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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494524
Report Date: 06/29/2026
Date Signed: 06/29/2026 10:26:31 PM

Document Has Been Signed on 06/29/2026 10:26 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:PEREZ FAMILY CHILD CAREFACILITY NUMBER:
197494524
ADMINISTRATOR/
DIRECTOR:		PEREZ, JOHANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 304-6887
CITY:WILMINGTONSTATE: CAZIP CODE:
90744
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
06/29/2026
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Johana Perez - LicenseeTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 06/29/2026, Licensing Program Analyst (LPA) Cristina Castellanos conducted an unannounced 3-Year Required Inspection at the above-referenced Family Child Care Home. Upon arrival, LPA was greeted by Licensee Johana Perez, who granted entry. Present during today’s inspection was Licensee Perez, Licensee’s minor daughter, Licensee’s assistant/father and 5 children in care.

The purpose of this inspection is to ensure that the licensee continues to meet the health, safety, and personal rights requirements outlined in Title 22 Regulations governing California Family Child Care Homes. The facility is licensed as a Large Family Child Care Home with a maximum capacity of 14 children. The program currently serves children as young as 6 weeks old and operates 24 hours Monday through Friday, offering overnight and weekend care if needed.

Capacity as specified on the license was observed to be in compliance.

The single-family home consists of a living room, a kitchen area, an attached garage, three bedrooms, two bathrooms, and a spacious backyard.

The Licensee confirmed that the following areas are OFF LIMITS to children in care: the converted garage, bedroom no. 1, bathroom no. 1, the living room, and the kitchen. LPA observed a safety gate installed in front of the playroom area, restricting access to the hallway leading to the living room and other off-limits areas. The Licensee also confirmed that there are no longer any pet dogs in the home. LPA reminded the Licensee that all off-limits areas must remain inaccessible to children at all times while care is being provided. A copy of the CAL FIRE – Office of the State Fire Marshal Information Bulletin 20-008 (issued March 19, 2021) was provided for review.


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NAME OF LICENSING PROGRAM MANAGER: Loyce Phillips
NAME OF LICENSING PROGRAM ANALYST: Cristina Castellanos
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/29/2026
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: PEREZ FAMILY CHILD CARE
FACILITY NUMBER: 197494524
VISIT DATE: 06/29/2026
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Families enter the home through the main entrance and proceed directly into the main living area, which serves as the walkway to the children’s designated playroom. The Licensee stated that the playroom, located in the master bedroom at the end of the home, is used as the primary day-care area, along with the backyard. According to the Licensee, children eat in the designated playroom and nap in bedroom no. 2.

Adequate heating and ventilation were present throughout all licensed areas. Age-appropriate toys and equipment were available and in good condition. The home maintains a working telephone.

Licensee confirmed that the home does provide meals and snacks to the children in care, which complies with dietary restrictions and allergies. LPA discussed the importance of maintaining clear communication among all individuals assisting with care to ensure awareness of any dietary restrictions or allergies.

No firearms or ammunition are stored on the premises. Detergents and cleaning compounds are stored away inside a closet with a door knob cover, out of children’s reach.

LPA observed Licensee test the dual smoke and carbon monoxide alarm in the home. LPA observed a working fire extinguisher mounted next to the main entrance. LPA reminded licensee to maintain proof of an annual service for the fire extinguisher.

The licensee confirmed that the home is prepared to accept a child who may require medication; however, no children currently in care require medication.

The Licensee ensures that children are supervised at all times and understands that children must never be left in parked vehicles. Car seats are used only for transportation and not for sleeping.

Safe Sleep regulations were reviewed due to the program’s availability for infant care. There is one crib or play yard available for each infant. All cribs and play yards are kept free of loose items while infants sleep, and nothing is hung above or attached to them. Infants are not swaddled while in care. The provider conducts and documents physical checks on sleeping infants every fifteen minutes, noting any signs of distress such as flushed skin, increased body temperature,


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NAME OF LICENSING PROGRAM MANAGER: Loyce Phillips
NAME OF LICENSING PROGRAM ANALYST: Cristina Castellanos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2026
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: PEREZ FAMILY CHILD CARE
FACILITY NUMBER: 197494524
VISIT DATE: 06/29/2026
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restlessness, or labored breathing. Infants sleeping in a separate room remain within visual observation through an open door. Infants up to 12 months of age are placed on their backs to sleep. The Individual Infant Sleeping Plan (LIC 9227) was reviewed.

LPA reviewed two personnel files and verified that the Licensee and assistant have a current Pediatric CPR/First Aid certification, completed on 11/20/2025, and a Mandated Reporter Training certificate, completed on 06/05/2024. LPA reminded the Licensee that Pediatric CPR/First Aid training must be completed through EMSA-approved providers. LPA also reminded the Licensee that Mandated Reporter Training must be renewed every two years.

LPA reviewed six children's files and found them to be complete. LPA provided the Licensee with the “Safe Sleep for Your Baby” brochure (NIH Pub. No. 12-7040) and a sample sleep log for review.

The Licensee was reminded that all adults 18 years and older living or working in the home, including employees and volunteers (except as specified in Health and Safety Code section 1596.871), must obtain a criminal record clearance or exemption, or transfer an existing clearance or exemption, prior to initial presence in the home. Failure to comply will result in a civil penalty of $100 per day, per person, for up to 5 days—or up to 30 days for repeat violations.

Incidental Medical Services (IMS) policy was reviewed. For IMS information, Licensee was referred to PIN 22-02-CCP. Information regarding the Americans with Disabilities Act (ADA) was provided, including the U.S. Department of Justice ADA Information Line and the publication Commonly Asked Questions About Child Care Centers and the ADA.

The Licensee was informed of the MyChildCarePlan.org website, a consumer education resource that connects families with child care providers and Resource and Referral Agencies throughout California.

Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, no deficiencies were cited during today’s inspection.

An exit interview was conducted and reviewed with Licensee Johana Perez. A copy of this report was discussed and left with Licensee. A Notice of Site Visit was given and must remain posted for 30 days. Failure to comply with the posting requirements shall result in an immediate civil penalty of $100.


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NAME OF LICENSING PROGRAM MANAGER: Loyce Phillips
NAME OF LICENSING PROGRAM ANALYST: Cristina Castellanos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2026
LIC809 (FAS) - (06/04)
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