197494692-1-16-2025-58-CC-AMOS-DCYVVH-20250116154623

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494692
Report Date: 01/16/2025
Date Signed: 01/16/2025 03:46:32 PM

Document Has Been Signed on 01/16/2025 03:46 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	RAPHAEL FAMILY CHILD CARE		FACILITY NUMBER:	197494692
ADMINISTRATOR/ DIRECTOR:	RAPHAEL, SARAH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 798-5106
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90046
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 22	CENSUS: 8	DATE:	01/16/2025
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:40 AM
MET WITH:	Licensee Sarah Raphael		TIME VISIT/ INSPECTION COMPLETED:	04:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 1/16/2025, Licensing Program Analyst (LPA) Amelia Morales conducted an unannounced- Required 1 Year inspection to the above facility. The purpose of the inspection was to ensure that health, safety, and personal rights as required by Title 22 Regulations governing California Family Child Care Homes will be met by the Licensee. LPA met with Licensee Sarah Raphael, who guided analyst on a tour of the home. An entrance checklist was provided. Licensee states that there are currently 22 children enrolled. A census was taken there were 8 children during the time of the visit and 3 staff members. The children’s roster was reviewed and is current. Per licensee, the facilities hours of operation are Monday through Friday 8:00 AM to 5:00PM. This is a two story home which includes: the day care room, 1 bedroom, dining room, kitchen, living room, 3 bathrooms, deck, shed, basement, and front yard ( day care area that is fenced). Per Licensee, areas off limits to children and parents include: 1 bedroom, dining room, kitchen, living room, bathrooms #1. Per Licensee, the dining room has an entrance to the day care room that remains locked during the hours of operation. This making the other rooms listed above inaccessible to the children in care. Other areas of the home that are off limits to the children in care are the: basement , bathroom #3 which is located inside the basement. This area is fenced with the use of a gate/fence and is locked. The off limit areas located in the backyard such as the deck and shed were made inaccessible with the use of a gate/fence and locked. Page 1 of 4

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Amelia Morales
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: RAPHAEL FAMILY CHILD CARE	FACILITY NUMBER: 197494692
	VISIT DATE: 01/16/2025

NARRATIVE

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Per Licensee, areas that are accessible to children include: the day care, front yard (day care area that is fenced) and bathroom #2. The bathroom that children use is located in the corner of the day care room, was observed to be clean and free of hazards.

LPA observed the following: the home is clean and orderly. There were age-appropriate toys and play items. Licensee was informed that baby-walkers, bouncers, jumpers, and other prohibited items will not be used for children in care. All electrical outlets have safety covers. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. The Licensee states that there are no poisons in the home. The Licensee does understand that poison must be locked with a key or combination lock. Per licensee, there are no pets and LPA did not observe any pets at the time of visit. Per Licensee, isolation area for sick children is at the end of the day care room. The main entry door is used to enter the facility. The home is not equipped with surveillance cameras. LPA observed mats at the facility for napping purposes.

The Smoke/carbon monoxide detectors were observed in the day care room, tested and found to be operable. The required (2A10BC) fire extinguisher was observed in the day care room and was purchased on 12/02/2024.

Children utilize the front yard (day care area to play). LPA observed that the outdoor play area is fenced. Per applicant, when children are having outside time, they will ensure 100% supervision and never leave children unattended. There were no bodies of water present.

The Licensee has current Pediatric First Aid and CPR. Proof of immunization against influenza, pertussis, and measles was readily available during today’s inspection. The Licensee has also taken the Mandated Reporter Training.

— Pediatric First Aid and CPR Card valid until: 08/18/2026
— Mandated Reporter Completed: 8/4/2023

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Amelia Morales
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2025

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: RAPHAEL FAMILY CHILD CARE	FACILITY NUMBER: 197494692
	VISIT DATE: 01/16/2025

NARRATIVE

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Per licensee, the facility does not provide food for children in care. Per Licensee, if children are unable to bring lunch, facility will provide snacks. Licensee was reminded if children bring food from home, it must be labeled with the child’s name and properly stored or refrigerated.

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.

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.

LPA discussed the safe sleep regulations with licensee [or facility representative] 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 [or facility representative] 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.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Amelia Morales
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: RAPHAEL FAMILY CHILD CARE	FACILITY NUMBER: 197494692
	VISIT DATE: 01/16/2025

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

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.

During the exit interview, the Licensee Sarah Raphael , confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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

The facility was found in compliance per Title 22 regulations, no deficiencies were issued during today's visit. There were no corrections requested during this visit.

Exit interview conducted and report was reviewed with the licensee Sarah Raphael.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Amelia Morales
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

LIC809 (FAS) - (06/04)

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