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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700335
Report Date: 09/27/2024
Date Signed: 09/27/2024 11:04:31 AM

Document Has Been Signed on 09/27/2024 11:04 AM - 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:LIMA FAMILY CHILD CAREFACILITY NUMBER:
195700335
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
09/27/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:20 AM
MET WITH:Derick Lima, ApplicantTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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On 9/27/24 Licensing Program Analysts (LPA) Jeanine Lipsey with applicant, Derick Lima. The purpose of the visit was, announce a pre-license visit to ensure that health, safety, and personal rights as required by Title 22 and Health and Safety Regulations governing California Child Care Homes will be met. Entrance check list was provided. This is an application for a small Family Child Care Home. Applicant is requesting a capacity of 8 children, ages 6 months to 6 years old. The Family Child Care Home will operate Monday – Friday 8:30 AM – 5:30 PM. Applicant stated that a cell phone, with active service in the home will be the main contact number while children are in care. The entrance will be through the side metal gate leading to the back yard.

LPA discussed the LIC282 Affidavit Regarding Liability Insurance with applicant. If applicant does not have insurance this form needs to be filled out and put in the child folder LPA discussed the LIC282 Affidavit Regarding Liability Insurance with applicant.

LPA reviewed with applicant, the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. LPA Lipsey observed the following required postings: LIC 610A Emergency Disaster Plan, PUB 394 Notification of Parents’ Rights Poster, and LIC 9148 Earthquake Preparedness Checklist. LPA advised, once licensed, the facility license shall be posted. LPA advised all LIC 9213 Notice of Site Visits shall be posted for 30 days after each site visit. LPA advised, any licensing report documenting a Type A citation must be posted for 30 days. LPA advised a fire/disaster drill log shall be available and performed at least every six months.

The applicant has completed preventive health and safety/Childhood Nutrition/ Lead Exposure Prevention on 4/28/24 and Mandated Reporter training completed on 7/22/24. The applicant has current pediatric CPR/First Aid training completed on 5/10/24.


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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Jeanine Lipsey
LICENSING EVALUATOR SIGNATURE: DATE: 09/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/27/2024
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LIMA FAMILY CHILD CARE
FACILITY NUMBER: 195700335
VISIT DATE: 09/27/2024
NARRATIVE
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Applicant, guided LPA on a tour of the home. All areas identified on the home sketch were inspected, including but not limited to off limit areas. Per applicant off limit areas will be in inaccessible. This home consists of 4 bedrooms, 2 bathrooms, sunroom, kitchen, breakfast nook, and living/dining room. Per applicant, the children will use the following areas: Dining room, infant bedroom #1, breakfast nook, sunroom, hallway (library) and bathroom #1.

The entire 2nd floor, bedrooms #2 & #3, #4, bathroom #2, and living room is off limits to the children in care. Safety gates are installed to make the kitchen inaccessible. There is locked door leading the Livingroom and stairs to the 2nd floor rendering it off limits to children in care. The kitchen cabinets and drawers were observed with a locking mechanism. The stove, refrigerator, sink and counter space area were observed. The bathroom, with working toilet and sink was observed to be free of hazards and good repair.

LPA observed a fireplace in the off-limit living room area behind a locked door rendering it inaccessible to children in care. LPA observed an open-faced heater in the sunroom blocked by a cabinet.

The dining room and sunroom was observed to have children size tables, chairs, toys and variety of age-appropriate materials. There were no fixtures, furniture, and equipment that have been banned or recalled by the United States Consumer Product Safety Commission. LPA observed emergency water in the kitchen and the first aid kit in the hallway was incomplete. The LPA observed the home was clean and orderly, with heating and ventilation for safety and comfort. Per applicant, children will eat in the dining room and sleep in the sunroom and bedroom #1. LPA observed applicant test the carbon monoxide/smoke detectors in the Dining room, sunroom, hallway, bedroom #1 and kitchen, they were in good working condition. LPA observed a fire extinguisher (2A10BC) in the kitchen with a purchase date of 9/16/24. LPA observed there were no defects or conditions which might endanger the children. All electrical outlets in the home were covered. The LPA observed there were no poisons, detergents, cleaning compounds, medicines, and other items which could pose a danger, accessible to children. Per applicant, there are no weapons or firearms of any kind in the facility currently. The LPA did not observe any weapons.

Cots were observed for napping. LPA advised, there shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. LPA observed the home to have 2 cribs. LPA advised, applicant the placement of cribs or play yards shall not hinder entrance or exit to and from the space where infants are sleeping.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Jeanine Lipsey
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LIMA FAMILY CHILD CARE
FACILITY NUMBER: 195700335
VISIT DATE: 09/27/2024
NARRATIVE
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LPA advised, mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged. Mattresses shall be made specifically for the size crib or play yard in which they are placed.

LPA advised, cribs or play yards shall be free from all loose articles, objects, bumper pads shall not be used, and there shall be no objects hanging above or attached to the side of the crib. Per Health and Safety Code Sections 1596.846(b) and (c), LPA advised, baby walkers, bouncers, Johnny jumpers, trampolines, and saucer chairs are not permitted.

LPA discussed when a child shows signs of illness, he/she shall be separated from other children until the nature of the illness determined. If it is a communicable disease, he/she shall be separated from other children until the infectious stage is over. The Isolation area will be in the hallway (library).

Children will utilize the back yard to play. Outdoor play area was observed to be fenced, and Per applicant, when children are having outside time, they will ensure 100% supervision and never leave children unattended. LPA did not observe nay bodies of water on the premises.

LPA discussed, the applicant shall be present in the home and shall ensure that children in care and always supervised. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.



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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Jeanine Lipsey
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: LIMA FAMILY CHILD CARE
FACILITY NUMBER: 195700335
VISIT DATE: 09/27/2024
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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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

On 6/25/24, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

LPA discussed, Smoking is prohibited on the premises of a family childcare home as specified in Health and Safety Code Section 1596.795(a). A baby walker shall not be allowed on the premises of a family childcare home in accordance with Health and Safety Code Sections 1596.846(b) and (c).

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.



LPA discussed the safe sleep regulations with applicant 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 applicant, 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.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Jeanine Lipsey
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: LIMA FAMILY CHILD CARE
FACILITY NUMBER: 195700335
VISIT DATE: 09/27/2024
NARRATIVE
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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

The following unmet licensing standards are needed before a license will be considered.

1.Painting on the 2nd floor need to be completed.

2.The paint discarded in the backyard need to be removed.

3.First aid kit to include Band-Aids, scissors and tweezers.

4.Wires near hot water heater need to be blocked so its inaccessible to the children.

Corrections are due by 10/28/24.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with applicant Derick Lima.


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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Jeanine Lipsey
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024
LIC809 (FAS) - (06/04)
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