197418198-12-11-2024-58-CC-JLIY-DBUQUH-20241211112846

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197418198
Report Date: 12/11/2024
Date Signed: 12/11/2024 11:28:54 AM

Document Has Been Signed on 12/11/2024 11:28 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

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

FACILITY NAME:	ESCOBAR FCC		FACILITY NUMBER:	197418198
ADMINISTRATOR/ DIRECTOR:	ESCOBAR, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 602-0707
CITY:	VAN NUYS	STATE: CA	ZIP CODE:	91406
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 10	CENSUS: 8	DATE:	12/11/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:20 AM
MET WITH:	Licensees Maria Escobar & Esmeralda Escobar		TIME VISIT/ INSPECTION COMPLETED:	11:45 AM

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On 12/11/2024 at 8:20am Licensing Program Analyst (LPA), Jeanine Lipsey conducted an unannounced Required 3 year Annual Inspection and was met by Licensees Maria Escobar & Esmeralda Escobar. 1 staff and 1 volunteer was also present. An Entrance checklist was provided. LPA observed eight children in care being supervised by four staff. Capacity as specified on the license is being maintained. Days and hours of operation are Monday through Friday 7:30am to 5:30 pm.

LPA observed the following required postings: License, PUB 394 Notification of Parents’ Rights Poster, and LIC 9148 Earthquake Preparedness Checklist. LPA advised all LIC9213 Notice of Site Visits shall be posted for 30 days after each site visit. LPA advised, any licensing report documenting a Type A citation must be posted for 30 days. LPA advised LIC610A Emergency Disaster Plan and a disaster/fire drill log shall be available to view with disaster drills completed at lease every six months. Disaster drills are documented and performed monthly.

LPA toured the home inside and outside. The home is a single story with 6 bedrooms, 4 bathrooms, with a living/dining room, family room and kitchen.

The areas that are accessible to children: are living/dining room, family room, bedroom #2, #3 and bedroom #5 (office), bathroom #1, and the backyard for outdoor activities. The isolation area will be located in the office.

Where children are less than five years old are in care, stairs shall be fenced or barricaded. LPA did not observe any stairs.

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Betty Bell	TELEPHONE: (424) 301-3063
Jeanine Lipsey	TELEPHONE: (424) 301-3077
	DATE: 12/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2024

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ESCOBAR FCC	FACILITY NUMBER: 197418198
	VISIT DATE: 12/11/2024

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LPA did not observe any poisons present during the inspection. Detergents, cleaning compounds, medication and other hazardous item were made inaccessible to children. Per licensees, there are no firearms, weapons or bodies of water on the premises. LPA observed the home to be free from defects or conditions which may endanger the children. Safety locks were installed on the off-limit cabinets and drawers.

LPA observed fully stocked first aid kit. LPA Lipsey observed a working carbon monoxide detector in the home, LPA was able to hear a successful test. Smoke detectors are located in all rooms and LPA was able to hear a successful test. Fire extinguisher 2A10BC was observed and located in the kitchen and family room and was purchased on 11/3/24. Electrical outlets were observed to be inaccessible to children in care with installed child proof outlets. The home was observed to be clean and orderly with heating and ventilation. LPA observed safe toys, play equipment, and materials. LPA verified the home has a working cell service.

LPA observed the outdoor area to be fenced and free from hazards LPA observed multiple play equipment in good repair. Licensee ensures that children in care are always supervised.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunizations Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, LIC 9227- Infant sleep form (0-12 months, and documentation of 15-minute Infant Sleep Check (0-24 months). All required documents were present in the files.

Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC-501: Personnel Record, LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. All required documents were present in the files.

Licensee’s pediatric CPR/First Aid was completed on 5/27/24 and 10/31/24. Mandated Reporter Training was completed on 11/3/24 for both licensees.

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SUPERVISOR'S NAME: Betty Bell	TELEPHONE: (424) 301-3063
LICENSING EVALUATOR NAME: Jeanine Lipsey	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2024

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ESCOBAR FCC	FACILITY NUMBER: 197418198
	VISIT DATE: 12/11/2024

NARRATIVE

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On this date, 12/11/2024 the California Attorney General - Megan's Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

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 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 and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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.

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/.

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SUPERVISOR'S NAME: Betty Bell	TELEPHONE: (424) 301-3063
LICENSING EVALUATOR NAME: Jeanine Lipsey	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2024

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ESCOBAR FCC	FACILITY NUMBER: 197418198
	VISIT DATE: 12/11/2024

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Licensees 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.

During the exit interview, the Licensees confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Exit interview was conducted and report was reviewed with the Licensees Maria Escobar & Esmeralda Escobar.

A notice of site visit was given and advised Licensees that it must remain posted for 30 days.

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SUPERVISOR'S NAME: Betty Bell	TELEPHONE: (424) 301-3063
LICENSING EVALUATOR NAME: Jeanine Lipsey	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2024

LIC809 (FAS) - (06/04)

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