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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197418442
Report Date: 11/14/2024
Date Signed: 11/14/2024 04:05:13 PM

Document Has Been Signed on 11/14/2024 04:05 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:LOVE THYSELF CHILD DEVELOPMENT CENTERFACILITY NUMBER:
197418442
ADMINISTRATOR/
DIRECTOR:		CHERYL M. MUHAMMADFACILITY TYPE:
850
ADDRESS:10411 SOUTH WESTERN AVENUETELEPHONE:
(323) 755-6151
CITY:LOS ANGELESSTATE: CAZIP CODE:
90047
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 26DATE:
11/14/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:CHERYL MUHAMMAD, DIRECTOR/LICENSEETIME VISIT/
INSPECTION COMPLETED:
02:30 PM
NARRATIVE
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On 11/14/2024, (Licensing Program Analyst) LPA Clayton conducted an unannounced visit to conduct a Case Management- Deficiencies inspection. LPA Clayton was greeted by Licensee Cheryl Muhammad. LPA Clayton toured the CCC for a Health and Safety inspection and observed __ children being supervised and cared for by __ fingerprint cleared staff.

On 09/10/2024 conducted an unannounced inspection where LPA Clayton reviewed multiple children’s files and observed them to be out of compliance as they were missing completed LIC 701 Physician’s Report – Child Care Centers (Child’s Pre-Admission Health Evaluation) forms.

LPA Clayton reminded licensee of the Title 22 Regulation which states that prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child, to be performed by, or under the supervision of, a licensed physician, and shall not be more than one year old, which enables the licensee to assess whether the center can provide necessary health-related services to the child.

On 11/14/2024 LPA Clayton reviewed 6 children’s files and 4 of them contained a completed LIC 701 Physician’s Report – Child Care Centers (Child’s Pre-Admission Health Evaluation) forms. Licensee stated that she is waiting on the remaining parents to return the forms.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, a Type B deficiency is cited, (see LIC 809D).



An exit interview was conducted, a copy of this report and Appeal Rights was reviewed and provided to licensee Cheryl Muhammad.

This report shall be made available to the public upon request.

LPA Clayton posted the Notice of Site Visit which is the to remain posted for 30 days.

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SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Lisa Clayton
LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024
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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Document Has Been Signed on 11/14/2024 04:05 PM - It Cannot Be Edited


Created By: Lisa Clayton On 11/14/2024 at 03:09 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: LOVE THYSELF CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 197418442

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/14/2024
Section Cited
CCR
101220(a)(1)

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Child's Medical Assessments (a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical.....(1) Such assessment shall be performed by, or under the supervision of, a licensed physician, and shall not be more than one year old when obtained.
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Licensee will ensure that all children in attendance have the completed LIC 701 forms added to their files as well and all newly enrolled children moving forward.
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This requirement was not met as evidenced by: LPA Claytons review of the childrens files and observations that none of them contained the LIC 701 forms, which poses and immedicte Health and Safety risk to children in care.
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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
LICENSING EVALUATOR NAME:Lisa Clayton
LICENSING EVALUATOR SIGNATURE:
DATE: 11/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/14/2024


LIC809 (FAS) - (06/04)
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