<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495629
Report Date: 06/18/2025
Date Signed: 06/19/2025 01:17:54 PM

Document Has Been Signed on 06/19/2025 01:17 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:ARDON FAMILY CHILD CAREFACILITY NUMBER:
197495629
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
06/18/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:43 AM
MET WITH:Applicant- Rossy AdornTIME VISIT/
INSPECTION COMPLETED:
11:47 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 6/18/2025 Licensing Program Analyst (LPA) Brittany Lovest conducted an ANNOUNCED PRE-LICENSING INSPECTION with applicant Rossy Ardon. Present during today’s visit was applicant Rossy Ardon. The purpose of the inspection is to ensure the health, safety and personal rights as required by Title 22 regulations governing California Childcare Homes will be met by applicant. This is an application for a small family childcare and the facility plans to operate Monday – Friday, 8:00am – 6:00pm. Applicant will serve children from 3 months to 12 years of age. Applicant will provide meals and snacks. LPA discusses the importance of maintaining a system where allergies and food restrictions are noted.

The home was toured indoors and outdoors with the applicant for a health and safety inspection.

The home is multi-unit property. The residence resides on a lot with two homes separated by a side gate and locked door on rear of applicants covered patio. The Home is the first residence on the lot walking through the front gate. Access to the rear unit is through the driveway of the applicant’s home.

The current facility sketch was reviewed, and LPA Lovest confirmed that home consists of the following: living room, bedroom #1, bathroom #1, bedroom #2, bedroom #3, bathroom#2, dining room #1, kitchen, laundry room, dining room #2, covered patio and front yard.

The Applicant has requested the following rooms be ON-LIMITS: Living room, bedroom #1 bathroom#1, dining room #1 and front yard. The designated sleep area for children is bedroom #1. The living room and the dining room #1 will be the primary Day care space.

The applicant has requested the OFF-LIMIT AREAS are as follows: bedroom#2, bedroom#3, bathroom #2, covered patio, kitchen, laundry room and dining room#2.

Page 1 of 4

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Brittany Lovest
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/18/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 5
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)
Page: 2 of 5
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: ARDON FAMILY CHILD CARE
FACILITY NUMBER: 197495629
VISIT DATE: 06/18/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Bedroom #2 is made inaccessible to children in care by a child proof doorknob. The entrance for Bathroom #2 and covered patio is through bedroom #3 which is made inaccessible by a child proof doorknob. Dining room #2 entrance is from dining room#1 which is made inaccessible by a safety gate. The laundry room kitchen and dining room #2 are connect by a hallway leading to an exit on the side of the home. The kitchen which leads to laundry room is made inaccessible by a safety gate at the entrance of dining room #1.

LPA reminded applicant that any area designated as OFF LIMITS should be made inaccessible during the hours of operation and/or while children are present.

Applicant and applicants’ spouse and applicants minor child resides in the home. The Applicant has a cat in home. Per applicant the cat will remain in the off limit covered patio during the hours of operation. LPA reviewed cats’ records and advised applicant to keep cats records up to date and available for departments review.

The home is neat and clean with heating and ventilation for safety and comfort. The FCCH has a working phone.

All adults living in the home and assistant and/or substitute care providers have submitted fingerprints and child abuse index check forms to Department of Justice and received a California clearance or exemption.

The home has a fireplace in the living room, an open face heater in dining room#1 and hallway. The fireplace is made inaccessible by a heat-resistant screen and a gate surrounding fireplace.

The Home has a fully charged fire extinguisher 2A:10: BC located in the kitchen under the sink and mounted to the wall in the laundry room. LPA observed a First Aid kit in Bathroom #1. The Home has a working smoke alarm and carbon monoxide detector in the living room.

All poisons and hazardous materials are kept out of the reach of children by being housed in locked cabinet in kitchen. Knives are stored in the top locked cabinet in off limits kitchen.

The bathroom is free of shampoo, mouthwash, toothpaste, medicines perfumes/lotions/cosmetics, solvents, etc. Applicant has locks for bathroom cabinets and walk in shower.

LPA observed outdoor area. LPA reminded applicant to ensure to visually supervision to children in care playing outdoors due to gate in front of home being accessible by attendees of home on rear of lot.

Page 2 of 4

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Brittany Lovest
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: ARDON FAMILY CHILD CARE
FACILITY NUMBER: 197495629
VISIT DATE: 06/18/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA informed applicant that Baby walkers, bouncers, jumpers, and similar items should not be used for children in care and must be kept inaccessible.

There are no pools, ponds, spas, or other bodies of water on the property. Any poisons, detergents/cleaning compounds, medication and hazardous items that can pose a danger to children are made inaccessible to children in care by being housed in locked off limit’s areas.

There are no guns or ammunition stored on the premises.

LPA observed age-appropriate toys, books and furnishing and equipment that are in good condition, free of sharp, lose or pointed parts.

The following correction need to be made before licensure:

1. Open face heater, heat resistant covering (surrounding, front and back of heater)

Plan of corrections and due dates: corrections shall be submitted by 7/2/25. The licensing determination of this application will then be reviewed with licensing program manager for final resolution.

The Applicant has current CPR/First Aid certificates and Mandated Reporter Training certificates and is in compliance with the immunization law which pertains to day care providers. LPA Lovest reminded applicant that the CPR/First Aid and Mandated Reporter training are to be updated every 2 years.

The applicant provided copies of CA drivers license for all adult residents during visit to be placed in file.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

Because the applicant rents the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

Page 3 of 4

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Brittany Lovest
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: ARDON FAMILY CHILD CARE
FACILITY NUMBER: 197495629
VISIT DATE: 06/18/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. 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) or (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

LPA provided applicant with the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and- resources/safe-sleep, as an additional resource. LPA also informed applicant 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. Prohibited items in Family Child Care Home flyer was provided.

The California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care- licensing/subscribe and select the Childcare option to receive email communication.

Exit interview conducted and report was reviewed with the applicant, Rossy Ardon.

Page 4 of 4

NAME OF LICENSING PROGRAM MANAGER: Karren Starks
NAME OF LICENSING PROGRAM ANALYST: Brittany Lovest
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2025
LIC809 (FAS) - (06/04)
Page: 5 of 5