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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192006738
Report Date: 08/06/2025
Date Signed: 08/06/2025 02:31:09 PM

Document Has Been Signed on 08/06/2025 02:31 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:LAVELLE FAMILY CHILD CAREFACILITY NUMBER:
192006738
ADMINISTRATOR/
DIRECTOR:		LAVELLE, L & KELLY, S.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 930-5769
CITY:COMPTONSTATE: CAZIP CODE:
90222
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
08/06/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:51 AM
MET WITH:Facility Representative Shanell, KellyTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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On 8/6/25 Licensing Program Analysts (LPA) Tyler Reyes conducted an unannounced Annual/Random inspection at the above facility. LPA met with Facility Representative Shanell, Kelly and provided an Entrance Checklist-Family Child Care Homes LIC 126. LPA conducted a tour of the facility led facility representative Kelly. LPA observed (5) children in care. Per facility representative the hours of operation are Monday-Sunday 6AM-6PM. Licensee also provides overnight care Monday - Sunday 6pm-6:00am. Care provided during the day and overnight combined shall not exceed 24 hours from the time the child entered into care. The facility is licensed to care for MAX. CAP (WHEN THERE IS AN ASSISTANT PRESENT): 12 - NO MORE THAN 4 INFANTS. CAP 14 - NO MORE THAN 3 INFANTS. 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6. LPA discussed and provided copies of Capacity Regulations for Family Child Care Home License, Personnel Report LIC 500, and Child Care Facility Roster LIC 9040. LPA spoke with the licensee via telephone. Licensee stated they were on the way to a medical appointment. LPA informed that attending a medical appointment is acceptable and to ensure temporary absences do not exceed 20 percent of operating hours and a cleared/associated adult is present to provide care and supervision.

During the inspection, the following individuals were present in the home: Facility Representative Kelly and Adult 1. Per Licensee via telephone A1 has been residing in the home for (5) years. LPA informed based on a check of the Department of Social Services Guardian Background Check System indicates A1 clearance Determination is in process which poses a health and safety risk. LPA informed that any individual that has direct contact with the children or resides at the facility is required to have a criminal record clearance or exemption.

Facility Sketch: The facility is a single-story structure that consists of a Front yard, living room, dining room, day care room, kitchen, (3) bedrooms, (2) restrooms, laundry area, detected garage, and backyard.

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NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Tyler Reyes
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/06/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: LAVELLE FAMILY CHILD CARE
FACILITY NUMBER: 192006738
VISIT DATE: 08/06/2025
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On-Limits: Front yard, living room, dining room, day care room, (1) restroom, and kitchen.

Off-Limit: (3) bedrooms, (1) restroom, detached garage, and backyard.

Facility Postings: LPA observed the required postings in the living room: Facility License, PUB 394 Notification of Parents’ Rights, and LIC 9148 Earthquake Preparedness, LIC 610A Emergency Disaster Plan, and Verification of Disaster and Fire Drills.

Emergency Disaster Drill: Fire Drill 7/1/25

Infants: LPA observed (1) infant in care. LPA discussed infant safe sleep with facility repersentative. Facility should supervise infants while they are sleeping adhering to physical checks every (15-minute) and ensuring infants are sleeping on their back. Documentation of these checks shall be maintained in the infant’s file and made available for Department review. Documentation shall include the date, infant’s name, and the time of each (15-minute) check. The infant’s authorized representative and emergency contact shall be notified if any signs of distress or labored breathing are observed. An individual Sleep Plan LIC 9227 shall be completed for each infant up to12 months of age. LPA provided the Licensee with copies of the Infant Safe Sleep information from the Family Child Care Home Licensing Requirements handbook. LPA observed a 15-min sleep log.

Items not permitted: LPA provided the Licensee with a picture listing some of the items not permitted in a family childcare home, which include a bouncer, a jumper, and a walker. These items are not allowed to be on the premises of the facility.

Meals: Per facility representative Kelly children will have meals in living room. Facility Representative Kelly was advised to ensure all food brought from home is properly labeled and stored. Per facility representative no children have reported food allergies.

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NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Tyler Reyes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: LAVELLE FAMILY CHILD CARE
FACILITY NUMBER: 192006738
VISIT DATE: 08/06/2025
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Medication: Per facility representative the facility will provide incidental medical services. If required, medication will be inaccessible to children by centrally storing and locking. Medications will be administered in accordance with PIN 22-02-CCP, which outlines requirements for proper storage, documentation, and staff training.

The following on-limit areas that will be used by children were inspected for safety, comfort, and cleanliness. Heating and cooling are provided by central air-conditioning. LPA observed age-appropriate toys and learning materials. Telephone service is provided via cell phone. LPA observed a fire extinguisher in the kitchen which pressure gauge indicated that the extinguisher needs to be recharged and with a purchase receipt of 5/17/23 which poses a potential health and safety risk. Family Child Care Homes are required to maintain a new or serviced fully charged fire extinguisher which is at least a 2A:10BC annually. (1) technical violation (TV) was issued for the missing outlet covers on electrical outlets. LPA observed an operable smoke and carbon monoxide detector in daycare room. LPA observed a knife in the kitchen holder on the countertype. LPA reminded the facility representative to ensure all knives and cleaning products are stored in a manner that is both inaccessible and age-appropriate for the children enrolled. Per facility representative Kelly there are no firearms on the premises. If firearms are present, LPA verified per Title 22 regulations that they are locked, with ammunition stored separately. .

