192011172-1-26-2024-54-CC-FWHE-CZUU25-20240126141123

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 192011172
Report Date: 01/26/2024
Date Signed: 01/26/2024 02:11:30 PM

Document Has Been Signed on 01/26/2024 02:11 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:	MADRIGAL FAMILY CHILD CARE		FACILITY NUMBER:	192011172
ADMINISTRATOR:	MADRIGAL, ROSA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 253-6416
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90003
CAPACITY:	14	CENSUS: 6	DATE:	01/26/2024
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME BEGAN:	01:32 PM
MET WITH:	Rosa Madrigal, Licensee		TIME COMPLETED:	03:30 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 conducted an Unannounced Required Annual inspection to the above facility. LPA disclosed the purpose of the inspection and met with Licensee, Rosa Madrigal who guided the LPA on a tour of the facility. There was six (6) day care child present during today’s inspection. Licensee states that there are currently fourteen (14) children enrolled. The children's roster was reviewed and is current. Per licensee, the facility’s hours of operation are currently from 6am to 6pm, seven days a week. Licensee provides overnight care on the weekends with accommodating schedules. 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 on January 22, 2024 This is a single story home which consists of two bedrooms and two bathrooms, kitchen, living room, backyard and back house. Home is separated into three living spaces, with Licensee using the front area of home and a back house is currently unoccupied. Areas used by the children is the middle house, which consists of a bathroom, kitchen, and main care area. Per Licensee, areas off limits to children and parents include front of the home and back house. LPA observed that there is a door with large couch blocking door to front area of the home, making it inaccessible to children in care. Per licensee, off limit areas are also locked during operating hours, 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. There is a working telephone maintained in the home. Entrance to facility is through the right side of the home. Kitchen is located to the right upon entry of Main Care Area. LPA observed knives to be kept in a high cabinet area making it inaccessible to children in care. LPA observed contents of cabinets in Kitchen area to contain food and plastic cups, plates, and Report continues- Page 1 of 4

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Franchesca White	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MADRIGAL FAMILY CHILD CARE	FACILITY NUMBER: 192011172
	VISIT DATE: 01/26/2024

NARRATIVE

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utensils.. LPA observed large couch, child size tables and chairs, cubbies for children's belongings, puzzles, play mats, dinosaur toys, and other age appropriate toys, free of loose and sharp parts. Licensee states she sanitizes toys after each use using a mild bleach solution. LPA observed small mattresses (3) and a Cosco pack-n-play in Main Care Area to be used for sleeping and possible overnight care. Per Licensee, she and the children will be in Main Care Area if overnight care is provided. Restroom used by the children is located to the left of Main Care Area. LPA observed restroom to be clean and free of hazards, and to have step stool for children to reach sink and have adequate handwashing supplies, and handwashing poster near sink. Per licensee, there are no pets and LPA did not observe any pets. 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 and understands that poison must be locked with a key or combination lock.

Per licensee, the children will have access to the backyard area which is accessible through sliding glass door in rear of Main Care Area. LPA observed backyard has turf grass throughout and adequate perimeter fencing throughout the yard. LPA observed plastic ride along toys, large plastic legos, plastic play structures, puzzles, and other age-appropriate toys free of loose and sharp parts available for the children in the backyard and all trees, shrubs, and plants are maintained.

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. Per licensee, they provide food for children in care.

The valve on the required 2A 10BC fire extinguisher indicates fully charged. LPA tested Smoke and carbon monoxide detectors to be in operable condition at time of inspection. LPA observed First Aid kit which is kept in Main Care Area on top of cubbies. The Licensee has current Pediatric First Aid and CPR. The Licensee has also taken the Mandated Reporter Training.
—CPR Card valid until: 8/27/2024
—Fire Extinguisher was last serviced on: 2/2023
—Mandated Reporter AB1207 Completed: 1/11/2024
Report continues- Page 2 of 4

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Franchesca White	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024

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: MADRIGAL FAMILY CHILD CARE	FACILITY NUMBER: 192011172
	VISIT DATE: 01/26/2024

NARRATIVE

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The following were discussed:
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.

Criminal Record Clearance

Licensee Rosa Madrigal 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.

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/.

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Franchesca White	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024

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: MADRIGAL FAMILY CHILD CARE	FACILITY NUMBER: 192011172
	VISIT DATE: 01/26/2024

NARRATIVE

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Licensee Rosa Madrigal was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Rosa Madrigal confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Based on Title 22, observations, record review, and interviews the following deficiencies will be cited and referenced on 809D.

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

Exit interview conducted and report was reviewed with the licensee Rosa Madrigal. A copy of the report and Appeal rights were given.

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Franchesca White	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024

LIC809 (FAS) - (06/04)

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