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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494665
Report Date: 04/17/2024
Date Signed: 04/17/2024 04:41:14 PM

Document Has Been Signed on 04/17/2024 04:41 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:LUU FAMILY CHILD CAREFACILITY NUMBER:
197494665
ADMINISTRATOR/
DIRECTOR:		JOSEPHINE LUUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 439-4076
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 12DATE:
04/17/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:07 PM
MET WITH:Josephine Luu, LicenseeTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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On 04/17/2024 at 12:07 PM, Licensing Program Analyst (LPA) Elicia Calvillo conducted an unannounced visit. LPA identified self and met with Josephine Luu, Licensee, who guided analyst on a tour of the inside and outside of the facility. LPA observed 2 Infants and 10 Children and 1 staff upon arrival.

Licensee guided LPA to the Infant Sleeping Room and LPA observed an infant sleeping behind the door that was restrained in a car seat. When Staff #1 saw LPA and Licensee enter the room, LPA told Licensee that no child can be kept restrained in a car seat, kept asleep in a car seat and that car seats are only used to transport children in a car. Licensee stated that that they did not know about this regulation and the infant just fell asleep and was being moved to the play yard. LPA observed when Staff #1 pick up the child #1 then the child #1 woke up. Licensee stated that Child #1 arrived about a quarter to nine (08:45 AM) and LPA observed a sign in sheet at the front door with Child #1 sign in by Parent #1 at 08:40 AM (photo taken). LPA reminded Josephine Luu, Licensee that car seats are for transportation only and shall not be used for sleeping.

Licensee did not ensure the Infant Safe Sleep of Child #1 in that Child #1 was asleep in a car seat in the Infant Room.

Licensee did not ensure the Personal Rights of Child #1 in that Child #1 was restrain in a car seat while asleep in the Infant Room.

Licensee did not ensure the Infant Safe Sleep of Child #1 in that Child #1 was asleep in a car seat that was placed behind the door of the Infant Sleeping Room.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE: DATE: 04/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/17/2024
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: LUU FAMILY CHILD CARE
FACILITY NUMBER: 197494665
VISIT DATE: 04/17/2024
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As a result of today's visit, three Type A Deficiencies was issued for, 102425 (h) Infant Safe Sleep, 102423 (a) (2) Personal Rights, and 102425 (a) (2) Infant Safe Sleep. The following deficiencies listed on the attached deficiencies page are being cited in accordance with California Code of Regulations Title 22.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. During this visit, the Licensee was provided with a copy of LIC 9224 Acknowledgement of Receipt of Licensing Reports Form and LIC 995A Notification of Parents’ Rights.

The Notice of Site Visit must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

A notice of site visit was given and must remain posted for 30 days, exit interview conducted and report appeal rights was reviewed with the licensee Josephine Luu

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 04/17/2024 04:41 PM - It Cannot Be Edited


Created By: Elicia Calvillo On 04/17/2024 at 02:20 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: LUU FAMILY CHILD CARE
FACILITY NUMBER: 197494665

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/17/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/18/2024
Section Cited
CCR
102425(h)

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102425 (h) Infant Safe Sleep (h) Car seats shall only be used for transportation purposes and shall not be used for sleeping. This requirement is not met as evidenced by:
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Licensee stated they removed the car seat from the Infant Sleeping Room. LPA observed car seat was placed in the kitchen area.
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Based on observation and interview, the licensee did not comply with the section cited above in that Licensee did not ensure Infant Safe Sleep of Child #1 in that Child #1 was asleep in a car seat in the Infant Room, which poses an immediate health, safety, or personal rights risk to persons in care.
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Type A
04/22/2024
Section Cited
CCR102423(a)(2)

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102423 (a) (2) Personal Rights (a) Each child…certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization... These rights include…: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement is not met as evidenced by:
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Licensee stated they will no longer restrain children while in care. Licensee stated they will review the personal rights regulation and review CDSS videos on personal rights by the plan of correction due date 4/22/2024
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Based on observation and interview, the licensee did not comply with the section cited above in that Licensee did not ensure the Personal Rights of Child #1 in that Child #1 was restrain in a car seat while asleep in the Infant Room, which poses an immediate health, safety, or personal rights risk to persons in care.
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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.
SUPERVISOR'S NAME:Rita Ramos
LICENSING EVALUATOR NAME:Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:
DATE: 04/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/17/2024


LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 04/17/2024 04:41 PM - It Cannot Be Edited


Created By: Elicia Calvillo On 04/17/2024 at 02:26 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: LUU FAMILY CHILD CARE
FACILITY NUMBER: 197494665

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/17/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/22/2024
Section Cited
CCR
102425(a)(2)

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102425 (a) (2) Infant Safe Sleep (a) There shall be one crib or play yard for each infant... (2) Placement of cribs or play yards shall not hinder entrance or exit to and from the space where infants are sleeping. This requirement is not met as evidenced by:
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Licensee stated they will remove the car seat from the Infant Sleeping Room on 4/17/2024 and licensee stated they will review safe sleep regulations and CDSS videos by plan of correction due date 4/22/2024.
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Based on observation and interview, the licensee did not comply with the section cited above in that Licensee did not ensure an Infant Safe Sleep of Child #1 in that Child #1 was asleep in a car seat that was placed behind the door of the Infant Room, which poses an immediate health, safety, or personal rights risk to persons in care.
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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.
SUPERVISOR'S NAME:Rita Ramos
LICENSING EVALUATOR NAME:Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:
DATE: 04/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/17/2024


LIC809 (FAS) - (06/04)
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