198019823-5-21-2026-54-CC-ACAN-DUAVDV-20260521162123

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019823
Report Date: 05/21/2026
Date Signed: 05/21/2026 04:22:51 PM

Document Has Been Signed on 05/21/2026 04:22 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	SMITH FAMILY CHILD CARE		FACILITY NUMBER:	198019823
ADMINISTRATOR/ DIRECTOR:	SHERIAH R. SMITH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 988-8262
CITY:	CARSON	STATE: CA	ZIP CODE:	90746
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 7	DATE:	05/21/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:12 PM
MET WITH:	LICENSEE SHERIAH R. SMITH		TIME VISIT/ INSPECTION COMPLETED:	04:30 PM

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Licensing Program Analysts (LPA) Ashley Calderon conducted an unannounced Annual/Random inspection at the above facility. LPA met with Facility Representative Shelinda Franklin who allowed LPA entrance into the facility and disclosed purpose of today's visit.

Via telephonically LPA Calderon informed Licensee Sheriah Smith of LPA's arrival and disclosed purpose of today's visit. Upon arrival LPAs observed (?) children in care during inspection. Facility hours of operation are Monday to Friday 6AM to 6PM, however, Licensee is available 24 hours if needed but understands a child should not exceed 24 hour care at one time. The licensee’s facility serves children newborn to 12 years. The licensee is approved to care for MAX. CAP(WHEN THERE IS AN ASSISTANT PRESENT): 12 - NO MORE THAN 4 INFANTS. CAP 14 - NO MORE THAN 3 INFANTS. 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6.

Areas off limits include: 3 Bedrooms, 1 bathroom, kitchen, garage and front yard. (off limit bedrooms have safety door knobs for inaccessibility).

Areas used by children include: Living (Family) Room, hallway for the children's restroom, and back yard. These areas are accessible during day care hours.
During the inspection, the following individuals were present in the home: Licensee, adult who resides in the home, Staff 1, and Staff 2. All individuals present in the home have been discussed and noted. All adults present in the home have obtained a criminal record clearance or exemption.

Facility Postings are posted in a prominent location at the entrance of the facility: LPA observed the required posting in the daycare room Facility License, PUB 394 Notification of Parents’ Rights, LIC 9148 Earthquake Preparedness, LIC 610A Emergency Disaster Plan, and LIC 9040 Children Roster.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2026

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: SMITH FAMILY CHILD CARE	FACILITY NUMBER: 198019823
	VISIT DATE: 05/21/2026

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LPA Calderon reviewed Disaster Drill log , last conducted 5/13/2026. Fire extinguisher was serviced with a service tag April 10,2026. During today's visit Licensee tested carbon and smoke alarm, they were both tested and found operable. Fire place is blocked by a heavy wooden cabinet that holds children's toys. Per Licensee, poisons are kept in the garage, LPA observed garage door locked. Garage door is located at the kitchen that is off limits to the children, there is a baby safety gate placed by the living room entrance for inaccessibility to kitchen, hallway and garage. Cleaning products are centrally stored underneath the kitchen sink with a child proof latch in the off limit area. Knives were observed located in high to reach cabinets near the microwave, inaccessible to children. Per Licensee, there are no firearms on the premises. If firearms are brought into the home to report before bringing them into the home and informed Licensee per Title 22 regulations that they are to be locked and ammunition stored separately in locked storage. LPA observed facility to have childproof electrical outlet covers.

Infants: during visit LPA reviewed 2 infant files, infants had 15 min sleep log. (6) play yards were observed, all had firm mattress and fitted sheets.

Outdoor: Children use the backyard for outdoor play. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA observed no bodies of water. At 2:30pm LPA Calderon observed in the back yard a loose gray cord by the door that leads to the children's play room and (2) loose cords, one black cord and white cord in the side runner that is accessible by children and located in the back yard children, pictures taken, deficiency given. Per Licensee, no pets currently at the home. Per Licensee, stated will go to the park with the after-school age children.

Staff Files: LPA reviewed Licensee and (2) staff files which included the following documentation's: Licensee has Pediatric First Aid and CPR expires 11/05/26, and Mandated Reporting Training Certificate 5/14/28.

Children Files: LPA reviewed (5) children files, which included the following documentation: LIC 282 Affidavit Regarding Liability Insurance, LIC 700 Identification and Emergency Information, LIC 627 Consent for Emergency Medical Treatment, LIC 995A Notification of Parents’ Rights, and LIC 9224 Acknowledgment of Receipt of Licensing Reports it was not applicable. (5) of (5) children had all required documentation.

During visit, LPA cleared deficiency cited on 4/20/23 visit, facility observed to be within License Capacity, plan of correction was cleared during today's visit. LPA Calderon gave consultation on (2) of licensee's children who will be adults, Licensee reporting. Submit LIC279 Application, LIC279B Current children living in home, and submit current Tuberculosis.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2026

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: SMITH FAMILY CHILD CARE	FACILITY NUMBER: 198019823
	VISIT DATE: 05/21/2026

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To improve the quality and value of the new inspection process, a survey may be sent to the

email address provided. Please complete the survey and share your inspection experience. If
you have any questions regarding the process or CARE tools, please send email inquiries to
inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its
tools and methods, please visit the Program website at
www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

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-andresources/
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.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Ashley Calderon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2026

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/21/2026 04:22 PM - It Cannot Be Edited

Created By: Ashley Calderon On 05/21/2026 at 03:56 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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: SMITH FAMILY CHILD CARE	FACILITY NUMBER: 198019823
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/21/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102423(a)(2)

Personal Rights

(a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation At 2:30pm LPA Calderon observed in the back yard a loose gray cord by the door that leads to the children's play room and (2) loose cords, one black cord and white cord in the side runner that is accessible by children and located in the back yard children, pictures taken, the licensee did not comply with the section cited above in [1] out of [1] hazadous items which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/05/2026
	Plan of Correction
1 2 3 4	Per Licensee, will ensure cords are attached to the wall and secure for safety. Pictures will be taken and sent to LPA Calderon by POC due.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: 05/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2026

LIC809 (FAS) - (06/04)

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