197494046-6-18-2026-30-CC-RRID-DV6TKH-20260618144757

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494046
Report Date: 06/18/2026
Date Signed: 06/18/2026 02:48:12 PM

Document Has Been Signed on 06/18/2026 02:48 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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	CHAMBERLAIN FAMILY CHILD CARE		FACILITY NUMBER:	197494046
ADMINISTRATOR/ DIRECTOR:	KRISTIN CHAMBERLAIN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(808) 346-0982
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90230
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 12	DATE:	06/18/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:50 AM
MET WITH:	Kristin Chamberlain		TIME VISIT/ INSPECTION COMPLETED:	02:57 PM

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On 6/18/2026, Licensing Program Analyst (LPA) Ranita Richmond conducted an unannounced visit to the above-named home. The reason for the visit is to conduct the Annual/ Random Inspection. LPA was greeted by licensee Kristin Chamberlain. LPA observed 12 children, being supervised and cared for by licensee and three finger print cleared adults. Hours of operation are Monday through Friday, 8:00am –5:00pm. Licensee is not open for overnight and weekend care. Licensee provides lunch and appropriate beverages.

LPA Richmond toured the home inside and outside for a Health and Safety inspection.

The home is a single story house which consist of the following: 3 bedrooms, 2 bathrooms, living room, dining room, kitchen, gated back yard, detached garage, and ADU. The home is neat and clean with heating and ventilation for safety and comfort.

The licensee stated the ON LIMIT AREAS are as follows: bedroom #2, bedroom #3, bathroom #2, gated back yard, and ADU. The licensee stated the following rooms are OFF LIMITS: living room, bedroom #1, bathroom #1, kitchen, and detached garage. The ISOLATION AREA will be in bedroom #3.

During inspection licensee advised LPA that she would like her mother in law to be allowed to care for her biological infant in instances that child becomes ill and needs to be isolated. LPA advised licensee that due to biological infant being part of the family childcare during operating hours, mother in law would need to be finger print cleared, have mmr, tdap, flu, tb, mandated reporter training, LIC 9108, and LIC 9052, as she would be interacting with the family childcare children. LPA advised licensee that the only way that this would not be necessary is if biological infant was cared for outside of the home.

Children and parents enter the FCC through the side gate to the right of the house. They then make two left turns to be located in front of sliding patio doors of bedroom #3. Inside bedroom #3 is bathroom #2. While standing in bedroom #3 to the right is bedroom #2. Inside bedroom #2 is a door that leads to the hallway where bedroom #1 to the right and bathroom #1 to the left.

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NAME OF LICENSING PROGRAM MANAGER: Loyce Phillips
NAME OF LICENSING PROGRAM ANALYST: Ranita Richmond
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/18/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2026

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: CHAMBERLAIN FAMILY CHILD CARE	FACILITY NUMBER: 197494046
	VISIT DATE: 06/18/2026

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The hallway has an entry way that leads to kitchen on the left and dining room, straight ahead, and living room to the right. Inside the kitchen is a door that leads to the outside, side of the house. Inside the living room is a door that leads to the outside front of the house. When entering the home from the side of the house if you make a left and then a right turn you are located in front of the additional dwelling unit in the back yard.

LPA observed a fully charged 2A:10B:C Fire Extinguisher in the hallway closet and one in the additional dwelling unit. The smoke detector is located on a wired pull system throughout the home. The last inspection for fire system was completed in August 2025. The home has a smoke detector/carbon monoxide dual located in bedroom #3.

Licensee is aware that the children must nap, toilet, and have meals in the home.

Licensee has documentation of fire/disaster drill completed March 26, 2026.

There is a screened fireplace in the living room and a covered open face heater in the living room. There are no pools, ponds or other bodies of water on the premises.

LPA Richmond observed age-appropriate toys, books and furnishings. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts.

Licensee has a cat that is housed in the off limits areas in bedroom #1 during daycare hours.

LPA reviewed 6 children’s files and observed them to be in compliance and included immunizations, parent’s rights, and consent for medical treatment.

LPA reviewed 4 personnel files. LPA Richmond observed the licensee has a current 1^st aid/cpr completed on 02/21/26. Licensee provided certificates of completion for mandated reporter training that are current for all staff. LPA observed all personnel files to have all necessary immunizations for childcare staff present.

LPA spoke with assistant Adriana Bastos who is currently employed at Chamberlain family childcare regarding her plans when opening Bastos family childcare. Per Adriana Bastos, her last day of employment at Chamberlain family childcare will be 7/31/26. Per Adriana she will not operate Bastos family childcare prior to 7/31/26. LPA requested Adriana complete a declaration to have on her plans regarding Bastos family childcare and her employment at Chamberlain family childcare on file. LPA received declaration for file.

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NAME OF LICENSING PROGRAM MANAGER: Loyce Phillips
NAME OF LICENSING PROGRAM ANALYST: Ranita Richmond
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/18/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2026

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: CHAMBERLAIN FAMILY CHILD CARE	FACILITY NUMBER: 197494046
	VISIT DATE: 06/18/2026

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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an 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. LPA advised licensee that all infants up to the age of 24 months must have sleep logs completed for each infant as they sleep. LPA reviewed LIC 9227 with licensee. LPA advised licensee that sleep sacks are prohibited due to being swaddling device.

Incidental Medical Services (IMS) are not 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 Richmond 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 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.

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.

No Deficiencies were cited today, per Title 22 Regulations and Health and Safety Codes.

An exit interview was completed with licensee Kristin Chamberlain. A copy of report was provided to licensee.
Notice of Site Visit provided and required to be posted for 30 days.

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NAME OF LICENSING PROGRAM MANAGER: Loyce Phillips
NAME OF LICENSING PROGRAM ANALYST: Ranita Richmond
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/18/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2026

LIC809 (FAS) - (06/04)

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