192008254-4-6-2023-30-CC-JCHR-CQMQL3-20230406121513

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 192008254
Report Date: 04/06/2023
Date Signed: 04/06/2023 12:15:32 PM

Document Has Been Signed on 04/06/2023 12:15 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	CHAVARRIA FAMILY CHILD CARE		FACILITY NUMBER:	192008254
ADMINISTRATOR:	CHAVARRIA, JOSEFINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 779-4111
CITY:	INGLEWOOD	STATE: CA	ZIP CODE:	90303
CAPACITY:	14	CENSUS: 6	DATE:	04/06/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:09 AM
MET WITH:	Josephina Chavarria		TIME COMPLETED:	12:25 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	On 4/6/2021 Licensing Program Analyst (LPA), Jillinda Chandler conducted an unannounced Annual Random/ I year required visit for Chavarria Family Child Care Home. Upon arrival present in the home was licensee, licensee's husband, adult son and one day care child. All persons requiring a criminal back ground check, were cleared. During the inspection 6 additional children arrived. The home is a 4 room, 2 restroom, single family, single story home. Day care activities are conducted in the dining area of the home, one room on the right side of the dinning area that is used for cribs and diaper changing, and in the detached garage in the back yard. Licensee was aware that children are to sleep, and toilet in the home, children uses the rest room located in the hallway to the right of the front door, also located in this area are two off limit bedroom the bedroom on the left of the dinning room is also off limits, all off limit areas were observed to be locked. LPA observed a stack of mats with sheets on them for napping, LPA advised licensee that the bedding should not be left on mats when they are stacked for sanitation purposes. The home was inspected inside and out for Health and Safety compliance per Title 22.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda Chandler	TELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CHAVARRIA FAMILY CHILD CARE	FACILITY NUMBER: 192008254
	VISIT DATE: 04/06/2023

NARRATIVE

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LPA observed the following:
Proper care and supervision was being provided by the licensee
The homes capacity was within the scope of the license
LPA observed 3 appropriate size fire extinguisher, the extinguishers were last inspected 10/19/2021, licensee was informed that the extinguishers should be serviced annually.
Carbon and smoke detectors were present & operable. The home has a hard wire fire alarm system.
Detergents, and knives were properly stored or locked and made inaccessible children.
Meals are provided by the licensee, children eat in the kitchen area, cabinets were locked or contained non-toxic materials. No guns or weapons present per licensee, no weapons were observed by LPA.
The home has a working telephone. LPA observed the homes parent notification board; the license, facility sketch, Emergency Disaster Plan, Notification of Parent’s Rights (the departments address needs updating), Lead Poison Awareness. The safe sleep poster was provided and licensee was instructed to get the California Safety Seat Law from the department's website.
A first aid kit was observed containing the required supplies: scissors, tweezers, bandages, medical ointment and a thermometer. Licensee’s Pediatric CPR and First Aid Card expires 12/2023
Licensees Mandated Reporter certificate expires 6/2023 No bodies of water were observed on the premises

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda Chandler	TELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CHAVARRIA FAMILY CHILD CARE	FACILITY NUMBER: 192008254
	VISIT DATE: 04/06/2023

NARRATIVE

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Children records were reviewed,.
Personal records were reviewed, LPA observed immunization records for licensee.
A roster was readily available and current for review. A copy was provided
Parents and authorized adults were not signing children in and out using their original signatures, parents with subsidized resources signed the child's attendance record, LPA advised licensee that there should be a sign in and out sheet primarily for the day care.
Licensee is not providing any Incidental Medical Services (IMS) at the time of inspection. IMS was discussed with licensee.
Toys, equipment and materials available and in good order Infant safe sleeping was discussed with licensee. LPA reminded licensee that children are only to use car seats during transportation, and appropriate children’s feeding chairs shall only be used during mealtime.
Outdoor activities were conducted in the back yard and detached garage, LPA did not observe any hazardous conditions in these areas.

No deficiencies were cited during todays inspection.
To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email to inspectionprocess@dss.ca.gov.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda Chandler	TELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CHAVARRIA FAMILY CHILD CARE	FACILITY NUMBER: 192008254
	VISIT DATE: 04/06/2023

NARRATIVE

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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/process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/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.

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

Exit interview conducted and report was reviewed with the licensee Josephina Chavarria,

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Jillinda Chandler	TELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

LIC809 (FAS) - (06/04)

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