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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198006584
Report Date: 12/11/2019
Date Signed: 12/11/2019 11:30:30 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:NICKLES-WEEMES FAMILY DAY CAREFACILITY NUMBER:
198006584
ADMINISTRATOR:NICKLES,SHEYRLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 808-9213
CITY:CARSONSTATE: CAZIP CODE:
90746
CAPACITY:14CENSUS: 6DATE:
12/11/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Sheyrl Nickles- Weems, LicenseeTIME COMPLETED:
11:50 AM
NARRATIVE
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LPA Sanchez conducted an unannounced Plan of Correction inspection to determine if the citation cited on 06/26/2019 has been corrected. LPA met with Licensee Sheyrl Nickles- Weems who guided LPA on a tour of the facility. Also present was Assistant Miriam Zarco. There were six children present during today's inspection, one of which was an infants.

The following citation has been corrected:

102416.5(d)(e)- Staffing ratio and capacity.
On the date of this Plan of Correction inspection, LPA confirmed with Licensee that she has hired another assistant to her facility to ensure facility is within her capacity. Based on the observations made by the LPA, the citation mentioned above has been corrected. (LIC 9224) acknowledgment receipt were missing for child #2, #4, and #5.

LPA issued the Confidential Names List (LIC 811) to the licensee during this visit. The Confidential Names List documents the children’s files that were reviewed during this inspection.

LPA gave out Safe Sleep handouts (A Child Care Provider's Guide to Safe Sleep & What Does A Safe Sleep Environment Look Like?).

Exit interview was conducted with Licensee. The Licensee was provided a copy of their appeal rights.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Susann SanchezTELEPHONE: (323) 981-3366
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: NICKLES-WEEMES FAMILY DAY CARE
FACILITY NUMBER: 198006584
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/11/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/11/2020
Section Cited

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A licensed child day care facility shall provide to the parents or guardians of each child receiving services in the facility copies of any licensing report that documents any Type A citation that represents an immediate risk to the health, safety, or personal rights of children in care as set forth in paragraph (1) of subdivision (a) of Section 1596.893b.
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This requirement was not met as evidenced by LPAs & RM during file review. LIC 9224 was missing for the dates of 06/26/2019. This poses an potential risk to the health and safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Susann SanchezTELEPHONE: (323) 981-3366
LICENSING EVALUATOR SIGNATURE:
DATE: 12/11/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/11/2019
LIC809 (FAS) - (06/04)
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