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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494658
Report Date: 03/02/2022
Date Signed: 03/14/2023 02:13:50 PM

Document Has Been Signed on 03/14/2023 02:13 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CISSE GUEYE FAMILY CHILD CAREFACILITY NUMBER:
197494658
ADMINISTRATOR:CISSE GUEYE, MARIAMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(424) 402-7239
CITY:LOS ANGELESSTATE: CAZIP CODE:
90025
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
03/02/2022
TYPE OF VISIT:Case Management - COVID-19UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Mariama Cisse GueyeTIME COMPLETED:
10:20 AM
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On 03/2/2022 at 9:00 am, Licensing Program Analyst (LPA) Judy Laureano conducted an unannounced Case Management – COVID-19 inspection for the purpose of following up on Unusual Incident Report (UIR) submitted on 01/12/2022. LPA Laureano with Mariama Cisse-Gueye who toured LPA through the inside and outside of the facility. LPA observed 10 children in care with 2 staff and licensee on site.

According to the UIR, on 01/12/2022- 1 staff member and 2 children were reported as testing positive for COVID-19.

Licensee stated all of the children and staff who were reported positive COVID have all isolated and have since all returned to the facility. All children and staff were tested prior to coming back to facility. Licensee confirmed all COVID procedures that facility has in place such as testing after any type of travel and minimizing visitors.

During inspection, LPA observed children playing outdoors. Additional mask available through the home, soap and paper towels were observed to be available at all handwashing sinks and hand sanitizer available through out the home.

Licensee confirmed facility greets children by the side gate of the home. LPA Laureano observed COVID-19 signage throughout the facility for mask wearing and washing hands. At the side entrance LPA Laureano observed all necessary posting for families. Licensee confirmed the use of text and email to communicate with parents. Parents receive all important information and daily updates.

LPA Laureano observed facility supply of PPE COVID supplies such as gloves, hand sanitizing

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE: DATE: 03/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/02/2022
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CISSE GUEYE FAMILY CHILD CARE
FACILITY NUMBER: 197494658
VISIT DATE: 03/02/2022
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wipes, liquid hand sanitizer, cleaning wipes, children mask, adult masks, and thermometers. Licensee confirmed that deep cleaning takes place twice a week and cleaning and sanitizing occur every evening.

LPA Laureano discussed with Licensee current COVID-19 resources and guidance. LPA encouraged licensee to contact the local Resource and Referral agency, Connections for Children, for resources and materials regarding COVID.

No deficiencies are cited, per Title 22, Division 12, Chapter 3, of the California Code of Regulations.

An exit interview was conducted and a copy of this report (LIC 809) and Notice of Site Visit were provided to Licensee, Mariama Cisse Gueye.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022
LIC809 (FAS) - (06/04)
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