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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191806752
Report Date: 12/20/2024
Date Signed: 12/20/2024 03:13:51 PM

Document Has Been Signed on 12/20/2024 03:13 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:HEATH, ANNIE MARIE FAMILY DAY CAREFACILITY NUMBER:
191806752
ADMINISTRATOR/
DIRECTOR:		HEATH, ANNIE MARIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 935-4448
CITY:LOS ANGELESSTATE: CAZIP CODE:
90019
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 2DATE:
12/20/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:24 AM
MET WITH:Annie HeathTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
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On 12/20/2024, Licensing Program Analyst (LPA) Veronica Wheatley conducted an Annual Inspection and was met by Licensee, Annie Heath. Days and hours of operation, Monday -Friday 6:30am to 6:00pm.

LPA toured the home inside. LPA observed licensee's 11 year old granddaughter. Current facility sketch reviewed and the licensee confirmed that the children are allowed in the living room and one bedroom. The remainder of the home is off-limits.

There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible during the inspection. The home does not have a fireplace. There are stairs in the home which are inaccessible by a locked door.

There is a working fire extinguisher, smoke detector, and carbon monoxide detector. There is adequate heating and ventilation for safety and comfort. There is central heating and air conditioning. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The licensee has permission slips for field trips. The outdoor play area in the backyard is fenced and there are no hazards to children present. The classroom behind the garage is safe and the children will not eat or sleep in this room. LPA did not observe any bodies of water.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
LICENSING EVALUATOR SIGNATURE: DATE: 12/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/20/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: HEATH, ANNIE MARIE FAMILY DAY CARE
FACILITY NUMBER: 191806752
VISIT DATE: 12/20/2024
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LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporte expires December 2026. Licensee’s pediatric CPR/First Aid expires May 2025. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. 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 discussed Safe Sleep Regulations with licensee. Licensee was informed there should be a crib or play yards for each infant. The play yard or crib must be kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Licensee will keep a sleeping log for the children. Provider will physically check on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Capacity as specified on the license is being maintained. There are no infants on the premises today.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.
Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited. Exit interview conducted. The report was read and provided to the licensee. The report shall be made available to the public upon request. Notice of Site Visit will be posted for 30 days.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2024
LIC809 (FAS) - (06/04)
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