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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197413992
Report Date: 03/04/2020
Date Signed: 03/09/2020 12:11:02 PM

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:JARAMILLO FAMILY CHILD CAREFACILITY NUMBER:
197413992
ADMINISTRATOR:JARAMILLO, CARLA & EDUARDOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 982-2271
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91605
CAPACITY:14CENSUS: 4DATE:
03/04/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
07:25 AM
MET WITH:Carla Jaramillo/LicenseeTIME COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA) Silva Garibyan conducted a site visit for the purpose of an Annual Random visit. LPA met with the licensee and toured the home inside and outside at 07:35 a.m on 03/04/2020. There were four children present at the time of the visit ( including one infant). All areas identified on the facility sketch were inspected. The licensee's home is a single story 3 bedroom, 2 bathroom home with living/dining room, kitchen, and detached garage. Main care is provided in the living room. Children have access to the dining area and use the bathroom in the hall way.. Children use the garage for time limited activities. The garage is used only for child care activities and no storage of any hazardous items. Children eat and sleep inside the home only. Off limit areas include the home's 2 bedrooms; there are safety devices on the door knobs making the contents of the rooms inaccessible. There is no pool, spa or other bodies of water on the premises. The LPA toured all areas used by children during this inspection. Licensee reports she has no firearms or weapons in the home. LPA also observed Licensee's current Pediatric CPR (Adult/Infant /Child) and Pediatric First Aid certifications ( expire 09/2020) . Family members residing in the home include four adults (licensees, their mother and adult son) and licensees' minor daughter ( 17 years old). The bathroom and the kitchen was observed free of chemicals or toxic items that can pose danger to children in care. The Fire Extinguisher (2A-10-BC) is mounted on the wall in the kitchen. There is a working smoke and Carbon Monoxide detectors located in the day care room. The bathroom and the kitchen was observed free of chemicals or toxic items that can pose danger to children in care. Licensee provides transportation for school aged children to school in the mornings and from school in the afternoons. Licensee ensures proper child seat restraints, maintains vehicle insurance and registration and current driver license for the driver. Licensee is aware that children must never be left in a parked vehicle. Children play in the front and back yards which were observed to be fenced and children are supervised. Page 1 of 3
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2020
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 3
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: JARAMILLO FAMILY CHILD CARE
FACILITY NUMBER: 197413992
VISIT DATE: 03/04/2020
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The First Aid kit was observed, and complete. LPA observed the fire drill log. The fire drills are done every month.
Licensee has the following documents posted in the FCCH; Facility License (LIC 203), Notification of Parents' Rights Poster (PUB 394) , Child Care Facility Roster (LIC9040), Emergency Disaster Plan (LIC610a), Lead Poisoning Facts/Potential Sources Of Lead/Effects Of Lead Exposure.
A review of the children's records was conducted and are found to have the following: LIC 282 Affidavit Liability Insurance, LIC 627/Consent for Medical Treatment, LIC 700/ID and Emergency Information, LIC 995A/Parent's Rights, LIC995E/Caregiver Background Check, LIC 9150/Parent Notification, LIC 9212/Parent's Responsibilities, PM 286/Immunization Card.

The following was thoroughly discussed with the licensee:

Assembly Bill 633: Upon receipt by the licensee, licensees are to provide to parents/guardians the following: Copies of any licensing reports that document a Type A citation- this includes facility visits and substantiated complaint investigations; copy of licensing documents pertaining to a conference conducted by a local licensing agency management representative and the licensee of this family child care home in which issues of noncompliance are discussed or copies of a summary of an accusation indicating the Department's intent to revoke the facility's license. Copies of any of the above licensing documents the licensee has received in the prior 12 months shall be provided to parents/guardians of newly enrolled child at the facility.
Senate Bill 792: This bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles. Licensees' and mother's immunization records are up to date.

Mandated Reporter: Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com.

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SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2020
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: JARAMILLO FAMILY CHILD CARE
FACILITY NUMBER: 197413992
VISIT DATE: 03/04/2020
NARRATIVE
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New Immunization Requirement: Law enacted by SB 277, beginning January 1, 2016, personal beliefs exemptions will no longer be an option for the vaccines that are currently required for entry into child care or school in California. Personal beliefs exemptions already on file will remain valid until the child reaches the next immunization checkpoint.

New Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment

Update on Incidental Medical Services: 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 discussed and provided the safe sleep for baby pamphlet. Each infant shall be constantly supervised and under direct visual observation by an adult person at all times. Under no circumstances shall any infant be left unattended. In order to visually observed and supervise sleeping infants there should be no obstruction to the view of the infants, which could include transparency walls and/or half walls. LPA recommended that infants sleep safest in crib with no bumpers, pillows, blankets, or toys, and on their backs, and every sleep time counts to reduce the risk of SIDS and other sleep related causes of infant death.



On March 04, 2020, the facility has been found operating within substantial compliance per the California Health & Safety Code(s) and Title 22 Regulation(s).


Exit interview was conducted and a copy of the report was provided
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SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Silva GaribyanTELEPHONE: (424) 301-3062
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2020
LIC809 (FAS) - (06/04)
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