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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197416889
Report Date: 10/29/2025
Date Signed: 10/29/2025 05:11:08 PM

Document Has Been Signed on 10/29/2025 05:11 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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:ANDERSON FAMILY CHILD CAREFACILITY NUMBER:
197416889
ADMINISTRATOR/
DIRECTOR:		ANDERSON, SUSAN AND TERRIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(424) 236-2823
CITY:HAWTHORNESTATE: CAZIP CODE:
90250
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
10/29/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:35 PM
MET WITH:Terri Anderson TIME VISIT/
INSPECTION COMPLETED:
05:30 PM
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On 10/29/2025 Licensing Program Analyst (LPA), Tyra Chavies conducted an unannounced Annual/Random Inspection at this facility to ensure the health and safety standards as required governing California Family Child Care Homes (FCCH). Present at the time of inspection is licensee, Terri Anderson.  During the time of the inspection, LPA observed 6 children in care being supervised by 2 staff members. Licensee states hours of operation for the FCCH are Monday-Friday 7:00 AM -7:00 PM. LPA Chavies verified the facility phone number is 424-236-2823 and verified email address: morena7823@gmail.com.

This home has 3 bedrooms, 1 bathroom, living room /dining room, kitchen, front yard and a backyard. The following areas will be accessible to children in care: Bedroom #2 and #3, living room, Bathroom, front and back yard. The following areas with be inaccessible to children in care: Bedroom #1 and Kitchen. Parents and children are to enter through the front door. LPA Chavies observed age-appropriate toys and books at the time of inspection in the primary care area (living room). Indoor furniture and equipment are in good condition, free of sharp, loose and/or pointed parts. The bathroom was toured. Licensee will ensure that children are being supervised at all time and/or make bathroom drawers inaccessible to children in care.

If a child becomes sick at the facility, Bedroom #2 will be used as an isolation room. All the cleaning products were stored and made inaccessible to the children. LPA Chavies reviewed storage of equipment and supplies. The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation.
NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Tyra Chavies
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/29/2025
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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ANDERSON FAMILY CHILD CARE
FACILITY NUMBER: 197416889
VISIT DATE: 10/29/2025
NARRATIVE
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Licensee was reminded that car seats are used for transportation purposes only and that highchairs are not used for sleeping children. There are no weapons or firearms on premises. Per the licensee, there are no bodies of water or pools on the premises. Licensee has verified that there are no pets in the home.

The facility does provide breakfast and lunch as well as am/pm snack. The food preparation area and storage areas are clean and in sanitary condition. Drinking water is available both indoors and outdoors. The facility has a smoke/ carbon monoxide detector (combination). LPA inspected and verified that there is a 3A40BC fire extinguisher on the premises.

POSTING REQUIREMENTS:
 License and other relevant notices are posted on the wall (Facility Sketch, PUB 394, LIC 9148, LIC 610A). Fire and disaster drills are being conducted as scheduled every month.

File Review:
LPA reviewed 4 children files and observed that files are incomplete with some necessary LIC forms. LPA advised licensee to review children's files and updated forms/documents.

LPA was unable to review the staff files at this time. LPA advised licensee to have separate files for each employee including each licensee and have all files available upon the arrival of any LPA in the future.

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.
NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Tyra Chavies
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2025
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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ANDERSON FAMILY CHILD CARE
FACILITY NUMBER: 197416889
VISIT DATE: 10/29/2025
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Commencing September 1, 2016, SB 792, prohibits a person from being employed or volunteering at a childcare facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the inspection. 

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 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 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.

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.

A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment.

Per Title 22 of the California Code of Regulations,  Division 12, Chapter 3, this facility is receiving Type B's and Technical Violations. (Please see LIC 809-D and LIC 9102)

Exit interview conducted and report was reviewed with the licensee, Terri Anderson.

A notice of site visit was given and must remain posted for 30 days.
NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Tyra Chavies
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/29/2025 05:11 PM - It Cannot Be Edited


Created By: Tyra Chavies On 10/29/2025 at 04:18 PM
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: ANDERSON FAMILY CHILD CARE
FACILITY NUMBER: 197416889

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/29/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(record review)], the licensee did not comply with the section cited above in 2 out of 4 (persons) which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/12/2025
Plan of Correction
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Each empolyee will take the Manadated Reporter Training
Type B
Section Cited
CCR
102418(a)
Immunizations
(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(record review)], the licensee did not comply with the section cited above in 4 out of 4 [(persons)] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/12/2025
Plan of Correction
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Licensee will reach out to parents and the parents will provide copys
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Karren Starks
NAME OF LICENSING PROGRAM MANAGER:
Tyra Chavies
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/29/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/29/2025


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