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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192009624
Report Date: 06/18/2019
Date Signed: 06/18/2019 01:38:16 PM

COMPREHENSIVE INSPECTION
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:BOTELLO FAMILY CHILD CAREFACILITY NUMBER:
192009624
ADMINISTRATOR:BOTELLO, JULIA G.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 350-8202
CITY:EL MONTESTATE: CAZIP CODE:
91731
CAPACITY:14CENSUS: 6DATE:
06/18/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Julia Botello, LicenseeTIME COMPLETED:
01:45 PM
NARRATIVE
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A RANDOM INSPECTION CONDUCTED IN SPANISH

Licensing Program Analyst (LPA), Mireya García conducted an unannounced annual random site inspection to ensure the health & safety standards as required by regulations governing family child care homes. Upon arrival, LPA met with Licensee, Julia Botello and Assistant Julia Ruedas, who toured the facility indoors and outdoors. There were 6 children present, along with 2 other assistants. Individuals residing in the home are the licensee, 2 daughters, and 2 sons. Licensee’s operating hours are from 7:30 a.m. - 6:00 p.m. from Monday through Friday.

The home is a one story, 2-Bedroom, 1-Bathroom home. The following areas are used for day-care: Living room, kitchen, 1 bathroom, and back yard. Off limit areas include: 2 bedrooms, and the laundry room.

Licensee has the Parent’s Rights poster and other appropriate forms posted on wall in the living room. Licensee’s First Aid/CPR pediatric certificate are valid through 06/2021. Licensee's disaster drill log notes last drill conducted on 05/10/19. Licensee has a working telephone.

The 2A10BC fire extinguisher located in the hallway of the kitchen was last serviced on 04/23/2018. Licensee stated she was going to get it serviced today. During LPA inspection Licensee's son took the fire extinguisher to get service. There is an operational smoke detector however, there is no carbon monoxide detector on premises.

SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2019
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: BOTELLO FAMILY CHILD CARE
FACILITY NUMBER: 192009624
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/18/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/18/2019
Section Cited
CCR
102417(g)(1)
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Operation of a Family Child Care Home
The home shall contain a fire extinguisher which meet standards established by the State Fire Marshal.
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During LPA's inspection, LPA observed Licensee's son (A#4) took fire extinguisher to get serviced and a new tag was placed with service date 06/18/2019.
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This requirement is not met as evidenced by LPA observing that the fire extinguisher
is fully charged, however it was last serviced on 04/23/2018.
This poses an potential health and safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2019
LIC809 (FAS) - (06/04)
Page: 5 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BOTELLO FAMILY CHILD CARE
FACILITY NUMBER: 192009624
VISIT DATE: 06/18/2019
NARRATIVE
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LPA inspected the kitchen and observed cleaning and poison compounds located in bottom cabinet. The cabinet has a steel barrel bolt unable to lock due to wood being broken, making accessible to children. Licensee stated that cabinet broke yesterday. During LPA's visit Licensees son removed all cleaning and poison compounds and placed items in the locked garaged located in the rear of the home. Knives are stored in a cabinet that is out of reach and inaccessible to children. During the tour of the laundry room LPA observed cleaning detergents and poison compounds were observed accessible in the floor area of the room near the washer. Licensee informed LPA she uses the laundry room for storage and does not have no where else to place items. LPA spoke with Licensee and Assistants about the health & safety standards as required by regulations governing family child care homes. LPA observed Licensee's son removed all cleaning and poison compounds out of the laundry room area into the locked garage. The bathroom used by the children was inspected. No hazards or violations were observed.

The home has electrical outlet covers throughout and maintains a First Aid Kit. There are adequate age appropriate toys, books, and games. There are no firearms present on the premises as stated by licensee. LPA inspected the backyard. LPA observed age appropriate toys and there is shade available. There are no pools or spas, or other bodies of water. Currently there are no pets.

Children's Roster, Children’s Files and Staff files were reviewed and found to be complete.

The following were discussed: Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being in the presence of the children in care. Individuals within one month of their 18th birthday must be fingerprinted immediately. No smoking, No infant walkers, No baby bouncers, No Johnny jumpers, No exersaucers and any other item that falls into that category. LPA discussed disaster drills, posting requirements, children records requirements, mandated child abuse and injury/death reporting.

SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2019
LIC809 (FAS) - (06/04)
Page: 2 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: BOTELLO FAMILY CHILD CARE
FACILITY NUMBER: 192009624
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/18/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/18/2019
Section Cited
CCR
102417(g)(4)(A)
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Operation of a Family Child Care Home. Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger to children shall be stored where they are inaccessible to children. Storage areas for poisons, firearms and other dangerous weapons shall be locked.
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During LPAs inspection, LPA observed Licensee's son (A #4) removed all cleaning and poison compounds out of the home to the locked garage located in the back of the home, making it inaccessible to children.
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This requirement is not met as evidenced by upon inspection of the kitchen and laundry room LPA observed Ajax, Clorox bleach, Raid, and Insect Killer solution located in the kitchen cabinet and laundry room floor where is accessible to children in care. This poses an immediate health and safety risk to children in care.
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Type A
06/19/2019
Section Cited
HSC
1597.543
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Carbon monoxide detectors required; inspection.

Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8
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Per Licensee and Assistant (A#2) will purchase carbon monoxide detector today at Home Depot and will install today and will submit picture to LPA via text by POC due date on 06/19/2019.
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(commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections.
This requirement is not met as evidenced by today's inspection, there was no carbon monoxide detector. This poses an immediate health and safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2019
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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BOTELLO FAMILY CHILD CARE
FACILITY NUMBER: 192009624
VISIT DATE: 06/18/2019
NARRATIVE
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LPA reviewed SIDs, Never Shake A Baby, and safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. Information on how to access safe sleep concepts was provided to Licensee and Assistant (A#2) in English and Spanish.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

LPA advised the Licensee to access forms and regulations on line at: www.ccld.ca.gov

Exit interview conducted with Licensee Julia Botello and Assistant Julia Ruedas. A copy of the Appeal Rights (LIC 9058 FAS 01/16) were given and explained. Licensee’s signature on this form acknowledges receipt of these rights.

A Confidential Names list (LIC811) was provided during this visit.

A copy of this report must be provided to the authorized representatives of all currently enrolled children and must also be provided to newly enrolled children for the next 12 months. The report shall be provided no later than the next business day or the next day the child is in care.

The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC9224) shall be signed and kept in each of the children’s records. Web site address to obtain forms, review quarterly updates, review Title 22 & Health & Safety Codes is: www.ccld.ca.gov.
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2019
LIC809 (FAS) - (06/04)
Page: 6 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BOTELLO FAMILY CHILD CARE
FACILITY NUMBER: 192009624
VISIT DATE: 06/18/2019
NARRATIVE
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Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty. Copies of this report must be posted for 30 days in a visible location for the authorized representatives of children.

The following deficiencies are being cited in accordance to Title 22 of the California Code of Regulations and/or Health & Safety codes. Please refer to LIC809D for documentation of deficiencies cited.
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Mireya GarciaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2019
LIC809 (FAS) - (06/04)
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