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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197405238
Report Date: 07/30/2024
Date Signed: 07/30/2024 11:51:46 AM

Document Has Been Signed on 07/30/2024 11:51 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:SAMAD FAMILY CHILD CAREFACILITY NUMBER:
197405238
ADMINISTRATOR/
DIRECTOR:		RANA SAMADFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 545-1824
CITY:MANHATTAN BEACHSTATE: CAZIP CODE:
90266
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
07/30/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:RANA SAMAD, LICENSEETIME VISIT/
INSPECTION COMPLETED:
12:10 PM
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On 7/30/2024 Licensing Program Analyst (LPA) Loyce Phillips conducted an unannounced Annual/Random inspection and was met by Licensee, Rana Samad. Licensee's son was present during inspection. All adults have a criminal record clearance on file. There were no children present during inspection. Licensee has requested to be remove from inactive status and resume operation. Licensee will operate Monday through Thursday from 8:00am to 5:00pm. The facility does have liability insurance on file.

LPA toured inside and outside the facility. This is a 2 story home with 5 bedrooms and 5 1/2 bathrooms with Living room, formal dining room, kitchen, family room, study and converted garage. Licensee was reminded that no eating, sleeping or toileting can be conducted in the garage. Children may only do daily activities in the garage.

The areas that are accessible to children: Converted garage, bedroom 5 (guest room) located downstairs, which is uses as the napping room. Children will utilize the bathroom located in bedroom 5. Children will have access to back yard area.

The areas that are off limits to children: The entire upstairs area, the living room, kitchen and family room. Children will only walk through the laundry room to access guest bedroom and bathroom.

There are no bodies of water on the premises. There are no firearms or ammunition stored on the premises. The backyard has a empty fountain. LPA did not observe any water in the fountain. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible to children. There is a full charged fire extinguisher located in laundry room. The facility has a working smoke detectors and carbon monoxide detector, inside the home. The facility has adequate heating and ventilation for safety and comfort. The FCCH has safe toys, materials and play equipment. LPA observed First Aid kit located in day care room. Children nap on cots and pack n' plays. The home has working telephone service and LPA confirmed the phone number is (310) 545-1824.

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE: DATE: 07/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/30/2024
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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SAMAD FAMILY CHILD CARE
FACILITY NUMBER: 197405238
VISIT DATE: 07/30/2024
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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. Capacity as specified on the license is being maintained.

Licensee’s Mandated Reporter was completed on 6/24/2024. Licensee’s pediatric CPR/First Aid was completed on 6/1/2024. LPA observed Licensee Flu vaccination, TB test and TDAP on file.

This facility does not provide Incidental Medical Services – IMS. For IMS information see PIN 22-02-CCP. 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 are available at: https://www.ada.gov/resources/child-carecenters/.

Licensee 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.

Safe Sleep - LPA discussed the safe sleep regulations with licensee Rana Samad and discussed the Child Care Licensing Safe Sleep webpage at:https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee 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.

809-C

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2024
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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SAMAD FAMILY CHILD CARE
FACILITY NUMBER: 197405238
VISIT DATE: 07/30/2024
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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.

MyChildCarePlan.org – Licensee 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.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies cited and technical advisories were discussed.

An exit interview was conducted, Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. A copy of this report was read and provided to the Licensee. This report shall me made available to the public upon request. LIC 9213 Notice of Site Visit was provided and required to be posted for 30 days.

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2024
LIC809 (FAS) - (06/04)
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