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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419851
Report Date: 10/18/2022
Date Signed: 10/19/2022 12:48:33 PM

Document Has Been Signed on 10/19/2022 12:48 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:STONE FAMILY CHILD CAREFACILITY NUMBER:
197419851
ADMINISTRATOR:STONE, AMANDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 625-5588
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91367
CAPACITY: 14TOTAL ENROLLED CHILDREN: 7CENSUS: 6DATE:
10/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:51 AM
MET WITH:Amanda StoneTIME COMPLETED:
07:00 PM
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On 10/19/2022 at 9:49 am LPA Deborah Lowe arrived at facility to review and obtain Licensee signature on all pages of the LIC809 Facility Evaluation Report for the Required - 1 Year Annual Visit that occurred on 10/18/2022. Due to a consistency check with LPAs computer, LPA was unable to review the report or obtain Licensee signature on 10/18/2022. On 10/19/2022 LPA Lowe left facility at 1:00 pm.

On 10/18/2022 at 11:00 am Licensing Program Analyst (LPA), Deborah Lowe conducted an unannounced Annual Required Inspection and was met by Licensee, Amanda Stone. Per Licensee, facility provides care to school age children only, ages 4 years old to 13 years. Days of operation are Monday – Friday, start time is dependent when children are released from school until 6:00 pm. Average start time depending on the day is between 1:30 pm – 2:30 pm.

LPA Lowe arrived at 11:00 am and observed no children in care at that time. LPA began visit and left facility at 12:30 pm, Licensee stated they needed to pick up children from school. LPA and Licensee agreed LPA will return in the afternoon when children are present. LPA Lowe returned at 3:43 pm. At 4:01 pm LPA observed 6 children in care. Adults present upon LPA return to facility include Licensee spouse (A1) and Staff 1 (S1).

LPA toured the home inside and outside. Per licensee care and supervision is not provided inside the main house. LPA Lowe observed the main house with kitchen, 3 bedrooms, bathroom and living room off limits by use of lock doors. One bathroom located near the kitchen is accessible for children use. Care and supervision was observed outside and within two ADU style structures located on the side of the home towards the back of the property. Available bathroom for the children is located in the main house accessible with a side door.

At 11:10 am LPA Lowe observed the swimming pool without a fence. Pool was observed to have a light weight blue pool tarp over the water. LPA observed a tarp barrier in the outdoor area separating the pool area from the children activity area that was observed to obscure the pool from view. From the ground to the bottom of tarp LPA Lowe observed an 11 inch gap near the children's outdoor activity space. The tarp barrier

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Deborah Lowe
LICENSING EVALUATOR SIGNATURE: DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/19/2022
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: STONE FAMILY CHILD CARE
FACILITY NUMBER: 197419851
VISIT DATE: 10/18/2022
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spans down from the home to the back of the property along the children's walk way to the child care area and outdoor activity space. LPA observed two areas of the tarp that was not secured creating an opening from walk way to pool area. LPA Lowe observed the pool area to be accessible to children in care.

LPA advised, per regulation 102417(g)(5)(A) - (A)Fences shall be at least five feet high and shall be constructed so that the fence does not obscure the pool from view. The bottom and sides of the fence shall comply with Division 1, Appendix Chapter 4 of the 1994 Uniform Building Code. In addition to meeting all of the aforementioned requirements for fences, gates shall swing away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate. Pool covers shall be strong enough to completely support the weight of an adult and shall be placed on the pool and locked while the pool is not in use.

Type A citation with civil penalty will be issued for the violation of Regulation 102417(g)(5)(A). Civil Penalty per H&S1597.58 (c) The department shall assess an immediate civil penalty of five hundred dollars ($500) per violation and one hundred dollars ($100) for each day the violation continues after citation, for any of the following serious violations: (3) Accessible bodies of water, when prohibited by this chapter or regulations adopted pursuant to this chapter.

LPA Lowe recommends Licensee to take a water/ pool safety course due to there is a pool on the property.

In 2015, facility was licensed with a mesh fencing around the pool that included a locked latched gate. Per licensee pool fencing was removed during the COVID-19 pandemic, The Department was not notified.

Current facility sketch reviewed on file with The Department shows with observations made during this visit shows facility made changes to the facility usage and location of identified areas of care and supervision. LPA advised per Regulation 102416.3(a)(6) - (a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.

