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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494770
Report Date: 05/08/2024
Date Signed: 05/16/2024 01:03:17 PM

Document Has Been Signed on 05/16/2024 01:03 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:DAVILA FAMILY CHILD CAREFACILITY NUMBER:
197494770
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 9DATE:
05/08/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Viviana DavilaTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On May 8, 2024, Licensing Program Analyst (LPA), V. Wheatley conducted an unannounced Annual Inspection and was met by Licensee, Vivianna Davila. Days and hours of operation are currently Monday through Friday 7:30AM to 5PM. LPA Wheatley observed 9 children napping and was supervised by licensee's mother. Upon LPA's arrival licensee was on break outside the home but walked up to the home when LPA arrived.

LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed and confirmed that the living room and one bedroom is used for the day care. The small room next to the bathroom is used for diaper changing only. Licensee states her bedroom is off-limits but needs a door with a lock or child proof gate. The kitchen child proof gate is broken. There is no swimming pool or other bodies of water on the premises. Per licensee, there are no firearms or ammunition on the premises. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible. There is a working fire extinguisher, smoke detector, and carbon monoxide detector (combo). The home has adequate heating and ventilation for safety and comfort. There is a screen wall heater and a portable air conditioner. There are no stairs in the home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number. LPA observed a children's roster.

LPA discussed Safe Sleep Regulations with licensee. Cribs and play yards will be kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider physically checks on sleeping infants up to 2 years old every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping. LPA did not observe any infants. All children are two to four years old.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
LICENSING EVALUATOR SIGNATURE: DATE: 05/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/08/2024
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: DAVILA FAMILY CHILD CARE
FACILITY NUMBER: 197494770
VISIT DATE: 05/08/2024
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Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. The children are no playing in the backyard at this time. Capacity as specified on the license is not being maintained.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporter Training expires August 2025. Licensee’s pediatric CPR/First Aid expires on 10/2024. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA discussed with the licensee the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, deficiencies are cited.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

Exit interview conducted. Report was read and provided to the licensee.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/16/2024 01:03 PM - It Cannot Be Edited


Created By: Veronica Wheatley On 05/08/2024 at 03:49 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: DAVILA FAMILY CHILD CARE
FACILITY NUMBER: 197494770

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/08/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.5(a)


This requirement is not met as evidenced by: LPA Wheatley observed 9 children napping on the premises. The maximum number of children allowed is 6 because non of the children were school aged. They were all 2 to 4 years old.
Deficient Practice Statement
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Based on LPA's observation and record review, the licensee did not comply with the section cited above in total count of 9 children on the premises which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 05/09/2024
Plan of Correction
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Licensee states she did not know that she could not have all preschool aged children. LPA showed the licensee the license which states. Licensee agrees and understands she must terminate the services for 3 children immediately and inform the Department by tomorrow 5/9/2024.
Type A
Section Cited
CCR
102416.5(c)


This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observation and record review, the licensee did not comply with the section cited above of total count which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 05/09/2024
Plan of Correction
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Licensee agrees and understands she must terminate the services of 3 children immediately and inform the Department by 5/9/2024. Licensee agrees to maintain capacity of 6 children unless she has 2 school aged children.
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:Maureen Neal
LICENSING EVALUATOR NAME:Veronica Wheatley
LICENSING EVALUATOR SIGNATURE:
DATE: 05/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/08/2024


LIC809 (FAS) - (06/04)
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