197700507-10-18-2021-12-CC-DMAX-C7WPET-20211018111541

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700507
Report Date: 10/18/2021
Date Signed: 10/18/2021 11:15:51 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	AVILA FAMILY CHILD CARE		FACILITY NUMBER:	197700507
ADMINISTRATOR:	NATALIE AVILA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 359-8849
CITY:	SYLMAR	STATE: CA	ZIP CODE:	91342
CAPACITY:	14	CENSUS: 0	DATE:	10/18/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:18 AM
MET WITH:	Applicant, Natalie Avila		TIME COMPLETED:	11:29 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	Licensing Program Analysts (LPA's) Maddox met with Applicant, Natalie Avila today for the purpose of conducting an announced Pre-Licensing inspection. Present today was Applicant only. The Applicant guided Analyst on a tour of the facility inside and outside. The home is a single-story family home with 2 bedrooms and 1.5 bathrooms. All adults in the home (Applicant and Spouse) have fingerprint clearances and exams for T.B. Play room, backyard, and half-bathroom. Home has central heating and air conditioning. The kitchen and bathroom were toured and inspected for proper storage of chemicals, detergents, cleaning compounds, medications and sharp pointed objects, all items were made inaccessible to children. The outside play area was clear of chemicals and debris, the entire yard is fenced. There is a fire place (under construction) located in the living room, LPA informed applicant the fire place should not be used while day care children are present and to make sure there is a barricade in place once its completed. All unused electrical outlets are plugged and play equipment and toys are available. Applicant is aware that baby walkers, bouncer, or any similar equipment are prohibited in any licensed facility. Per Applicant, there are no weapons or firearms of any kind on the premises. The required fire extinguisher (2A 10BC), smoke detector, and carbon monoxide devise are in operable condition. Roster and Disaster drill logs presented to Applicant during this inspection.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna Maddox	TELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2021

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: AVILA FAMILY CHILD CARE	FACILITY NUMBER: 197700507
	VISIT DATE: 10/18/2021

NARRATIVE

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Licensee can access forms online at www.ccld.ca.gov . LPA observed all required forms posted; Regulation prohibits the smoking of tobacco in any licensed facility.

*The Applicant is reminded of the requirement to report and unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC 624B.

*IMS was discussed, Applicant states she will not provide IMS at this time and will not dispense medications.
*The applicant is urged visit the U.S. Consumer Product Safety Commission web page at www.cpsc.gov to ensure that equipment purchased for the day care has not been recalled

*Once licensed, the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809/LIC9099) must also be posted for 30 days. A civil penalty of $100 per violation will be assessed for noncompliance.

This also applies to any adult PRIOR to them moving into the home or who currently lives in the home. Also, PRIOR to employment of any adult, you must submit the LIC508, TB screening and obtain a background clearance through LIVESCAN.

Applicant was informed of new regulations regarding Safe Sleep (102425 INFANT SAFE SLEEP) and the requirement to complete An Individual Infant Sleeping Plan [LIC 9227 (3/20)] for each infant up to 12 month of age the provider has in care and maintained at the facility in the infant’s file.

Exit interview conducted, Fire clearance has been received for the large capacity, home was found to be incompliance with Title 22 Regulations and ready for licensure. Backyard is off limits for now until gate a barrier is in place.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna Maddox	TELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2021

LIC809 (FAS) - (06/04)

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