198021764-5-26-2026-33-CC-CNGN-DUFS49-20260526133221

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021764
Report Date: 05/26/2026
Date Signed: 05/26/2026 01:32:44 PM

Document Has Been Signed on 05/26/2026 01:32 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	HARRIS FAMILY CHILD CARE		FACILITY NUMBER:	198021764
ADMINISTRATOR/ DIRECTOR:	LILY HARRIS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 666-3459
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90065
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 17	CENSUS: 12	DATE:	05/26/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Licensee, Lilly Harris		TIME VISIT/ INSPECTION COMPLETED:	01:45 PM

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On Tuesday, May 25, 2026 9:30 a.m., Licensing Program Analysts (LPAs) J. Solorio-Campos and C. Nguyen conducted an unannounced annual inspection and met with licensee Lily Harris, whom the purpose of the visit was explained, and guided LPAs on a tour of the facility. Entrance Checklist LIC 126 was provided. Licensee states that there are 17 children enrolled. LPAs observed 12 children, 4 staff, and 1 Speech Therapist. LPAs observed facility to be within ratio. Licensee stated operating hours are Monday to Friday from 8:00 a.m – 5:00p.m.

This is a single-story home located on a duplex property which consists of 2 bedrooms, 1 bathroom, living room, dinning area, kitchen, front and rear yard (both fenced around the perimeter).

Off limit areas: Bedroom #2 and kitchen (inaccessible with child proof gate)

Areas accessible to children: Living room, dinning area, bedroom #1, bathroom located on the left side of the hallway, the front and rear yard.

Family members residing in the home were discussed (criminal record clearances on file). The LPAs toured all areas used by children during this visit. For ill isolation, licensee stated that an area by the front door of the living room and outside if whether permits is utilized.

LPAs did not observe the following required postings in the entry way of the facility: License, LIC 9148 Earthquake Preparedness Checklist, LIC 610A Emergency Disaster Plan, Pub 394 Notification of Parents Rights, and LIC 999 Facility sketch. LPAs consulted with licensee regarding required postings and observed her post them on her wall.

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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2026

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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: HARRIS FAMILY CHILD CARE	FACILITY NUMBER: 198021764
	VISIT DATE: 05/26/2026

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LPAs inspected the facility for safety, comfort, cleanliness, ventilation and working cell phone. For ventilation, LPAs observed AC units and central air. Per Licensee, the children and parents with enter through the front door. The infants will sleep in the bedroom #1 and living room and will be placed in playpens during nap time. Older children will sleep in the living room/bedroom #1 on mats/cots. LPAs observed age-appropriate napping equipment. Licensee states that bedding is washed on a weekly basis at facility or parents wash them from home.

At 10:00 a.m., LPAs observed the living room and bedroom #1 furniture, manipulatives, books, soft climbing supplies, toys, puzzles, art materials and other age-appropriate materials that were well maintained and free of loose, sharp, and pointed parts.

Per Licensee, children are using the front patio for outdoor play time. The outdoor play area was observed to be fenced around the perimeter. LPAs observed that the outdoor patio has toys and other climbing materials for children to play with that were well maintained and free of loose, sharp, and pointed parts.

At 10:30 a.m.,LPAs entered the bathroom and observed a working toilet, working sink with hand soap. LPAs observed personal items stored in a high cabinet above the toilet which are inaccessible to children. LPAs reminded licensee and personal items (ex; shampoo, toothpaste, mouthwash, or items that fall into that category) must be made inaccessible to children.

LPAs asked the licensee if there were any pets, poisons, firearms, or weapons, or bodies of water. Licensee stated they do not have any of the other above mentioned and LPAs did not observe any. The licensee was informed that if any poisons (ex; drano, rat poison or items that fall into that category), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately.

Licensee stated the facility provides breakfast/afternoon snack and children’s parents pack lunch for their child. LPAs informed licensee any food brought from the children's homes, the container shall be labeled with the child's name and properly stored or refrigerated. Licensee stated that there is 1 child with severe food allergies and LPAs observed storage of medication in a high shelf in the kitchen was not labeled in its original packaging which a potential health, safety, and personal rights risk to children in care. LPAs observed the first aid kit in the kitchen to be complete.

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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2026

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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: HARRIS FAMILY CHILD CARE	FACILITY NUMBER: 198021764
	VISIT DATE: 05/26/2026

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LPAs observed cleaning compound items stored underneath the kitchen sink, and observed a child proof gate which is inaccessible to children. LPAs observed the knives and sharp objects stored inside a top cabinet making it inaccessible for children.

At time of inspection, LPAs observed the required 2A10BC fire extinguisher located in the kitchen and the valve on the green area indicating fully charged. LPAs reminded licensee that fire extinguishers shall be serviced or purchased with receipt attached on a yearly basis. LPAs observed the last emergency drill conducted on 4/1/2026. LPAs observed a carbon monoxide detector and smoke alarm combined and located in the living room and was operable.

LPAs observed licensee’s American Heart Association Pediatric First Aid/ CPR certification and expires 10/2026, and has proof of immunization against Pertussis, MMR, and Influenza declination. Licensee has completed the Child Abuse Mandated Reporter (AB 1207) training and expires 08/02/2026. Licensee was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com.

LPAs also reviewed children’s roster, children files including sleep logs and staff files. LPAs observed the files to be incomplete. LPAs conducted a children file review and deemed it not complete: 2 out of 5 children did not have Infant Sleep Logs in their file for LPAs to review which a potential health, safety, and personal rights risk to children in care.

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.

LPAs discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as

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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2026

LIC809 (FAS) - (06/04)

Page: 4 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: HARRIS FAMILY CHILD CARE	FACILITY NUMBER: 198021764
	VISIT DATE: 05/26/2026

NARRATIVE

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an additional resource. LPAs also informed licensee of the importance of checking for and removing any 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

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.

During the exit interview, licensee confirmed that there are no Registered Sex Offenders living in the facility and LPAs completed the RSO profile in FAS.

Based on this information, the following deficiencies on the attached LIC 809D are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview conducted and report was reviewed with the licensee Lily Harris, along with appeal rights.

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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Caroline Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2026

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/26/2026 01:32 PM - It Cannot Be Edited

Created By: Caroline Nguyen On 05/26/2026 at 01:00 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: HARRIS FAMILY CHILD CARE	FACILITY NUMBER: 198021764
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/26/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(j)(2)(D)

Infant Safe Sleep

Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above in 2 out of 5 children did not have Infant Sleep Logs in their file which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/15/2026
	Plan of Correction
1 2 3 4	Licensee will provide LPA proof of infant sleep log by POC due date.

Type B

Section Cited

CCR

102423(a)

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: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation record review, the licensee did not comply with the section cited above in 1 child with severe food allergies and medication was observed to not be in its original packaging nor labeled which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/15/2026
	Plan of Correction
1 2 3 4	Licensee will provide LPA proof medication storage by POC due date.

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

	Katrina Chicote
NAME OF LICENSING PROGRAM MANAGER:

	Caroline Nguyen
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/26/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2026

LIC809 (FAS) - (06/04)

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