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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494225
Report Date: 01/16/2020
Date Signed: 01/16/2020 04:34:51 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:LEIVA FAMILY CHILD CAREFACILITY NUMBER:
197494225
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
01/16/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:37 PM
MET WITH:LicenseeTIME COMPLETED:
04:38 PM
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On 1/16/2020 Licensing Program Analyst Chandler made an unannounced visit to the Leiva Family Child Care home for the purpose of conducting an increase in capacity inspection. Present in the home were the licensee, the licensees spouse and 5 day care children which included the licensee's two minor children. Licensee provided LPA with a tour of the home. All adults in the home have criminal back ground clearances.

The home has two levels with 5 rooms in total and two restrooms, day care is conducted in the lower level of the home utilizing 3 rooms for day care purposes and 1 rest room. The upper level of the home consist of two bedrooms, living room, kitchen, dining room and 1 rest room, this area is off limits to childcare. The upper level was made inaccessible using child proof gates.

LPA observed the fire departments required repairs and requirements; pull alarm system and single latching doors.

There are no corrections or changes to the departments initial inspection as recorded in the pre-licensing inspection conducted on 6/19/2019.

Licensee has provided proof of the required academic curriculum necessary to increase the homes capacity to 14.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2020
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: 01/16/2020
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Licensee was informed regarding a Large Family Child Care Homes, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either:

twelve children, no more than four of whom may be infants;

or more than twelve and up to fourteen children only if the criteria in Section 1597.465 of the Health and Safety Code are met.

Licensee was advised to review Section 1597.465 of the Health and Safety Code for further criteria regarding ages and ratios.

Licensee shall provide parents with the LIC. 9150 -Parent Notification Additional Children in Care, a copy shall be placed in each child's personal folders.

Licensee was also reminded that the capacity must not exceed the licensed capacity of the home at any time during day care days and hours.

Based on todays report and completed recommendations the home shall be recommended for an increase.

This report was read by the licensee and a copy was provided.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Jillinda ChandlerTELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2020
LIC809 (FAS) - (06/04)
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