192007002-2-15-2024-54-CC-FWHE-D2GV9S-20240215151448

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 192007002
Report Date: 02/15/2024
Date Signed: 02/15/2024 03:14:55 PM

Document Has Been Signed on 02/15/2024 03:14 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:	ZELAYA FAMILY CHILD CARE		FACILITY NUMBER:	192007002
ADMINISTRATOR:	ZELAYA, BLANCA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 778-3723
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90003
CAPACITY:	14	CENSUS: 8	DATE:	02/15/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	01:50 PM
MET WITH:			TIME COMPLETED:	03:45 PM

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) Franchesca White arrived at the above facility for the purpose of an unannounced 3 year required annual inspection. Upon arrival, LPA disclosed the purpose of the inspection and met with Licensee, Blanca Zelaya, who guided the LPA on a tour of the facility. Also present were two adults, who live in the home and all have criminal record clearance. There was eight (8) day care children present during today’s inspection. Licensee states that there are currently ten (10) children enrolled. The children's roster was reviewed and is current. Per licensee, the facility’s hours of operation are 8:00 AM to 5:30 PM, Monday thru Friday. Emergency Disaster Plan, License, and Parents’ Rights were posted at the time of inspection. Disaster drill log was also available during today’s inspection, last disaster drill conducted on1/9/2024 . This is a single-story home which consists of three bedrooms and two bathrooms, kitchen, living room, and detached garage. Main Care Areas used by the children include the living room, Bathroom 1, Bedroom 1 (used for napping), Kitchen for eating, front yard and side yard with detached garage. Per Licensee, areas off limits to children and parents include Bedroom 2, Bedroom 3, and Bathroom 2, and backyard. Per licensee, off limit areas are also locked during hours of operation, LPA observed doors to be locked. All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. Before entering the home, cubbies for the children's belongings, and a sign in rack is on the porch, and side of the steps. The parent board is to the right of the steps. Upon entry of the home you walk into Living Room, which Licensee states she will use for isolation area for sick children. At 1:45 PM, LPA observed a wall heater in the living room that is barricaded by a gate, A/C unit in wall in living room, ceiling fan, and a portable A/C unit in Bedroom 1. .............................................Report Continues 1 of 4 Pages......................................................................

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Franchesca White	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2024

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 4

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: ZELAYA FAMILY CHILD CARE	FACILITY NUMBER: 192007002
	VISIT DATE: 02/15/2024

NARRATIVE

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There is a working telephone maintained in the home. At 1:50 PM, LPA observed Bathroom 1, used by the children down the hallway to the right, to have a diaper changing table, diapers stocked, adequate handwashing supplies, child safety lock on cabinet under sink, and to be free of hazards. At 1:55 PM, LPA observed Bedroom 1, down the hallway to the left, that will be used for napping to have a wooden Kaplan crib and four blue mats for sleeping. At 1:57 PM, LPA observed Kitchen to have child safety locks on all low cabinets, and oven knobs to have child safety covers. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. The Licensee states that there are no poisons in the home. At 2:00 PM, LPA observed medicines and knives to be kept in high cabinet in kitchen, making it inaccessible to children in care and detergents and cleaning compounds to be kept under kitchen sink with an operable child safety lock making it inaccessible to children in care at time of inspection. The Licensee does understand that poison must be locked with a key or combination lock.
At 2:04 PM, LPA observed front yard to have a gate stretching the length of the front gate to the wall in front of the house separating the play area from the driveway. Front yard is completely shaded by two well trimmed trees that cover the dramatic outdoor play areas consisting of child size couches and lounge chairs with two hand washing stations. A large slide and stepping apparatus perfectly tucked under the trees and scaffold umbrella providing more shade to the front yard. 2:12 PM another yard is fenced by a locked gate that extends to the detached garage. This area has total shade provided by tent coverings. This side yard area that children use for daycare activities to have child appropriate tables, chairs, outdoor handwashing station, black cushioning material and turf grass through out, art materials, plastic play kitchen, and other age appropriate toys free of lose and sharp parts available for children in care at time of inspection. At 2:15PM, LPA observed detached garage that children will use for more activity space to have books, child size couch, soft play toys, and other age appropriate toys free of lose share parts available for children in care at time of inspection. At 2:18 PM, LPA observed a locked gate with a sign stating off limits area to the rear backyard, making this area inaccessible to children in care. Per licensee, there are no pets and LPA did not observe any pets.

Per Licensee, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPA observation did not see any bodies of water around the premises and LPA did not observe any weapons. Per licensee, they provide food for children in care.

..............................................................Report Continues 2 of 4 Pages..................................................

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Franchesca White	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: ZELAYA FAMILY CHILD CARE	FACILITY NUMBER: 192007002
	VISIT DATE: 02/15/2024

NARRATIVE

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The valve on the required 2A 10BC fire extinguisher indicates fully charged. Smoke and carbon monoxide detectors are in operable condition. LPA observed First Aid kit is kept hanging on kitchen wall. The Licensee has current Pediatric First Aid and CPR. Proof of immunization against influenza, pertussis, and measles was readily available during today’s inspection. The Licensee has also taken the Mandated Reporter Training
—CPR Card valid until: 10/2025
—Fire Extinguisher was last serviced on: 3/15/2023
—Mandated Reporter AB1207 Completed: 3/3/2022
—Children records and required licensing forms were discussed as well as mandated child abuse reporting and criminal record clearance requirement.

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 Blanca Zelaya 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 Blanca Zelaya 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 [or facility representative] 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. ..............................Report Continues 3 of 4 Pages........................

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Franchesca White	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: ZELAYA FAMILY CHILD CARE	FACILITY NUMBER: 192007002
	VISIT DATE: 02/15/2024

NARRATIVE

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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/.
MyChildCarePlan.org – Centers and Family Child Care Homes
Licensee Blanca Zelaya 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.

Based on observations, interviews, and record review there are no deficiencies sited today under Title 22.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Blanca Zelaya. A copy of the report, Notice of Site Visit, and Appeal rights were given to Licensee.

.........................................................End of Report 4 of 4 pages..............................................................

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Franchesca White	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024

LIC809 (FAS) - (06/04)

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