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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494860
Report Date: 08/18/2021
Date Signed: 08/18/2021 03:16:51 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:SCHORR FAMILY CHILD CAREFACILITY NUMBER:
197494860
ADMINISTRATOR:ELISHEVA SCHORRFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(848) 525-3464
CITY:LOS ANGELESSTATE: CAZIP CODE:
90035
CAPACITY:14CENSUS: DATE:
08/18/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Elisheva SchorrTIME COMPLETED:
12:00 PM
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On 8/18/2021 at approximately 10:00 a.m. Licensing Program Analysts (LPA) Judy Laureano and Lillian Casillas conducted an announced inspection with applicant Elisheva Schorr for the purpose of an announced pre-licensing inspection of 1430 Cardiff Avenue, Los Angeles, CA 90035. The purpose of this visit is to ensure the standards for a Family Child Care Home are being met in accordance to California Tittle 22 Regulations and California Health and Safety Codes.

The applicant is applying for a large family childcare license with a max capacity of 14. Property owner/landlord consent (LIC 9151) is on file. The licensee rents the property with her husband and 5 minor children. A copy of the rent/lease agreement was received.

Per the application, currently, the ages the applicant wishes to provide services for children 2 years old to 3 years old with the hours of operation being Monday through Friday, 8:45 a.m. to 1:30 p.m. Applicant was informed that any changes to ages, hours and days of operation shall be submitted to the department for approval prior to initiation of changes.

The home is a duplex home which consists of 3 bedrooms, 2-bathroom, kitchen, breakfast nook, living room, dining room and laundry room. Detached garage is designated as OFF LIMITS to the children in care.

Parents will access the day care through the front door. As you enter the facility, on one side is the living room which has been designated as off limits to the children in care.

SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021
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: SCHORR FAMILY CHILD CARE
FACILITY NUMBER: 197494860
VISIT DATE: 08/18/2021
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The living room has decorative fire place with couches and a bookshelves around the space.

Across from the living room the dinning room is designated as the day care room. LPA observed children size table and chairs and a minimal children’s materials. A variety of toys were observed. LPA advised applicant to add a parent board to display all mandatory materials for parents. Applicant stated children will not be napping while in care.

Next to the dining room, the breakfast nook will be used for the day care. All electric outlets were observed and inspected. LPAs observed a dining room table with chairs and a high chair. The space has built in shelves where children’s materials were stored.

LPAs observed the kitchen. The stove, refrigerator, dishwasher, sink and counter space area were observed and inspected. All kitchen cabinets were observed. LPA observed safety latches on cabinet under the sink. Knifes and sharp object were observed stored in the top cabinet, made inaccessible to the children in care.

Next to the kitchen, a laundry room was observed and the second exit. LPAs observed applicant test the carbon monoxide and smoke detector. LPA advised applicant to store water bottles and miscellaneous items in the garage. LPA observed the door that leads to the back yard.

All bedrooms in the home and one bathroom are off limits to the children in care. LPAs informed applicant that all doors need to be kept closed during the hours of operation. Bedrooms are accessible through the main hallway as you enter the home. Bedroom 1, Bedroom 2 and bedroom 3 with bathroom were inspected. Bedroom 3 was observed to have a second door that leads to the back yard that remains locked during all times

SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021
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: SCHORR FAMILY CHILD CARE
FACILITY NUMBER: 197494860
VISIT DATE: 08/18/2021
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The hallway was observed to have a carbon monoxide and smoke detector that was tested by applicant. Built in cabinets were observed to have a variety of children’s puzzles and materials. Fire extinguisher was observed in the hallways near the entrance. LPAs reminded applicant to have fire extinguisher service yearly.

The bathroom that children will used is located down the hallway. LPAs inspected a toilet, sink, bathroom and shower. LPA advised applicant to add a hand washing sign to ensure children wash their hands properly. All electric outlets were inspected and covered. Applicant was advised to add safety latches to drawers in the bathroom and remove all hair products from shower and bathtub.

Outdoor Space: Back yard is covered with artificial turf. LPAs observed a variety of age appropriate toys.

The following items are pending prior to licensure to be completed by Wednesday, August 25, 2021.

Kitchen: Knifes in the upper cabinet.

Dinning Room: Parent board needed.

Laundry Room: Removing items from the floor.

Bathroom: Safety latches to cabinet under the sink and removing all products from shower and tubs.