Per licensee there are no firearms or ammunition on the premises, LPA did not observe any firearms. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and page 2

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Deborah Lowe
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
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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: STONE FAMILY CHILD CARE
FACILITY NUMBER: 197419851
VISIT DATE: 10/18/2022
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ventilation for safety and comfort, located in the ADU style building. LPA observed no stairs in this home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (818) 887-7516.

There are currently no infants in care. LPA discussed Safe Sleep Regulations with licensee. LPA Lowe observed children under adult supervision at all times during visit and LPA verified licensee is aware children shall not be left in parked vehicles. Licensee stated all children are escorted from outside area to bathroom by a staff member. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were incomplete with emergency contact information as required. LPA advised per Regulation 102417(g)(7) -(7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care.

Children’s files were observed with consent for emergency medical treatment and notification of parent’s rights.

Per Licensee, Mandated Reporter Training has not been completed. LPA advised per H&S Code 1596.8662(b)(1) (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.

A review of records does not indicate that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles. LPA advised, Per H&S Code 1597.622(a)(1) - (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

LPA advised, Per H&S Coded 1597.622(c) - (c) The family day care home shall maintain documentation of the required immunization's or exemptions from immunization, as set forth in this section, in the person's page 3

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Deborah Lowe
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
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: STONE FAMILY CHILD CARE
FACILITY NUMBER: 197419851
VISIT DATE: 10/18/2022
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personnel record that is maintained by the family day care home.

All adults present were observed to have background clearances. There are no excluded individuals present at this home. A valid and current CPR/First Aid certificate was observed for S1.

A review of files shows employee with out a completed signed statement about their criminal record history. LPA advised, per Regulation 102416.1(a)(11) - (11) A signed statement regarding their criminal record history as required by Section 102370(c).

Incidental Medical Services (IMS) are currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. 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 and Licensee discussed 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.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

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 Child Care Home. 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep website athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an page 4

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Deborah Lowe
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
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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: STONE FAMILY CHILD CARE
FACILITY NUMBER: 197419851
VISIT DATE: 10/18/2022
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additional resource. 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.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809 D) Licensee was provided a copy of appeal rights.

LPA Deborah Lowe informed licensee Amanda Stone that this report dated 10/18/2022 document(s) one Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Lowe informed the licensee to provide a copy of this licensing report dated 10/18/2022 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

On 10/19/2022 Exit interview conducted and report was reviewed with the licensee, Amanda Stone. During exit interview Licensee, Amanda Stone requested to consult with Licensing Program Manager (LPM) Lisa Rios regarding the Type A citation and Civil Penalty. At 11:48 am Amanda called and left a voice message for LPM Rios. At 11:59 am LPM Rios returned call and spoke with Licensee.

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SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Deborah Lowe
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
LIC809 (FAS) - (06/04)
Page: 3 of 10
Document Has Been Signed on 10/19/2022 12:48 PM - It Cannot Be Edited


Created By: Deborah Lowe On 10/18/2022 at 06:42 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: STONE FAMILY CHILD CARE
FACILITY NUMBER: 197419851

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/18/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(5)(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: (5) All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence. (A)Fences shall be at least five feet high and shall be constructed so that the fence does not obscure the pool from view. The bottom and sides of the fence shall comply with Division 1, Appendix Chapter 4 of the 1994 Uniform Building Code. In addition to meeting all of the aforementioned requirements for fences, gates shall swing away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate. Pool covers shall be strong enough to completely support the weight of an adult and shall be placed on the pool and locked while the pool is not in use.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview with licensee, and record review of previous visit reports, the licensee did not comply with the section cited above in pool was observed without a gate enclosure, observed tarp barrier does not met regulation for visability to pool and accessible 11 inch gap from ground to bottom of tarp which poses an immediate health, safety or personal rights risk to persons in care. This will result in an immediate Civil Penalty of $500.
POC Due Date: 10/19/2022
Plan of Correction
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2
3
4
Licensee stated they are looking into replacing the pool fencing. Licensee stated they will temporarily move the care and supervision of children to the front of the property locking the gate access to the back and side access to the property until pool gate has been installed. Children will be escorted by staff to restroom. LPA reminded licensee of one hundred dollars ($100) for each day the violation continues after citation, for any of the following serious violations: (3) Accessible bodies of water, when prohibited by this chapter or regulations adopted pursuant to this chapter. Licensee stated they will notify LPA Lowe of plan moving forward by end of business on 10/21/2022.

