Services (IMS). IMS was discussed with licensee. LPA observed an Epi Pen that had expired, a technical violation was issued and licensee was advised to have the parent provide a non-expired Epi-pen.
All adults in the home cleared a Criminal Background Clearance.
SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023
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: LEIVA FAMILY CHILD CARE
FACILITY NUMBER: 197494225
VISIT DATE: 02/03/2023
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Toys, equipment and materials available and in good order Children napped in cribs or cots were found to be in good condition. Infant safe sleeping was discussed with licensee. LPA reminded licensee that children are only to use car seats during transportation. Outdoor activities were conducted in the upstairs grassy (second level, bricked area is not used for outdoor activity) a court yard LPA did not observe any hazardous conditions in this area.

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.

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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023
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: LEIVA FAMILY CHILD CARE
FACILITY NUMBER: 197494225
VISIT DATE: 02/03/2023
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LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Yemili Leiva.

SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023
LIC809 (FAS) - (06/04)
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