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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419688
Report Date: 05/26/2023
Date Signed: 05/26/2023 03:01:42 PM

Document Has Been Signed on 05/26/2023 03:01 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 NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:AUSTIN FAMILY CHILD CAREFACILITY NUMBER:
197419688
ADMINISTRATOR:AUSTIN, LATIESHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 333-4647
CITY:LOS ANGELESSTATE: CAZIP CODE:
90008
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
05/26/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:05 PM
MET WITH:Licensee Latisha AustinTIME COMPLETED:
03:15 PM
NARRATIVE
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On 05/26/2023 at 1:06 PM, Antonio Almanza, Licensing Program Analyst (LPA) were at the licensed facility conducting an alternate inspection when the deficiencies listed below were observed. LPA observed 13 children in care, and 2 staff providing care and supervision.

Deficiencies observed:
Upon arrival to the facility LPA observed 11 children and 1 infant sleeping. LPA observed Staff 2 providing care and supervision. Staff 2 does not have a criminal record clearance and is not associated to the facility. Staff 2 is reporting that has been helping when they need help usually for 20 to 30 minutes at a time. Staff 2 stated that started helping since 2016 and just comes when needed. LPA observed an infant child sleeping in a swing rocker. LPA notified staff that swing rockers are prohibited in Licensed Family Child Care Homes. Licensee removed swing rocker and placed it in licensees closet inaccessible to children.

During todays visit 2 Type A deficiencies were cited during today's inspection (see LIC 809Ds). Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). Civil Penalty was issued on LIC421BG.

A copy of this report must be provided to the authorized representatives of all currently enrolled children and any newly enrolled child for the following 12 months.
The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC9224) shall be signed and kept in each of the children’s records. The report shall be provided no later than the next business day or the next day the child is in care.

A copy of this Report, Notice of Site Visit, and Appeal Rights (LIC 9058), were provided and explained to Latiesha Austin, Licensee

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE: DATE: 05/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/26/2023
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 05/26/2023 03:01 PM - It Cannot Be Edited


Created By: Antonio Almanza On 05/26/2023 at 02:28 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: AUSTIN FAMILY CHILD CARE
FACILITY NUMBER: 197419688

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/26/2023
Section Cited
CCR
102417(g)(10)

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102417(g)(10) Operation of a Family Child Care Home A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Section 1596.846(b) and (c).
This Requirement is not met as evidenced by:
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Licensee has made swing rocker inaccessible to children in day care.
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Based on observation, interview and record review, LPA observed an infant sleeping a swing rocker , which poses an immediate or Health and Safety, and personal rights risk to persons in care.
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Licensee will provide written statement of understanding that Swings/rockers are not allowed in licensed homes.
Type A
05/26/2023
Section Cited
CCR102370(d)

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Criminal Record Clearance All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility:
This Requirement is not met as evidenced by:
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Staff 2 will not be allowed back into facility until criminal record clearance has been received. Licensee will provide written statement acknowledging understand of regulations.
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Based on observation, interview and record review, Staff 2 is reporting that has been in facility helping since 2016, LPA observed S2 providing care to children, which poses an immediate or Health and Safety, and personal rights risk to persons 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:Betty Bell
LICENSING EVALUATOR NAME:Antonio Almanza
LICENSING EVALUATOR SIGNATURE:
DATE: 05/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/26/2023


LIC809 (FAS) - (06/04)
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