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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494150
Report Date: 05/20/2025
Date Signed: 05/20/2025 12:27:17 PM

Document Has Been Signed on 05/20/2025 12:27 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:AKA FAMILY CHILD CAREFACILITY NUMBER:
197494150
ADMINISTRATOR/
DIRECTOR:		AKA, CHINWEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 635-9422
CITY:LOS ANGELESSTATE: CAZIP CODE:
90043
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
05/20/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:50 AM
MET WITH:Licensee, TIME VISIT/
INSPECTION COMPLETED:
12:40 PM
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On 4/30/2025 Licensing Program Analyst (LPA) Dawn Dowling arrived at Licensee's home for the purpose of conducting an Annual Inspection. LPA Dowling arrived at 10:00 am and rang the Ring bell several time without an answer. At 10:03 am LPA Dowling telephoned Licensee at (323) 635-9422 the listed contact number and spoke with Licensee, informing Licensee that LPA Dowling was at residence for the purpose of conducting an annual inspection. Licensee indicated she was not at home at the moment and would be on her way in about 20 minutes, LPA Dowling informed licensee that LPA would wait at residence for her arrival.

At 10:25 am LPA Dowling returned to the residence and rang the bell. LPA Dowling was greeted by Licensee Chinwe Aka, Entrance Checklist – Family Child Care Homes LIC 126 was provided to the Licensee’s to help facilitate the inspection.
At the time of inspection there were no children present, licensee indicates that the children currently enrolled are picked up after school for care. There are currently (six) children enrolled. Facility capacity is in compliance for a large Family Childcare Home. Hours of operation are Mon-Fri 06:00 AM 6:00 PM.

This is a 5 bedroom 3 Bathroom Home which consists of a Living Room, Dining Room Area, Kitchen, there is a bedroom upstairs that is accessed through a door in downstairs area that is inaccessible to children in care, door has door lock cover on it. The off limits area are 3 bedrooms, 2 bathrooms, the front and back yard. The areas that are accessible for children in care are 2 bed rooms in back and 1 bathroom.

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NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Dawn Dowling
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2025
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 NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: AKA FAMILY CHILD CARE
FACILITY NUMBER: 197494150
VISIT DATE: 05/20/2025
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 Home is equipped with 2 fully charged fire extinguishers which are at least 2A:10BC, they were last serviced on 10/2/2024;Licensee uses cell phone as way for parents to contact licensee, home is equipped with a working smoke alarm and a carbon monoxide detector; All poisons are locked; Hazardous materials are kept out of the reach of children (inaccessible); According to Licensee, there are no weapons or firearms at the home. None were observed by LPA; Licensee does not use backyard for play area, they use a neighborhood park and has obtained parents permission to transport children to the park in her vehicle; there are no bodies of water were observed during the inspection; Toys and playthings are safe, clean, and appropriate for the age of the children; Licensee currently does not have children 24 months and younger in care there were no baby walkers, bouncers, jumpers, and similar items observed in home.
The home has a first aid kit (it is missing band aids, tweezers) this was discussed with licensee.
Parents provide packed lunch for children to bring to day care, Licensee was reminded that food brought from home, it must be labeled with the child’s name and properly stored or refrigerated. Licensee provides snacks to children in care.

Individuals residing in the home have been discussed and noted. All adults present in the home have obtained a criminal record clearance or exemption. License indicates that it is only her and her spouse residing in home at this time, her children are away at school. LPA Dowling reminded licensee since they are over 18 years of age they will need to be fingerprinted so when they come home they are finger print cleared.

During the inspection at 12:20 pm Licensee indicated she needed to go pick up a child, LPA Dowling will continue inspection at later time in order to allow licensee to pick up the child for care. Licensee was allowed to go pick up child and to call LPA when she was back home. LPA received call from licensee at 12:47 pm that she was back home. LPA Dowling informed her LPA would be returning to residence at 1:24 pm LPA received a call that licensee had to go leave home in order to pick up another child from school and would be back at 2:30 pm

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NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Dawn Dowling
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: AKA FAMILY CHILD CARE
FACILITY NUMBER: 197494150
VISIT DATE: 05/20/2025
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LPA Dowling is unable to complete the annual due to licensing needing to leave to pick up another child for care. LPA will complete inspection at a later date.