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:Lisa Rios
LICENSING EVALUATOR NAME:Deborah Lowe
LICENSING EVALUATOR SIGNATURE:
DATE: 10/19/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2022


LIC809 (FAS) - (06/04)
Page: 6 of 10
Document Has Been Signed on 10/19/2022 12:48 PM - It Cannot Be Edited


Created By: Deborah Lowe On 10/18/2022 at 06:42 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: STONE FAMILY CHILD CARE
FACILITY NUMBER: 197419851

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/18/2022

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
1
2
3
4
Based on interivew with licensee and record review of staff files, the licensee did not comply with the section cited above in licensee and 2 out of 2 staff have not completed Mandated Reporter training which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/18/2022
Plan of Correction
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Licensee and staff will complete Mandated Reporter child care provider training located at https://mandatedreporterca.com/. Licensee will email LPA Lowe the completed Mandated Reporter certificates to deborah.lowe@dss.ca.gov by end of business on or before 11/18/2022. On 10/19/2022 LPA Lowe received via email S1 completed Mandated Reporter certificate.
Type B
Section Cited
CCR
102416.1(a)(11)
Personnel Records
(a) Personnel records shall be maintained on each employee and shall contain the following information: (11) A signed statement regarding their criminal record history as required by Section 102370(c).

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on record review, the licensee did not comply with the section cited above in 2 out of 2 staff files reviewed were missing criminal record statements which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/21/2022
Plan of Correction
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2
3
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On 10/18/2022 S1 completed the LIC508 Criminal Record Statement and provided to LPA. Licensee will have remaining staff complete LIC 508 Criminal Record Statement and email completed document to LPA Lowe at deborah.lowe@dss.ca.gov by end of business on or before 10/28/2022.
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:Lisa Rios
LICENSING EVALUATOR NAME:Deborah Lowe
LICENSING EVALUATOR SIGNATURE:
DATE: 10/19/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2022


LIC809 (FAS) - (06/04)
Page: 7 of 10
Document Has Been Signed on 10/19/2022 12:48 PM - It Cannot Be Edited


Created By: Deborah Lowe On 10/18/2022 at 06:43 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: STONE FAMILY CHILD CARE
FACILITY NUMBER: 197419851

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/18/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.3(a)(6)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview with licensee, and record review, the licensee did not comply with the section cited above in changes made from an area of the family child care home previously identified as "off limits" is now being used for care and supervision of children in care which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/28/2022
Plan of Correction
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2
3
4
Licensee will complete a new facility sketch with plan of usage for care and supervision. Licensee will email updated facility sketch and plan at deborah.lowe@dss.ca.gov by end of business on or before 10/28/2022.
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

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 in 3 out of 3 staff files reviewed were missing verification that staff have been have been immunuzed against influenza, pertussis, and measels which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/18/2022
Plan of Correction
1
2
3
4
Licensee will obtain a copy of licensee and staff verification they have been immunuzed against influenza, pertussis, and measels. Licensee will email immunization verification at deborah.lowe@dss.ca.gov by end of business on or before 11/18/2022.
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:Lisa Rios
LICENSING EVALUATOR NAME:Deborah Lowe
LICENSING EVALUATOR SIGNATURE:
DATE: 10/19/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2022


LIC809 (FAS) - (06/04)
Page: 8 of 10
Document Has Been Signed on 10/19/2022 12:48 PM - It Cannot Be Edited


Created By: Deborah Lowe On 10/18/2022 at 06:43 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: STONE FAMILY CHILD CARE
FACILITY NUMBER: 197419851

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/18/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(7)
Operation of A Family Child Care Home
(7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care.

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 in 4 out of 5 children's files reviewed were missing emergency contact information which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/28/2022
Plan of Correction
1
2
3
4
Licensee will request parents to complete the LIC 700 Identification and Emergency Information Child Care Center/Family Child Care Homes. Licensee will email completed documents to LPA Lowe at deborah.lowe@dss.ca.gov on or before end of business on 10/28/2022.
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:Lisa Rios
LICENSING EVALUATOR NAME:Deborah Lowe
LICENSING EVALUATOR SIGNATURE:
DATE: 10/19/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2022


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