<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700335
Report Date: 10/10/2024
Date Signed: 10/10/2024 08:53:28 AM

Document Has Been Signed on 10/10/2024 08:53 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:
10/10/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:15 AM
MET WITH: Derick LimaTIME VISIT/
INSPECTION COMPLETED:
09:00 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 10/10/24 Licensing Program Analysts (LPA) Jeanine Lipsey with applicant, Derick Lima. The purpose of the visit was, an announce continued 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. There were no children present.

The applicant lead LPA on a tour to observed the un-met licensing standards that were needed before a license will be considered. LPA observed a parent board with the required postings at the rear of the home were the children will enter, a fully stocked first aid kit, the paint in the back yard was properly discarded and removed, the wires near the water heater were made inaccessible to the children blocked by a small wood door, and the painting was completed on the second floor. The second floor consist of 2 bedrooms and a bathroom, which belongs to the the applicant and grandmother.

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.



Exit interview conducted and report was reviewed with applicant Derick Lima.

.

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Jeanine Lipsey
LICENSING EVALUATOR SIGNATURE: DATE: 10/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/10/2024
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 1