197494080-8-9-2019-30-CC-JCHR-BEVT7R-20190809142909

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494080
Report Date: 08/09/2019
Date Signed: 08/09/2019 02:29:17 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:	AMADOR FAMILY CHILD CARE		FACILITY NUMBER:	197494080
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	08/09/2019
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:24 PM
MET WITH:	Licensee		TIME COMPLETED:	02:32 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 8/9/2019 Licensing Program Analyst (LPA) Chandler made an announced visit to the Amador family day care for the purpose inspecting the home for an increase in capacity. The home has a fire clearance for 14 children. Day care activities shall be conducted in the living room, bedrooms number 2 (infant room) and 3 (toddler room). An updated facility sketch was not required. The home has one assistant. All adults requiring a criminal background check are cleared and associated to the home. There is a large family dog in the home. The day care operates 24 hours, 7 days a week. All areas of the home were inspected for health and safety compliance per Title 22. The following was observed: There were no children in care during todays inspection. Carbon monoxide and smoke detectors were present Fire extinguisher was present Heaters were barricaded Toys and equipment were observed Children will use the back yard for out door activity Transportation is not provided Toxins and other detergents were inaccessible No bodies of water were observed on the premises No guns or weapons were present in the home during todays inspection.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Jillinda Chandler	TELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2019

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: AMADOR FAMILY CHILD CARE	FACILITY NUMBER: 197494080
	VISIT DATE: 08/09/2019

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
26
27
28
29
30
31
32

CAPACITY INCREASE
For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either:
Twelve children, no more than four of whom may be infants; or
More than twelve and up to fourteen children only if the criteria in Section 1597.465 of the Health and Safety Code are met.
Health and Safety Code section 1597.465 states:
A large family day care home may provide care for more than 12 children and up to and including 14 children, if all of the following conditions are met:
At least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age.
No more than three infants are cared for during any time when more than 12 children are being cared for.
The licensee notifies a parent that the facility is caring for two additional school-age children and that there may be up to 13 or 14 children in the home at one time. Parents shall complete LIC. 9150,
The licensee obtains the written consent of the property owner when the family day care home is operated on property that is leased or rented.
If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).
The total licensed capacity for a Large Family Child Care Home shall not exceed fourteen children.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Jillinda Chandler	TELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2019

LIC809 (FAS) - (06/04)

Page: 2 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: AMADOR FAMILY CHILD CARE	FACILITY NUMBER: 197494080
	VISIT DATE: 08/09/2019

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
26
27
28
29
30
31
32

Based on today inspection licensee shall correct the following prior to licensing

1. Make kitchen inaccessible to children in care
2. Remove material from cubbie rack.

Licensee will send photos of the corrections to LPA.

Licensee had a previous license and therefore qualifies for a large family day care.

Also discussed today: Safe sleeping, the licensee has safe sleeping guidelines in her admissions agreement.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Jillinda Chandler	TELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2019

LIC809 (FAS) - (06/04)

Page: 3 of 3