Poisons/Cleaning Products: Poisons and cleaning products are kept key locked in off-limit laundry area cabinet. No personal hygiene products were observed in on-limit restroom.

Outdoor: Children may use the front yard for outdoor play. The front yard is enclosed. Per facility representative children will be supervised during outdoor play. Per facility representative no pets. No animal feces were observed. LPA observed an empty inflatable pool deflated in off-limit backyard. LPA discussed and provided copies of information for bodies of water from California-DSS-Manual-CCL. LPA discussed and reminded the Licensee of the requirement to always maintain visual supervision of children, as outlined in Title 22 Regulations. LPA discussed and provided copies of PIN 25-06 Extreme Heat Prevention.

Files: LPA was unable to review staff and children’s files per licensee and facility representative. Files are key locked in a cabinet which pose a potential risk. LPA reminded the licensee the files must be readily available and that the facility representative should have access to produce them upon request.

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NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Tyler Reyes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
LIC809 (FAS) - (06/04)
Page: 5 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: LAVELLE FAMILY CHILD CARE
FACILITY NUMBER: 192006738
VISIT DATE: 08/06/2025
NARRATIVE
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LPA conducted an interview with facility representative regarding the following topics: infant safe sleep practices, the facility’s plan to support children’s learning and development, procedures for keeping parents informed, strategies for managing challenging behaviors, and protocols for managing food allergies. LPA discussed reporting requirement and the staff’s responsibilities as a mandated reporter, including the obligation to report to Community Care Licensing and emergency personnel when necessary.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Facility representative was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product 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 their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

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NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Tyler Reyes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
LIC809 (FAS) - (06/04)
Page: 6 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: LAVELLE FAMILY CHILD CARE
FACILITY NUMBER: 192006738
VISIT DATE: 08/06/2025
NARRATIVE
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Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Facility Representative Kelly confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty. Exit interview conducted and Appeal Rights provided with Facility Representative Kelly. Please see attached LIC 809-D for citations. (4) Type B's were issued and (1) Technical Violation.

NAME OF LICENSING PROGRAM MANAGER: Karen Chambers
NAME OF LICENSING PROGRAM ANALYST: Tyler Reyes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
LIC809 (FAS) - (06/04)
Page: 3 of 8
Document Has Been Signed on 08/06/2025 02:31 PM - It Cannot Be Edited


Created By: Tyler Reyes On 08/06/2025 at 01:52 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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LAVELLE FAMILY CHILD CARE
FACILITY NUMBER: 192006738

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(1)
(1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in LPA observed a fire extinguisher in the kitchen which pressure gauge indicated that the extinguisher needs to be recharged and with a purchase receipt of 5/17/23 which poses a potential health, safety or personal rights risk to persons in care
POC Due Date: 08/13/2025
Plan of Correction
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Licensee will ensure the maintain a new or serviced fire extinguisher annually. Licensee will service fire extinguisher or purchase a fire extinguisher. POC will be cleared by a visit.
Type B
Section Cited
CCR
102391(d)
(d) The licensee shall permit the Department to inspect, audit, and copy children's records or other family child care home records upon demand during normal business hours. Records may be removed if necessary for copying.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, the licensee did not comply with the section cited above in LPA was unable to review children's files per licensee and facility representative files are key locked in a cabinet and facility repersentative did not have access which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/13/2025
Plan of Correction
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Licensee will ensure all children files are readily available. POC will be cleared by visit.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Karen Chambers
NAME OF LICENSING PROGRAM MANAGER:
Tyler Reyes
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/06/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/06/2025 02:31 PM - It Cannot Be Edited


Created By: Tyler Reyes On 08/06/2025 at 01:55 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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LAVELLE FAMILY CHILD CARE
FACILITY NUMBER: 192006738

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.1(d)
(d) All personnel records shall be maintained at the child care home and shall be available to the licensing agency for review.

This requirement is not met as evidenced by:
Deficient Practice Statement
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3
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Based on interview, the licensee did not comply with the section cited above in LPA was unable to review staff files per licensee and facility representative files are key locked in a cabinet and facility repersentative did not have access which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/13/2025
Plan of Correction
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Licensee will ensure all staff files are readily available. POC will be cleared by visit.
Type B
Section Cited
HSC
1596.871(c)(1)(A)
Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision (f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above at 11:37AM on 8/6/25 a check of the Department of Social Services Guardian Background Check System indicates Adult 1 (A1) clearance Determination is in process which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/13/2025
Plan of Correction
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Licensee will ensure all adults residing in the home are cleared and associated to faciliy. Licensee will ensure Adult 1 (A1) is cleared and associated if going to reside in the home. A1 is not to have direct contact with the children enrolled until cleared and associated. POC will be cleared by visit.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Karen Chambers
NAME OF LICENSING PROGRAM MANAGER:
Tyler Reyes
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/06/2025


LIC809 (FAS) - (06/04)
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