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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016139
Report Date: 09/03/2021
Date Signed: 09/03/2021 01:32:37 PM

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:MISSION KIDZ CHILD CARE CENTERFACILITY NUMBER:
198016139
ADMINISTRATOR:ANDREA CANALESFACILITY TYPE:
850
ADDRESS:415 W. TORRANCE BLVD.TELEPHONE:
(310) 386-0690
CITY:CARSONSTATE: CAZIP CODE:
90745
CAPACITY:50CENSUS: 14DATE:
09/03/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Naomi Iosia, DirectorTIME COMPLETED:
03:00 PM
NARRATIVE
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This complaint inspection was conducted by Katrina Chicote, Licensing Program Analyst (LPA) on 09/03/2021 at 2:30 PM For the purpose of initiating the 10-day inspection. During this visit, LPA observed Staff 4(S4) to be in Room 1 providing care for children in care at time of inspection. Upon review, LPA did not observe S4's name on personnel report. Per Director, she states that S4 is a returning employee but does not have fingerprint clearance, and Director states that S4 has been employed with the facility now since June. This is a violation of Title 22 regulation requirements and poses an immediate health, safety, and personal rights risk to children in care and a civil penalty assessed.

LPA advised Director that all adults 18 years of age and older providing Care & Supervision and/or have continuous presence in the facility shall adhere to a criminal background clearance with the Department of Justice, FBI and Child Abuse Index Check. 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.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2021
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MISSION KIDZ CHILD CARE CENTER
FACILITY NUMBER: 198016139
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/03/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/06/2021
Section Cited

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101170(a)(1)(E) Criminal Record Clearance
An applicant and any person specified in subdivision (b) shall submit a second set of fingerprints to the Department of Justice for the purpose of searching the records of the Federal Bureau of Investigation, in addition to the search required by subdivision (a).
This regulation was not met as evidenced by:
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Based on observations, interviews, &record review, Director states that S4 does not have fingerprint clearance. LPA confirmed on personnel report that S4 is not listed and has been employed since June. LPA observed S4 providing care for children.
This poses an immediate health, safety, or personal rights risk to 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: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:
DATE: 09/03/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/03/2021
LIC809 (FAS) - (06/04)
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