197416346-5-3-2024-58-CC-SGAN-D4WPE6-20240503111438

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197416346
Report Date: 05/03/2024
Date Signed: 05/03/2024 11:15:58 AM

Document Has Been Signed on 05/03/2024 11:15 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:	DIGNADICE FAMILY CHILD CARE		FACILITY NUMBER:	197416346
ADMINISTRATOR/ DIRECTOR:	DIGNADICE, LEA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 769-5366
CITY:	NORTH HOLLYWOOD	STATE: CA	ZIP CODE:	91606
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 6	CENSUS: 1	DATE:	05/03/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	07:30 AM
MET WITH:	Lea Dignadice, Licensee		TIME VISIT/ INSPECTION COMPLETED:	11:15 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	Licensing Program Analyst (LPA) Silva Garibyan conducted a site visit for the purpose of a Required - 3 Year visit . LPA met with the licensees and toured the home inside and outside at 7:30AM on 05/03/2024. There was one child present at the time of the visit. Licensee's home is a single story 2 bedroom, 3 bathroom home with living room, dining room, kitchen, laundry room and a playroom that is a converted garage. The room has been legally converted and a carport is constructed at the front of the home. Family members residing in the home include the licensee, her husband and her adult daughter. Main care is provided in the play room/converted garage at the front of the facility. There is a bathroom inside the play room for children's use. Licensee has an operating smoke/carbon monoxide detectors in the child care room as well as an operating and fully charged Fire Extinguisher. Main care is provided in the playroom located at the front of the home. This room has a small kitchenette area that contains a mini refrigerator, sink and microwave oven. There is a bathroom accessible from this room for children's use. The room also contains a smaller room used for napping infants and contains 3 play pens, and a diaper changing table. Off limit areas include the kitchen, the home's 2 bedrooms and the laundry room. The kitchen is made inaccessible by locks at the tops of the double doors. Children nap throughout the living room and the playroom. LPA observed two child size tables, eight chairs, three high chairs, and napping equipment (including three play pans and eight cots). Page 1 of 4

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024

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: DIGNADICE FAMILY CHILD CARE	FACILITY NUMBER: 197416346
	VISIT DATE: 05/03/2024

NARRATIVE

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There is no pool, spa or other bodies of water on the premises. Licensees report they have no firearms or weapons in the home. LPA did not observe any weapons. LPA toured all areas used by children during this inspection. The bathroom in the play room and the kitchen was observed free of chemicals or toxic items that can pose danger to children in care. All electrical outlets in the home were covered. The outdoor play area/back yard was inspected. Outdoor play area/front yard was inspected. The yard consists of a cemented area for bicycle play and two fenced areas with artificial grass where small slides and a small play structure is positioned. Ground toys are also used and were observed to be in good condition. The First Aid kit was observed and complete. LPA observed the fire drill log. The fire drills are done every six months. Licensees was unable to demonstrate current proof of CPR/First Aid Certificates (expired on 7/10/2023). The licensees have current Mandated Reporter (completed on 05/03/2024). Licensees provide meals and snacks. LPA discuss food preparation, storage and ensuring a log and information regarding dietary restrictions and allergies are kept up to date. Licensees stated that a cell phone with active service in the home will be the main contact number while children are in care.
LPA observed the Parent Board with all necessary posting required ( Facility License (LIC 203), Emergency Disaster Plan (LIC610A), Notification of Parents' Rights Poster (PUB 394), If You see Something Say Something poster, Car Seat Safety poster). Child Care Facility Roster (LIC9040) was on file.
A review of the children's records was conducted and are found to have the following: LIC 282 Affidavit Liability Insurance, LIC 627/Consent for Medical Treatment, LIC 700/ID and Emergency Information, LIC702, LIC 995A/Parent's Rights, LIC995E/Caregiver Background Check, LIC 9150/Parent Notification, LIC 9212/Parent's Responsibilities, PM 286/Immunization Card. Page 2 of 4

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024

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: DIGNADICE FAMILY CHILD CARE	FACILITY NUMBER: 197416346
	VISIT DATE: 05/03/2024

NARRATIVE

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A review of records indicates that Licensee has immunization records on file for influenza, pertussis and measles. All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

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.

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.

No infants are enrolled at this time. LPA discussed the safe sleep regulations with licensees 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. Page 3 of 4

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024

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: DIGNADICE FAMILY CHILD CARE	FACILITY NUMBER: 197416346
	VISIT DATE: 05/03/2024

NARRATIVE

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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.

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/.

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.

During the exit interview, the licensees Lea Dignadice confirmed that there are no Registered Sex Offenders living in the facility.
A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Lea Dignadice.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/03/2024 11:15 AM - It Cannot Be Edited

Created By: Silva Garibyan On 05/03/2024 at 09:41 AM

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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: DIGNADICE FAMILY CHILD CARE	FACILITY NUMBER: 197416346
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/03/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102416(c)

Personnel Requirements

(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. Licensees was unable to demonstrate current proof of CPR/First Aid Certificates (expired on 7/10/2023), which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/10/2024
	Plan of Correction
1 2 3 4	Per Licensee, proof of correction will be sent to LPA via email by 05/10/2024

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Betty Bell

LICENSING EVALUATOR NAME:

Silva Garibyan

LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2024

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024

LIC809 (FAS) - (06/04)

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