Outdoor space: wire secured to the wall.

An exit interview was conducted and copy of this report will be emailed to Elisheva Shorr. A follow up pre licensing visit will be scheduled if applicant is unable to submit corrections via email. A final decision of License issuance will be determined by the department unit licensing Manager.

ALL CORRECTIONS WERE COMPLETED BY THE END OF THE VISITS.

SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021
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: SCHORR FAMILY CHILD CARE
FACILITY NUMBER: 197494860
VISIT DATE: 08/18/2021
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The following was discussed with the applicant:
Applicant was made aware of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541
Email Address: childcareadvocatesprogram@dss.ca.gov

Mandated Reporter Training: Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com. Licensee was reminded of their responsibility to report suspected child abuse.

Mandatory Forms for the children’s files and provider’s files were discussed. Applicant was referred to LIC 311D: Records To Be must be kept current, as well as the roster and Drill Log additional forms can be obtained from Maintained At The Facility - Family Child Care Home. Applicant was reminded that all documents for children's records the Department website: www.ccld.ca.gov

FORMS TO BE POSTED


· LIC203 Facility License
· LIC 610A Emergency Disaster Plan
· LIC 9148 Earthquake Preparedness Checklist
· PUB394 Notification of Parents Rights Poster
Children’s records requirements:
· LIC 700 Identification and Emergency Information
· LIC 627 Consent for Emergency Medical Treatment
· LIC 282 Affidavit Regarding Liability Insurance
· LIC 9150 Parent Notification Additional Children in Care

SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021
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: SCHORR FAMILY CHILD CARE
FACILITY NUMBER: 197494860
VISIT DATE: 08/18/2021
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· Immunization record
· PUB 72- Family Child Care Consumer Guide
· LIC 995A Notification of Parent’s Rights
· CDPH 286 (Immunization Blue Card)
FACILITY RECORDS:
· LIC 624B Unusual Incident/Injury Report
· LIC 9040 Child Care Facility Roster
· LIC 9052 Employee Rights,
· LIC 9108 Statement Acknowledging Requirement to Report Child Abuse
· LIC 9149 Landlord Consent Form, if you plan to care for more than 6 children for a Small
· LIC 9151 Property Owner/Landlord Notification Form
· Proof of current pediatric CPR and First Aid Certificates

· Copy of your deed or lease/rental agreement


· Documentation of Fire and Disaster drills
· Proof of immunization's against pertussis (TDAP), measles (MMR), and influenza
· Mandated Reporter certificate – www.mandated reporterca.com – renewed every two years.
Licensee was made reminded that it is the licensee’s, as well as anyone who assists in providing care responsibility to know the regulations. Licensee was also encouraged to read the Child Care quarterly updates every season as they come out to stay informed of any changes or updates to statutes and regulations.

Applicant was advised that regulation prohibits the smoking of tobacco in a private residence licensed as a family child care home during the hours of operation. Applicant was made aware that state law prohibits baby walkers, bouncy seats, exer-saucers and any other items that fall into that category. Applicant was also reminded that only children who are eating may be in highchairs and that car seats are utilized only for transportation.

SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021
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: SCHORR FAMILY CHILD CARE
FACILITY NUMBER: 197494860
VISIT DATE: 08/18/2021
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Applicant was informed about SAFE SLEEP PRACTICES and was reminded that all infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome). LPA provided applicant with SAFE to SLEEP handouts. Applicant was also informed that the provider is required to wash hands after every diaper change and to never shake a baby to prevent the Shaken Baby Syndrome.

Safe Sleep Links:
AAP: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx


NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative

Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials

·Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. If the aforementioned is not adhered to, a Civil Penalty of up to $500, per non-cleared adult will be assessed immediately. Please advise your analyst of any person who will be visiting regularly or for longer than one week.
·In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR & Pediatric First Aid certification and a valid criminal record clearance associated to the facility license.
·A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.

·Annual fees must be paid promptly and by the due date or a late fee shall be assessed, and/or the License shall be terminated. (If paying by check please make sure to write facility number on check to ensure that payment is applied to your facility number)
· The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked, and batteries should be replaced.
·Changes should be reported the to the Department as soon as they occur such as construction and remodeling.Telephone number changes and/or if you move from home

SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Judy LaureanoTELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021
LIC809 (FAS) - (06/04)
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