On 5/1/2025 LPA Dowling arrived at facility at 2:06 unannounced to continue the annual inspection. LPA Dowling rang the ring door bell. LPA Dowling waited several minutes for licensing to answer. At 2:10 PM LPA Dowling telephoned licensee at
9323) 635-9422 the listed number on facility profile. Licensee answered the phone and LPA Dowling informed licensee that LPA was at facility to continue the annual inspection. Licensee indicated she was out doing school pick up's and would not be back until after 3:00 PM. LPA Dowling informed licensee that LPA would come at another date after 3:00pm when she has completed her school pick up's.

At 2:25 PM licensee telephone LPA Dowling to inform LPA that she has a few kids and she's out of the home from 12:15 PM to 3:00 PM doing various school pick up's for the children she has in care, they go to different schools and get out at different times. LPA Dowling informed licensee again that the continuation annual will need to be done and LPA will come after 3:00 PM on another day in order to complete the inspection.

LPA Dowling returned on 5/20/2025 at 10:22 am to complete the annual inspection, licensee was not at residence, an unidentified lady was parked in the front of the residence and came out of her vehicle asking LPA Dowling, if I was looking for someone? LPA Dowling informed person that I am from licensing here to conduct an inspection and the lady phoned Licensee who indicated to have LPA Dowling wait and she would be on her way in about 15 minutes. LPA Dowling waited for licensee to arrive. At 10:50 am Licensee arrived at the residence in order to complete the inspection. Licensee gave LPA Dowling a tour of the residence, the main child care room is in the back, bedroom #1; Bedroom#2 used for napping area has 2 play yards (licensee doe not currently have any children enrolled that are 24 months of age or younger and several cots. Furnishing and equipment appeared in good repair, toys and other material were clean and in good repair. The other room used is the living room area which has gate and front area used as isolation area. LPA Dowling observed wall heaters (screened making it inaccessible for children in care).



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NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Dawn Dowling
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
LIC809 (FAS) - (06/04)
Page: 4 of 7
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: AKA FAMILY CHILD CARE
FACILITY NUMBER: 197494150
VISIT DATE: 05/20/2025
NARRATIVE
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Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunizations Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights

Licensee records were reviewed
— Pediatric First Aid and CPR expires: 06/2026
— Mandated Reporter AB1207 expired: 0109//2027
Licensee provided Immunization Record for Petrussis, Measles, Mumps, Rubella (MMR) and TB test, Licensee provided declanation of Flu Test statement.

Licensee does not provide medical services and Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a plan for providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Center and the ADA, available at: http://www.ada.gov/childqanda.htm

License 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 reminded of their responsibility to report suspected child abuse. Mandatory Forms for the children’s files and provider’s files were discussed. Licensee was made aware that state law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category. Licensee was reminded that all infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome), and that the Provider is required to wash hands after every diaper change and to never shake a baby to prevent the Shaken Baby Syndrome. 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. Licensee was also reminded that only children eating may be in highchairs and that car seats are utilized only for transportation.



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NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Dawn Dowling
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC809 (FAS) - (06/04)
Page: 5 of 7
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: AKA FAMILY CHILD CARE
FACILITY NUMBER: 197494150
VISIT DATE: 05/20/2025
NARRATIVE
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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&Rs) throughout California.

The licensee was advised the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, (Type A violation), a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. The applicant was made aware that a licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment.

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

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Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California

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NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Dawn Dowling
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/20/2025 12:27 PM - It Cannot Be Edited


Created By: Dawn Dowling On 05/20/2025 at 12:06 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: AKA FAMILY CHILD CARE
FACILITY NUMBER: 197494150

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.5(g)
Staffing Ratio and Capacity
(g) For the purpose of meeting the criteria in Sections 1597.44 and 1597.465 of the Health and Safety Code, for a school age child who is under age six, the licensee shall maintain documentation verifying the child’s enrollment and attendance at kindergarten, including transitional kindergarten, or elementary
school.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above in 6 out of 6 enrolled children do not have documentation of enrollment in school on file which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/03/2025
Plan of Correction
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Licensee will have parents provide copy of report card showing proof of enrollment in school
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Raul Navarro
NAME OF LICENSING PROGRAM MANAGER:
Dawn Dowling
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/20/2025


LIC809 (FAS) - (06/04)
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