197494482-5-14-2024-30-CC-LPHS-D59VHZ-20240514162758

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494482
Report Date: 05/14/2024
Date Signed: 05/14/2024 04:28:12 PM

Document Has Been Signed on 05/14/2024 04:28 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	FERNANDEZ FAMILY CHILD CARE		FACILITY NUMBER:	197494482
ADMINISTRATOR:	FERNANDEZ JACKELINE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(424) 269-0837
CITY:	HAWTHORNE	STATE: CA	ZIP CODE:	90250
CAPACITY:	14	CENSUS: 6	DATE:	05/14/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	JACKELINE FERNANDEZ, LICENSEE		TIME COMPLETED:	04:45 PM

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On 5/14/2024 Licensing Program Analyst (LPA), Loyce Phillips conducted an unannounced Annual/Random Inspection and was met by Licensee, Jackeline Fernandez. LPA observed 6 children in care with Assistant. All adults have a criminal record clearance. The facility operating hours are Monday through Friday from 5:30am to 6:00pm. The facility has liability insurance. Capacity as specified on the license is being maintained during today's inspection.

LPA toured inside and outside the facility. The home consist of 4 bedrooms, 3 bathrooms with living room, den/family room, kitchen, dining area, laundry room and detached garage.

The areas that are accessible to children: living room, dining area, bathroom #1 located in bedroom #1. The family room is accessible for children to walk through only.

The areas that are off limits to children: Bedrooms #2, #3 and #4. Bathrooms #2 and #3, the kitchen, laundry room, family room and garage/storage area.

There is no swimming pool or other bodies of water on the premises. Licensee stated there are no firearms in the home. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible to children. LPA observed a fireplace in the family room made inaccessible to children.

There is a fully charged fire extinguisher located in the dining area hall way. The facility has a working smoke detector and carbon monoxide inside the home that was tested and working properly. The facility has adequate heating and ventilation for safety and comfort. Safe toys, materials and play equipment observed. The facility has a First aid kit located in the main day care room. Children nap on mats. The home has working telephone service and LPA confirmed the phone number is 424-269-0837. 809-C

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Loyce Phillips	TELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: FERNANDEZ FAMILY CHILD CARE	FACILITY NUMBER: 197494482
	VISIT DATE: 05/14/2024

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Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. Capacity as specified on the license is being maintained.

Licensee’s Mandated Reporter Training was completed on 2/82024 Licensee’s pediatric CPR/First Aid was completed on 8/9/2023

This facility does not provides Incidental Medical Services – IMS. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Safe Sleep - LPA discussed the safe sleep regulations with Licensee, Jackeline Fernandez and discussed the Child Care Licensing Safe Sleep webpage at:https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. 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. LPA discussed infant safe sleep log and provided an example of a sleep log to Licensee. LPA explained and provided LIC 9227 to Licensee.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

809-C.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Loyce Phillips	TELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: FERNANDEZ FAMILY CHILD CARE	FACILITY NUMBER: 197494482
	VISIT DATE: 05/14/2024

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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies cited. Technical advisory discussed.

An exit interview was conducted, a copy of this report was read and provided to Licensee, Jackeline Fernandez. This report shall me made available to the public upon request. LIC 9213 Notice of Site Visit was provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Loyce Phillips	TELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

LIC809 (FAS) - (06/04)

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