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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191596628
Report Date: 05/16/2019
Date Signed: 05/16/2019 10:42:26 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:DELAYO FAMILY DAY CAREFACILITY NUMBER:
191596628
ADMINISTRATOR:DELAYO, MARTHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 814-9009
CITY:BALDWIN PARKSTATE: CAZIP CODE:
91706
CAPACITY:14CENSUS: 2DATE:
05/16/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:44 AM
MET WITH:Marha Delayo, LicenseeTIME COMPLETED:
10:45 AM
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Licensing Program Analyst (LPA) Mireya Garcia conducted an unannounced plan of correction visit to the above facility to ensure that the deficiencies cited on 04/25/2019 have been corrected. LPA met with Martha Delayo, Licensee, who guided analyst on a tour of the facility. There were 2 children present upon arrival.

The following was observed:

- The gym equipment has been removed from the outdoor play area and stored in the garage to ensure that children do not have access to them.

-The plant with sharp thorns that was in the outdoor play area has been removed and was trashed.

-The 3 drop-side cribs that were in the children's activity room were removed and trashed.

- The fire extinguisher has been replaced with a new one, date of purchase on receipt 04/28/2019.

- Licensee and Assistant (husband) completed training for pediatric CPR and First aid on 05/11/2019.


Based on LPA's observation and information obtained during this inspection, the Type B deficiencies issued on 04/25/2019 have been cleared. A Letter of Deficiency Citations Cleared will be provided to the licensee via mail.


At this time, the facility is in compliance. Therefore, no deficiencies are being cited.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Martha Delayo, Licensee. -----------End of Report.
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2019
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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