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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417464
Report Date: 01/22/2025
Date Signed: 01/22/2025 01:53:09 PM

Document Has Been Signed on 01/22/2025 01:53 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:SALAZAR FAMILY CHILD CAREFACILITY NUMBER:
197417464
ADMINISTRATOR/
DIRECTOR:		MARIA SALAZARFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 689-9881
CITY:SANTA MONICASTATE: CAZIP CODE:
90405
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
01/22/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:MARIA SALAZAR, LICENSEETIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
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On 01/22/2025, Licensing Program Analyst (LPA) Lisa Clayton made an unannounced visit to the Salazar Family Child Care Home to conduct the Required 3-year inspection. LPA was greeted by Licensees Maria and Trinidad Salazar. LPA Clayton observed 6 children being supervised by both Licensee and fingerprint cleared assistant. Per Licensee the hours of operation are Monday through Friday 8am – 5pm. Licensee provides water. The parents provide all meals.

LPA toured the entire home inside and outside for a Health and Safety inspection. The home is neat and clean and has ventilation for safety and comfort. The home has working telephone and LPA Clayton confirmed the number is (310) 689 - 9881.

LPA Clayton confirmed that the home consists of the following: laundry room (back porch) living room, kitchen/dining room, 2 bedrooms, 1 bathroom, detached garage/storage room, and fenced front and back yards.

The ON LIMIT AREAS are as follows: laundry room, living room (day care activity room), kitchen, bathroom, bedroom #2 (napping room) and fenced backyard. The ISOLATION AREA will be bedroom #2.

The OFF-LIMIT AREAS are as follows: bedroom #1, and the garage/storage room, all of which are inaccessible to children in care by closed and/or locked doors and visual supervision.

Furniture and equipment in the home are in good condition and free of sharp, loose, or pointed parts.

There are no pools, ponds or any other bodies of water on the premises. There are no firearms or ammunition on the property.

LPA Clayton observed a play structure in the fenced back yard which appears to be not age appropriate for the children in care. LPA Clayton observed the structure to be in need of repair and instructed Licensee Maria to restrict the children from using the play structure until she has it inspected. Licensee Maria agreed and acknowledged understanding.


Karren StarksTELEPHONE: (310) 740-3038
Lisa ClaytonTELEPHONE: (424) 301-3206
DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/22/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 01/22/2025 01:53 PM - It Cannot Be Edited


Created By: Lisa Clayton On 01/22/2025 at 01:16 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: SALAZAR FAMILY CHILD CARE
FACILITY NUMBER: 197417464

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/22/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA Clayton observation that the licensees are not conducting diasater drills and therefore not documenting them, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/22/2025
Plan of Correction
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Licensees and staff will watch the Disaster Planning Fire Safety video and submit a written understanding of the video to the department no later than February 1, 2025. Licensee will conduct fire drills and disaster drills at least once every six months and the licensee shall document the drills, including the date and time of each drill, and keep the documentation at the family childcare home.
Type B
Section Cited
CCR
102417(g)(10)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (10) A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Sections 1596.846(b) and (c).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA Clayton observation of an exersaucer in the unlocked storage room and a baby walker in the living room, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/22/2025
Plan of Correction
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Licensees will ensure that a baby walker or exersaucer are not on the premises of a family childcare home in accordance with Health and Safety Code Sections 1596.846(b) and (c).

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:Karren Starks
TELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME:Lisa Clayton
TELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:
DATE: 01/22/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/22/2025


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Document Has Been Signed on 01/22/2025 01:53 PM - It Cannot Be Edited


Created By: Lisa Clayton On 01/22/2025 at 01:16 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: SALAZAR FAMILY CHILD CARE
FACILITY NUMBER: 197417464

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/22/2025

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 LPA Clayton file record review the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/27/2025
Plan of Correction
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Licensees and staff will complete required Mandated Reporter training no later than January 27, 2025 and submit the certificate of completion to the department immediately upon completion.

Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA Clayton childrens file review and no Individial Infant Sleep Plan forms were observed, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/27/2025
Plan of Correction
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LPA Clayton instructed licensee Maria to have all parents of children 0 – 12 months to complete the LIC 9227 (Individual Infant Sleeping Plan) form immediately and the keep them in the childrens file and available for review by the department.
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:Karren Starks
TELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME:Lisa Clayton
TELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:
DATE: 01/22/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/22/2025


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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: SALAZAR FAMILY CHILD CARE
FACILITY NUMBER: 197417464
VISIT DATE: 01/22/2025
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The home has a fully charged 3A40BC fire extinguisher on the back porch, a working carbon monoxide detector in the kitchen and working smoke detector in the hallway.

LPA Clayton instructed licensee Maria to complete the Disaster plan and submit to the Department no later than 01/25/2025.

LPA Clayton reminded Licensees that any poisons, detergents/cleaning compounds, medication and hazardous items that can pose a danger to children are to be made inaccessible to children in care.

LPA Clayton reminded licensee that a family child care is required to conduct fire drills and disaster drills at least once every six months and the licensee shall document the drills, including the date and time of each drill, and keep the documentation at the family child care home.

LPA Clayton reviewed 5 children’s files which contain current contact information for authorized representatives and/or relatives who can assume responsibility for the child, signed Parent’s Rights, current immunization records, and a signed Consent for Emergency Medical Treatment.

Licensees have current CPR/First Aid. LPA Clayton reminded Licensee Maria that Mandated Reporter certificates are to be renewed every 2 years. Licensee has immunizations records that are in compliance with immunizations required for childcare providers.

LPA Clayton and licensee Maria reviewed the Safe Sleep regulations and LPA Clayton provided her with a copy of the regulation for her review. LPA Clayton reminded license to check the Safe Sleep webpage on the Child Care website https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and­resources/safesleep as an additional resource.

LPA Clayton informed applicant of the importance of checking for recalled infant devices on the United States Consumer Products 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 the purchased equipment.

SUPERVISOR'S NAME: Karren StarksTELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025
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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: SALAZAR FAMILY CHILD CARE
FACILITY NUMBER: 197417464
VISIT DATE: 01/22/2025
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Incidental Medical Services (IMS) are not currently being provided. LPA Clayton instructed licensee that all medications are to be stored in a locked box, inaccessible to children in care. LPA Clayton provided Licensee with an IMS Plan sample and instructed her to submit the completed plan to the office immediately upon completion. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA reminded Licensee of the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&R) throughout California.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Childcare Home. A Type A Violation and a Civil penalty of 100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated


During the exit interview, Licensee confirmed that there are no Registered Sex Offenders living in the home and LPA completed the RSO profile in FAS.

During the inspection LPA Clayton observed an exersaucer in the unlocked storage room and a baby walker in the living room. LPA Clayton reminded licensees that a baby walker shall not be allowed on the premises of a family childcare home in accordance with Health and Safety Code Sections 1596.846(b) and (c).
SUPERVISOR'S NAME: Karren StarksTELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025
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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SALAZAR FAMILY CHILD CARE
FACILITY NUMBER: 197417464
VISIT DATE: 01/22/2025
NARRATIVE
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LPA Clayton reminded licensee that a family childcare is required to conduct fire drills and disaster drills at least once every six months and the licensee shall document the drills, including the date and time of each drill, and keep the documentation at the family childcare home.

LPA Clayton instructed licensee Maria to have all parents of children 0 – 12 months to complete the LIC 9227 (Individual Infant Sleeping Plan) form immediately.

LPA Clayton instructed Licensees and staff to complete required Mandated Reporter training no later than January 27, 2025 and submit the certificate of completion to the department immediately upon completion.

Per Title 22 Regulations and Health and Safety Codes, Deficiencies and Technical Violations were cited today (see LIC 809D).

An exit interview was conducted, a copy of this report was read and provided to licensee and will be made available to the public upon request.

LPA Clayton posted a Notice of Site Visit which is required to be posted for 30 days.

SUPERVISOR'S NAME: Karren StarksTELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025
LIC809 (FAS) - (06/04)
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