197494657-11-25-2020-30-CC-DMIA-BVPR27-20201125113751

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494657
Report Date: 11/25/2020
Date Signed: 11/25/2020 11:38:08 AM

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:	RICKS-SCAMALDO FAMILY CHILD CARE		FACILITY NUMBER:	197494657
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	11/25/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	07:20 AM
MET WITH:	Shauna Ricks-Scamaldo, Applicant, and Nicolas Scamaldo, Applicant's husband		TIME COMPLETED:	11:55 AM

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 11/25/2020 at 7:20 am, Licensing Program Analyst (LPA) Denise Miranda arrived at 716 Westmount Dr, West Hollywood, CA 90069, for the purpose of conducting an announced prelicensing inspection. LPA met with Shauna Ricks-Scalmado and discussed the purpose of the visit. Present at the time of the inspection was Shauna Ricks-Scalmado, applicant and Nicolas Scamaldo, Applicant’s husband. LPA verified that all adults present in the home have obtained criminal record clearances and are associated to the facility. LPA reviewed the facility sketch (indoor and outdoor) and it was observed do not match the physical plant of the home. Applicant have applied for a small capacity license. Per applicant, operating hours are Monday through Friday from 07:00am to 6:00pm. The applicant was advised that during hours of childcare that the applicant shall be present in the home and shall ensure children in care are always visually supervised. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, poisons, detergents/cleaning compounds, medication and hazardous items that can pose a danger to children. Per applicant, the children will nap in the daycare room and living room. Children in the family child care home will enter the facility through the drive way to the back gate of the home and access through the backyard (outdoor space) to the family room. This are house main floor: The home is a one story a duplex detached house that includes: 1 bedroom, 2-bathrooms, living room, daycare room (dining room), kitchen, den and attached garage. The following areas are designated as follows: ** day care room – This is where main care will be conducted. LPA observed the day care room to have age appropriate furniture, games, learning materials and activities for children in care. Furniture was observed with no loose or sharps parts, clean and in good repair.

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Denise Miranda	TELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:	DATE: 11/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2020

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

FACILITY NAME: RICKS-SCAMALDO FAMILY CHILD CARE	FACILITY NUMBER: 197494657
	VISIT DATE: 11/25/2020

NARRATIVE

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**Bathroom#1 – located next to the day master bedroom.

** Backyard/play area located on the back of the house, between the entrance door of the day care room and attached garage.

** Living room – Per applicant she will make this area on limit, however, applicant will follow the plan of correction to make this area as access to the children in care.

Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service, ventilation and central heater. Applicant completed health preventive and safety training and has current pediatric CPR, first aid certificate

Off limits to day care children:

***Master bedroom and master bathroom, kitchen, front yard, den and attached garage. Per applicant children will not have access to this area.
Per applicant, the garage will be close during day care hours and children will not have access to this area.

***LPA observed no bodies of water.
LPA observed no fireplace in this house.

The carbon monoxide detector and smoke detector were tested at the time of the visit. LPA observed a 3A:40B:C. LPA also observed a working heater/central air.

The applicant has completed preventive health and safety/Childhood Nutrition and Mandated Reporter training 05/5/2020. There are age appropriate toys and equipment for the children. Lead Poisoning Prevention training completed on 9/24/2020. Pediatric First Aid, Child/Infant CPR AED, Adult CPR expired on 4/15/2022.

Per applicant, there are no firearms and weapons on the premises. Applicant provided a statement during this inspection.
LPA observed mats or cots to accommodate infants on napping time.
The following was discussed with the applicant:
Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Denise Miranda	TELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:	DATE: 11/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2020

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

FACILITY NAME: RICKS-SCAMALDO FAMILY CHILD CARE	FACILITY NUMBER: 197494657
	VISIT DATE: 11/25/2020

NARRATIVE

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-In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR & Pediatric First Aid certification and a valid criminal record clearance associated to the facility license.
-A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.
-Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License shall be terminated.
-The fire extinguisher type 2A10BC must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should check, and batteries replaced as needed.
-Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.
-Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. (use LIC624B for written report).

LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. LIC311D: CHILDREN RECORDS: LIC: 700 Identification and Emergency Information, 702 Child’s Pre-Admission Health History LIC 995E Caregiver Background Check Process, 995A Notification of Parent’s Rights, 627 Consent For Emergency Medical Treatment, 613A Personal Rights, LIC282 Affidavit Regarding Liability Insurance, LIC9150 Parent Notification, Additional Children in Care. FACILITY RECORDS: LIC9149 Property Owner/Landlord Consent, PUB 394 Notification of Parents Rights, PUB 269 California Child Passenger Safety Law, LIC 9040 Facility Roster, LIC624A Death Report, LIC6101A Emergency Disaster Plan, LIC9148 Earthquake Preparedness Checklist, LIC 624 Unusual Incident/Injury Report.

LIC311D Forms/Records to keep In Your Family Child Care Home, Family Child Care Self-Assessment Guide. STAFF RECORDS: LIC 508 Criminal Record Statement, LIC 501 Personnel Record, LIC 503 Health Screening/TB, LIC9052 Employee Rights, LIC9108 Statement Acknowledging Requirement to Report Child Abuse, LIC 9163 Request for LIVESCAN, LIC9188 Criminal Record Exemption Transfer Request, LIC 9182 Criminal Background Clearance Transfer Request, LIC9052 Employee Rights

The licensee was informed of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Denise Miranda	TELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:	DATE: 11/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2020

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

FACILITY NAME: RICKS-SCAMALDO FAMILY CHILD CARE	FACILITY NUMBER: 197494657
	VISIT DATE: 11/25/2020

NARRATIVE

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order to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541

Email Address: childcareadvocatesprogram@dss.ca.gov. The following were also 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. New Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment. All appeals must be sent to: Department of Social Services | El Segundo Child Care Office | 300 N. Continental Blvd., Suite 290-A |El Segundo, CA 90245.

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. Assembly Bill 1207: California Child Care Workers; Mandated Training Requirement. Beginning January 1, 2018, all licensed providers, applicants, directors and employees must complete Mandated Reported Training prior to March 30, 2018 and renew training every two years at: www.mandatedreporterca.com.

Nutrition Requirement: Beginning January 1, 2016, AB 290 will require for each new license issued, at least one director or teacher at each child care center or family child care home to have at least one hour of training in the importance of childhood nutrition. This applies to anyone submitting a new application, relocating their facility, selling their facility or transferring their license. Please note this training cannot be completed online or by home study programs. The training must be taken from an Emergency Medical Services Authority (EMSA) approved training program OR an accredited college or university.

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Denise Miranda	TELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:	DATE: 11/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2020

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: RICKS-SCAMALDO FAMILY CHILD CARE	FACILITY NUMBER: 197494657
	VISIT DATE: 11/25/2020

NARRATIVE

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LPA Miranda, provided all forms/records to keep in her family child care home:
During this inspection, LPA also provided the following documents about SIDS. 1) Notification of Parents’ Rights, 2) Child Care Provider’s Guide to Safe Sleep by the American Academy of Pediatrics, 2) Never ever shake a Baby by California Department of Social Services, 3) Prohibited Items in FCCH, 4) Health Drinks for young children, 5) Wash your hands- CDC, 6) Mandated Reporter Training , 7) 311D Forms/Records to Keep in your Family in Child Care Home and immunization card CDPH 286.

Applicant provided an updated Facility Sketch - Floor plan and yard.

During this inspection, LPA conducted a RAST/covid-19 technical support.

The following is needed priory to licensure: ****During this inspection, applicant will make the living room area on limit. Applicant will make this area accessible to children. Applicant will remove all the hazardous and poising products and cover Applicant will cover the edges of the coffee table, remove all pillows and the two plants that were hanging by the main window, barricade the internet box and cables.

****Emergency disaster supplies (review lic9148 and provided photos with supplies necessary for disaster, such as water and 100% juice)

***Applicant will place documents that shall be post. (see form LIC-311D).

****Applicant to email and mail or drop the photos and documents to LPA no later than Friday, December 4^th 2020.

Exit interview was conducted with Shauna Ricks-Scalmados, applicant. A copy of this report and all other Licensing reports must be made available to the public for 3 years.

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Denise Miranda	TELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:	DATE: 11/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2020

LIC809 (FAS) - (06/04)

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