197494819-3-15-2022-30-CC-LPHS-CCJQVB-20220315123005

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494819
Report Date: 03/15/2022
Date Signed: 03/15/2022 12:30:16 PM

Document Has Been Signed on 03/15/2022 12:30 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	LEVITT FAMILY CHILD CARE		FACILITY NUMBER:	197494819
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 8	DATE:	03/15/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	VIRGINIA LEVITTT		TIME COMPLETED:	12:40 PM

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On 3/152022 at 10:00AM Licensing Program Analyst (LPA) Loyce Phillips conducted a Case Management - Licensee Initiated visit. This inspection is due to an application received for a capacity increase. LPA, met with Licensee, Virginia Levitt and was guided on a tour of the facility. The facility intends to operate Monday through Friday 9:00am to 3:00pm.

The areas identified on the facility sketch were inspected. This is a 3 bedrooms, 2 bathrooms home with living room, dining room, kitchen, laundry room, den, detached garage and back room (detached from the home). The back room is a single standing room. Licensee resides in the home with adult roommate. All adults have criminal record clearance. Licensee provides am snacks to children. Areas that are accessible to children are as follows: Back room (main day care room), den, bathroom #2 located adjacent to the den and back yard. The backyard has grass and concrete with age appropriate toys.

The off-limits areas are as follows: Bedroom #1, #2, #3, living room, dining room, kitchen, laundry room, bathroom #1 and detached garage. The off-limits rooms are made inaccessible by a safety gate and child proof door knobs. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, poisons, detergents/cleaning compounds, medication and hazardous items that can pose a danger to children are inaccessible. LPA observed age appropriate safe toys inside. Licensee advised; children will nap on mats. The facility has a smoke detector that was tested and operating.

LPA reviewed with Licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

809-C

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3063
LICENSING EVALUATOR NAME: Loyce Phillips	TELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022

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: LEVITT FAMILY CHILD CARE	FACILITY NUMBER: 197494819
	VISIT DATE: 03/15/2022

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Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 resources. LPA also informed applicant 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.

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: http://www.ada.gov/childqanda.htm

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletter and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at

https://www.cd.ss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

809-C

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3063
LICENSING EVALUATOR NAME: Loyce Phillips	TELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022

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: LEVITT FAMILY CHILD CARE	FACILITY NUMBER: 197494819
	VISIT DATE: 03/15/2022

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Based on today's inspection the following corrections are required prior to issuing updated license:

- Air conditioning unit made inaccessible.

- Heater made inaccessible.

Proof of corrections is to be provided to the Department by 3/22/22.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed Licensee, Virginia Levitt.

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3063
LICENSING EVALUATOR NAME: Loyce Phillips	TELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022

LIC809 (FAS) - (06/04)

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