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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197409429
Report Date: 03/10/2026
Date Signed: 03/10/2026 12:25:55 PM

Document Has Been Signed on 03/10/2026 12:25 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:JACKSON FAMILY CHILD CAREFACILITY NUMBER:
197409429
ADMINISTRATOR/
DIRECTOR:		NOREEN JACKSONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 779-0606
CITY:LOS ANGELESSTATE: CAZIP CODE:
90044
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
03/10/2026
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:49 AM
MET WITH:Noreen Jackson, LicenseeTIME VISIT/
INSPECTION COMPLETED:
12:50 PM
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On 3/10/2026 Program Analyst (LPA), Shandra Powell conducted an unannounced Annual Required Inspection at above mentioned facility. Upon arrival, LPA was greeted by Noreen Jackson, Licensee. A copy of the Entrance Checklist for Child Care homes form (LIC 126) was provided to the licensee upon entry. LPA observed 3 children with Licensee. Present during today’s inspection volunteer, Debora Samayoa and Assistant Alicia Flores was present.

The hours of operation are Monday through Friday from 6:45 a.m. to 11:00 p.m. Home is available for transportation to and from school. Home is not available for weekend care.

LPA observed Facility License, Notification of Parents Rights, Earthquake Preparedness posted on a cardboard located in the dining room area. LPA reviewed the Emergency Disaster Plan LIC610A, Disaster and Fire Drill Log per documentation. LPA observed Earthquake drill was conducted on 02/27/2026. LIC9040 Facility Roster was observed with 14 children enrolled which include 3 infants. LPA reminded licensee a assistant must be present when more than 8 children are in care.

The home is a two story dwelling with 3 bedroom, 2 ½ bathrooms with a kitchen, living room, dining room area and a self enclosed back yard with a bonus room located in back yard. Licensee stated no day-care is conducted in the bonus room located in the back yard.
Licensee confirmed the following OFF LIMITS AREAS: 2nd story is made inaccessible with a safety gate at the bottom of the stair case. Kitchen is designated as OFF LIMITS to the children in care; safety gate between kitchen and dining room. LPA reminded licensee that all areas designated as OFF LIMITS- need to be made inaccessible at all times.
NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Shandra Powell
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/10/2026
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: JACKSON FAMILY CHILD CARE
FACILITY NUMBER: 197409429
VISIT DATE: 03/10/2026
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LPA observed the area designated for day care use and observed age-appropriate toys. Licensee confirmed the living room and dining room area are designated as day care space. Children size table and chairs were observed in the space. Licensee confirmed children nap and eat in the living room and dining room area. LPA observed napping cots in the home.

Adequate heating and ventilation for safety and comfort were observed in the space.
Safe toys and play equipment were observed. The home has a working telephone service and LPA confirmed the phone number and email address.

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. LPA observed one car seat located on the front porch during inspection. Capacity as specified on the license is being maintained during today’s inspection; 5 children were present during today’s inspection.

Bathroom used for day care was inspected. Bathroom is located next to the living room area. Bathroom was observed with a toilet, sink and changing table. All cleaning compounds were inaccessible to children in care.

The licensee was informed that any changes to ages, hours and days of operation shall be submitted to the department via signed LIC 279, for approval prior to initiation of changes including changes to the structure of the home.

The back yard was observed and inspected. Outdoor space is gated and children access the back yard through the sliding door in the dinning room area. LPA observed age appropriate outdoor toys. LPA observed a additional unit attached to the home which is located on the left side of the home. The additional unit has a bedroom, bathroom and kitchen with an open concept which is accessible thru a gate in front of the home or the gate in the back of the home. Licensee stated no one lives in the unit at this time. LPA requested a new facility sketch be completed for the home to include the additional unit.
NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Shandra Powell
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2026
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: JACKSON FAMILY CHILD CARE
FACILITY NUMBER: 197409429
VISIT DATE: 03/10/2026
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There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. A barricaded fire place was observed in the living room.

LPA observed licensee test the smoke detector and carbon monoxide in the home. A working fire extinguisher was observed by the main entrance.

Each family child care home shall conduct fire drills and disaster drills at least once every six months.

Licensee provide breakfast snack and lunch is currently participating in the food program. LPA discussed the importance of maintaining a system where allergies and food restrictions are noted.

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.

LPA discussed the safe sleep regulations with licensee [or 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 licensee [or facility representative] of the importance of checking for and removing any 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/.
NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Shandra Powell
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2026
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: JACKSON FAMILY CHILD CARE
FACILITY NUMBER: 197409429
VISIT DATE: 03/10/2026
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MyChildCarePlan.org – CCC and FCCH
Licensee [or 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.
Megan’s Law - FCCH
During the exit interview, the Licensee [name], confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
Closing Script- CCC and FCCH
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.
Notice of Site Visit- CCC and FCCH
A notice of site visit was given and must remain posted for 30 days.
Exit Interview - CCC and FCCH
Exit interview conducted and report was reviewed with the licensee [or facility representative] (include name).
NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Shandra Powell
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2026
LIC809 (FAS) - (06/04)
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