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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191609128
Report Date: 04/07/2025
Date Signed: 04/07/2025 01:28:12 PM

Document Has Been Signed on 04/07/2025 01:28 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:WIENER FAMILY DAY CAREFACILITY NUMBER:
191609128
ADMINISTRATOR/
DIRECTOR:		GILLIAN DUMAS WIENERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 452-5740
CITY:SANTA MONICASTATE: CAZIP CODE:
90405
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 12DATE:
04/07/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Gillian Dumas Wiener, LicenseeTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
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On 04/07/2025, Licensing Program Analyst (LPA) Lisa Clayton made an unannounced visit to the Wiener Family Child Care Home to conduct the Required 3-year inspection. LPA was greeted by Licensee Gillian Dumas Wiener. LPA Clayton observed 12 children in care, being supervised by Licensee and 3 fingerprint cleared assistants. Per Licensee the hours of operation are Monday through Friday. 8:30am – 2pm. Licensee provides morning snack and water.

LPA toured the entire home inside and outside for a Health and Safety inspection. The home is neat and clean and has ventilation for safety and comfort. The home has working telephone and LPA Clayton confirmed the number is (310) 452-5740.

LPA Clayton confirmed that the home consists of: living room, dining room, kitchen, laundry room, 2 bedrooms, 1 bathroom, family room/office, detached bungalow (2 rooms) and fenced front and back yard.

The ON LIMIT AREAS are as follows: family room/office (to access the bathroom only), bathroom #1, fenced backyard, detached bungalow classroom 1, detached bungalow classroom #2. Classroom 1 has a kitchenette and a bathroom with 2 toilets and 2 sinks for the children’s use only. The isolation area is in the family room.

The OFF-LIMIT AREAS are as follows: living room, dining room, kitchen, laundry room, bedroom #1, bedroom #2, all of which are inaccessible to children in care by closed and/or locked doors and visual supervision.

Furniture and equipment in the home are in good condition and free of sharp, loose, or pointed parts. LPA Clayton inspected the classrooms and observed age-appropriate toys, books and furnishings. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards.

There are no pools, ponds, spas, or any other bodies of water on the property. There are no firearms or ammunition on the property.


NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Lisa Clayton
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/07/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 04/07/2025 01:28 PM - It Cannot Be Edited


Created By: Lisa Clayton On 04/07/2025 at 12:50 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: WIENER FAMILY DAY CARE
FACILITY NUMBER: 191609128

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/07/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA Clayton file/staff record review that the renewal was not completed the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/14/2025
Plan of Correction
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Licensee will provide proof of completion of the required Mandated Reporter training for herself and staff no later than Monday April 14, 2025. Licensee will ensure that the requirement is met every 2 years.
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on staff file/record review the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/14/2025
Plan of Correction
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Licensee will provide proof of the immunizations records required for child care staff no later than Monday April 14, 2025. Licensee will ensure that thre records are kept in the staffs files for review by the department.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Karren Starks
NAME OF LICENSING PROGRAM MANAGER:
Lisa Clayton
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/07/2025


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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: WIENER FAMILY DAY CARE
FACILITY NUMBER: 191609128
VISIT DATE: 04/07/2025
NARRATIVE
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The home has a fully charged 2A10BC fire extinguisher on the covered patio, and a working smoke detector/carbon monoxide detector combo in the hallway, and a working smoke detector and a working carbon monoxide detector in classroom #1. LPA Clayton provided licensee with a fire/disaster drill log and reminded licensee to conduct the drills at least every 6 months.

LPA Clayton reminded Licensees that any poisons, detergents/cleaning compounds, medication and hazardous items that can pose a danger to children are to be made inaccessible to children in care.

LPA Clayton reviewed 5 children’s files which contain current contact information for authorized representatives and/or relatives who can assume responsibility for the child, and a signed Consent for Emergency Medical Treatment. LPA Clayton provided licensee with a current Parent’s Rights and Personal Rights Forms. LPA Clayton reminded licensee to have copies of the childrens immunization records in the childrens files.

Licensee provided proof of current CPR/First certification, which expires October 2026. LPA Clayton reminded Licensee that Mandated Reporter certificates are to be renewed every 2 years. Licensee has immunizations records that are in compliance with immunizations required for childcare providers. LPA Clayton reminded licensee to have copies of the staff immunization records in the files.

Licensee provides care to children 2 years of age and older. LPA Clayton advised applicant if needed, to access the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and­resources/safesleep as an additional resource.

LPA Clayton informed applicant of the importance of checking for recalled infant devices on the United States Consumer Products 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 the purchased equipment. LPA Clayton discussed of the importance of checking for recalled infant devices on the United States Consumer Products 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 the purchased equipment.

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Lisa Clayton
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2025
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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: WIENER FAMILY DAY CARE
FACILITY NUMBER: 191609128
VISIT DATE: 04/07/2025
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Incidental Medical Services (IMS) are not currently being provided. LPA Clayton provided Licensee with the IMS Sample form and instructed her to submit a copy to the department immediately upon completion. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA reminded Licensee of the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations. Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&R) throughout California.
Licensee was reminded that all adults 18 and over living or working in the home, 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 Childcare Home. A Type A Violation and 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.

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



LPA Clayton instructed Licensee to update and submit proof of the following to the Department no later than Monday April 14, 2025.
· completed Mandated Reporter training certificate for herself and her staff – emailed to LPA
· an updated Disaster Plan – emailed to LPA
· an updated Parent Board with current documents all visible to the public
· immunization records for staff (MMR, Tdap/Dtap, TB, Influenza vaccine or declination letter) – emailed to LPA

Per Title 22 Regulations and Health and Safety Codes, Deficiencies and Technical Violations were issued today (see LIC 809D and LIC 9102).
An exit interview was conducted, a copy of this report was read and provided to licensee Gillian.

LPA Clayton posted a Notice of Site Visit which is required to be posted for 30 days.

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Lisa Clayton
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2025
LIC809 (FAS) - (06/04)
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