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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494469
Report Date: 02/05/2025
Date Signed: 02/05/2025 11:01:41 AM

Document Has Been Signed on 02/05/2025 11:01 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:EISEN FAMILY CHILD CAREFACILITY NUMBER:
197494469
ADMINISTRATOR/
DIRECTOR:		EISEN, SARAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(201) 640-1900
CITY:LOS ANGELESSTATE: CAZIP CODE:
90036
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 7DATE:
02/05/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Licensee, Sarah EisenTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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On February 5, 2025, at 8:45 am Licensing Program Analysts (LPA) Priscilla Ochoa conducted an unannounced annual inspection at the above facility. LPA was greeted by Licensee, Sarah Eisen who guided LPA on a tour of the facility. Licensee’s spouse and assistant were also present during the inspection. Per licensee there are 11 children enrolled and LPA observed 7 children in care. Hours of operation are Monday – Thursday from 8:30 am – 2:45 pm and Friday from 8:30 am to 12:30 pm.

Family members residing in the home are 2 adults who has criminal record clearance and 6 minor children. This is a single-story home that consist of 3 bedrooms, 2 bathrooms, living room, dining room, kitchen, laundry room, detached garage and backyard which is fenced.

Off limit areas include 1 bedroom, laundry room, and 1 bathroom.

Areas accessible to children in care are 1 bathroom, 2 bedrooms, living room, dining room, detached garage and back yard which is fenced.

At 9:00 am, licensee’s spouse guided LPA on a tour of the facility. Upon entrance of the front door, LPA inspected the living room area were multiple age-appropriate toys were displayed and a couch area. Next, LPA inspected the dining room area, where a table with chairs and licensing board was observed. LPA was then guided through the hallway, from the dining area where LPA inspected the bathroom that children have access too. The bathroom was observed to be clean and orderly. There were no hazards observed that can pose a danger to children in care. Moving along the hallway, LPA then observed the 2 bedrooms. LPA observed licensee’s children’s beds and cribs. LPA did not observe any hazards that can pose a danger to children in care. Per licensee daycare children do not go into the 2 bedrooms but, they do have access to them. The bedroom doors remain closed during daycare hours. The kitchen is next to the dining area. Per licensee children just walk through the kitchen to access the back yard.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE: DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/05/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: EISEN FAMILY CHILD CARE
FACILITY NUMBER: 197494469
VISIT DATE: 02/05/2025
NARRATIVE
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 LPA observed kitchen cabinets and drawers to be inaccessible to children in care. Licensee knifes and other sharp objects were in a locked drawer. LPA was then guided to the backyard from the kitchen and observed more age-appropriate toys for children in care. LPA also observed a trampoline under a tree. LPA discussed with the licensee that the tree should be trimmed as the branches are too close to the trampoline and can pose a danger to children. Licensee and spouse mentioned that they will move the trampoline forward so it’s not next to the tree. The detached garage was then observed, which is used as an activity room for children in care. LPA observed multiple art and crafts materials for children in care. Napping equipment was not observed, as licensee states that children do not nap. If a child is tired, the parent is called right way and is picked up. All areas were observed to be clean, orderly, comfortable, and well ventilated.

There are first aid supplies available. Per licensee, the facility only provides snacks to children in care. Children bring lunch from home. LPA reminded the licensee, food that is brought from home must be labeled with the child’s name, in a closed container and stored properly or refrigerated. The front porch is used to isolate a child when they become ill. A staff member stays with the child on the front porch while the parent picks up their child.

Licensee's poisons, detergent, cleaning compounds, medications and other items which could pose a danger to child are stored where they are inaccessible to children.

LPA observed a functioning smoke/carbon monoxide detector in the hallway. A 2A-10BC fire extinguisher was observed in the kitchen with a purchased receipt of 2/05/2025. There is a working telephone on site.

Per the licensee, there are no firearms, pets or bodies of water on the premises. Licensee does obtain a current Pediatric First Aid and CPR certification which expired on 1/30/2026.

LPA conducted a children file review and deemed not complete. 3 out of 3 children files that were reviewed were missing LIC 995A, Family Child Care Home Notification of Parent's Rights for LPA to review. LPA conducted staff file review and deemed complete.

Licensee has completed mandated reporter training which expires 12/19/2025. All childcare employees must complete mandated reporter training within 30 days of hire and renew training every two years at www.mandatedreporterca.com

Per the licensee, fire and disaster drills are conducted monthly; last drill was conducted on 1/06/2025.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: EISEN FAMILY CHILD CARE
FACILITY NUMBER: 197494469
VISIT DATE: 02/05/2025
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Licensee has the required documents posted in the FCCH; Facility License (LIC 203), Notification of Parents' Rights Poster (PUB 394) and Emergency Disaster Plan (LIC610a) .

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 Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B. The on Duty Worker is available for questions Monday through Friday at (323) 981-3350 from 8:00 AM - 5:00 PM.

The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot-line at 1-800-540-4000. Also call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).

The licensee was informed that the presence of adults in the home without Criminal Record Clearance or Exemption will be cited and civil penalty assessed for $100 per day. The licensee may find additional information and forms on the DSS website at www.ccld.ca.gov including information on the Live Scan application (LIC 9163). Appointments can be made for Live Scan at 1-800-315-4507

The following was discussed with the licensee:


Capacity requirements, Roster requirements, Posting requirements, Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children’s files and provider’s files, and Safe Sleep Awareness. The role and responsibilities of being a mandated reporter were reviewed. Licensee was reminded that supervision is always required to children in care.

Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility’s phone number; if the phone number is changed, licensing must be notified.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: EISEN FAMILY CHILD CARE
FACILITY NUMBER: 197494469
VISIT DATE: 02/05/2025
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Regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare home and in those areas of the family day care home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category.

--Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.


-- Our Quarterly updates come out every 3 months they are also now in Spanish please log in to the CCLD website or you can email our advocates to have the quarterly updates send directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] 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 informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

The Licensee, Sarah Eisen confirmed that there are no Registered Sex Offenders living in the facility.

LPA provided consultation during inspection.

Based on the LPA’s observations and record review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health and safety.

A notice of site visit was given and must remain posted for 30 days during facility’s hours of operation. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and a copy of the report was provided to Licensee, Sarah Eisen.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/05/2025 11:01 AM - It Cannot Be Edited


Created By: Priscilla Ochoa On 02/05/2025 at 10:46 AM
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
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: EISEN FAMILY CHILD CARE
FACILITY NUMBER: 197494469

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/05/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102419(d)(1)
Admission Procedures and Authorized Representatives Rights
(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). (1) The licensee shall request the child's parent or authorized representative to sign and date the bottom portion of the notice form LIC 995A (8/06), which acknowledges that the parent or
authorized representative has received and read the LIC 995A. The bottom portion of this form
must be kept in the child’s file as proof that the parent or authorized representative has been
notified of his or her rights and received a copy of the Caregiver background Check Process, LIC
995E (6/05), and the Family Child Care Consumer Awareness Information, LIC 9212 (10/05).

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 3 out of 3 children files did not have LIC 995A Family Child Care Home Notification of Parent's Rights, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/10/2025
Plan of Correction
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Licensee will have parents complete and submit LIC 995A and licensee will send LPA proof by POC date 2/10/2025

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:Ana Chico
LICENSING EVALUATOR NAME:Priscilla Ochoa
LICENSING EVALUATOR SIGNATURE:
DATE: 02/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/05/2025


LIC809 (FAS) - (06/04)
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