198016150-6-26-2026-54-CC-ACAN-DVEPZQ-20260626114554

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198016150
Report Date: 06/26/2026
Date Signed: 06/26/2026 11:46:20 AM

Document Has Been Signed on 06/26/2026 11:46 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	WILLIAMS FAMILY CHILD CARE		FACILITY NUMBER:	198016150
ADMINISTRATOR/ DIRECTOR:	WILLIAMS, ROSALIND		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 462-9958
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90061
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 6	CENSUS: 2	DATE:	06/26/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:09 AM
MET WITH:	Licensee Rosalind Williams		TIME VISIT/ INSPECTION COMPLETED:	11:55 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	Licensing Program Analyst (LPA) Ashley Calderon conducted an unannounced random/annual to the above facility. Upon arrival, LPA disclosed the purpose of the inspection and met with Licensee Rosalind Williams, who granted entry to facility. Facility hours of operations are currently Monday - Friday 7am - 10:30pm and Saturday's 7am-5:30pm, and facility cares for infants - 13 year old children. Upon arrival LPA observed 2 child and individual adults (2) present were fingerprinted. This is a single-story home which consists of three bedrooms and two bathrooms, Kitchen, Living Room, Dining Room, garage, front yard (porch) and backyard. Per Licensee, areas used by the children include backyard, front yard porch ,Living Room with Bathroom (1) located in living room Per Licensee, areas off limits to children and parents include: Bedrooms 1,2,3, Bathroom 2, Kitchen and garage (locked) . The children's roster was reviewed and is current. LPA observed required postings at time of inspection located in living room. Disaster drill log was also available and reviewed during today’s inspection, last disaster drill conducted on 05/12/2026. There was age appropriate toys, materials and equipment available for children. Per Licensee, Williams provides and maintains the cleanliness of the sheets and blankets weekly for napping children. Per Williams, there currently is (2) infants in care, 1 infant present during visit. LPA observed a play yard in the living room, per Licensee Williams informed LPA infants currently enrolled infants uses the cots and currently play yard is not used for sleeping; LPA observed no fitted sheets observed for the firm mattress observed in the play yard, consultation provided.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/26/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2026

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: WILLIAMS FAMILY CHILD CARE	FACILITY NUMBER: 198016150
	VISIT DATE: 06/26/2026

NARRATIVE

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All areas identified on the facility sketch accessible to children were inspected to ensure that they are clean and orderly. LPA observed central ventilation and heating, inaccessible on ceiling. There is a working telephone maintained in the home via lineline. Off limit area are all the bedrooms and bathrooms located behind the wooden barn sliding door in the living room, there is a high to reach latch for inaccessibility.

Kitchen was observed, area is off limit and licensee has placed a baby safety gate for inaccessibility. LPA observed wall electrical fireplace in kitchen , per licensee it does not project heat. Knives are stored inaccessible on the top of the refrigerator, and cleaning components in the shed and on top of the refrigerator. Facility is on a food program; LPA informed Licensee if children bring food from home to properly label with their names and store food items.

Fire extinguisher was serviced and inspection tag observed 11/26/24, deficiency cited. Carbon monoxide and smoke alarm was tested and found operable. Per Licensee, no pets and no children on medication. LPA did not observe any guns / firearms during visit (per Licensee, there are none in the home).

LPA Calderon observed backyard. Licensee stated has poisons (weed/plant killer) in locked garage and shed; observed in backyard inaccessible to children. There is age appropriate toys for the children to play with outside and patio furniture / outside fire place is covered for inaccessibility. Backyard entrance is located in the living room, door has a double door: screen door and glass doors. No bodies of water observed on premises. Backyard is fenced off for safety.

Records were reviewed, (2) staff records: Licensee Mandated Reporter - Child Care Provider training expires 6/10/28 and Pediatric 1st Aid and CPR exp 3/2027 and staff assistant (who resides in the home) it qualified to be left alone with children for transportation or when Licensee temporary absent of 20% daily hours of operations. Staff assistant only had TDAP, missing MMR and TB records, deficiency cited. Children records were reviewed: (3) records , all appropriate documentation's are in place. LPA observed Infants form for 0-12 months that require LIC9227 Individual Infant Safe Sleep Plan and infants under 24 months had documentation of 15 min Sleep Log; although some logs had dates and some didn't therefore; LPA provided consultation.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/26/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2026

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: WILLIAMS FAMILY CHILD CARE	FACILITY NUMBER: 198016150
	VISIT DATE: 06/26/2026

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Licensee was reminded that all adults 18 and over 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 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.
LPA discussed the safe sleep regulations with licensee 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 licensee 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.
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.
Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Based on today's visit, Per California Code of Regulation Title 22 (2) deficiencies cited, facility was found in compliance and no citations were provided on this visit.

A notice of site visit was emailed due to printer issues and must remain posted for 30 days from this visit date. Exit interview conducted and report was reviewed with the licensee Rosalind Williams.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/26/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2026

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/26/2026 11:46 AM - It Cannot Be Edited

Created By: Ashley Calderon On 06/26/2026 at 11:03 AM

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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: WILLIAMS FAMILY CHILD CARE	FACILITY NUMBER: 198016150
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/26/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(1)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation fire extinguisher observed in the kitchen service tag dated11/26/24 , past the State Fire Marshall Requirement, the licensee did not comply with the section cited above in [1] out of [1] State Fire Marshall Requirement which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/10/2026
	Plan of Correction
1 2 3 4	Licensee during visit called inspector to conduct service for fire extiguisher, left voice message. Licensee will get fire ext. serviced and send photo of service tag to LPA Calderon.

Type B

Section Cited

HSC

1597.622(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review staff assistant only has immunization record Tdap, missing MMR / TB, the licensee did not comply with the section cited above in [1] out of [1] staff record which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/24/2026
	Plan of Correction
1 2 3 4	Immunization records for staff assistant (resides in the home) will be obtained per Licensee and submit a copy to LPA Calderon.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Warren Birks
NAME OF LICENSING PROGRAM MANAGER:

	Ashley Calderon
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/26/2026

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2026

LIC809 (FAS) - (06/04)

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