198001079-3-5-2020-54-CC-RJOS-BMEUNK-20200305144403

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198001079
Report Date: 03/05/2020
Date Signed: 03/05/2020 02:44:10 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	SANDOVAL FAMILY CHILD CARE		FACILITY NUMBER:	198001079
ADMINISTRATOR:	SANDOVAL, YOLANDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 589-1174
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90001
CAPACITY:	14	CENSUS: 9	DATE:	03/05/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:29 AM
MET WITH:	Yolanda Sandoval; Licensee		TIME COMPLETED:	02:47 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	Licensing Program Analyst (LPA) Reiko Jones-Modeste conducted an unannounced random inspection. LPA met with Licensee, Yolanda Sandoval who guided analyst on a tour of the facility. Upon arrival were Licensee, Licensee Assistant Marta Balthazar and nine napping children. Disaster drill log was available, last drill documented was 02/2020. This is a one-story home which consists of 4 bedrooms, 2 bathrooms, kitchen, living room, enclosed patio, garage and front yard (fenced). The children areas include rear children's room, front children's room, enclosed patio, living room, kitchen and front yard area. Per licensee, areas off limits to children and parents include: 2 bedrooms, licensee's bathroom and detached garage. The LPA toured all areas used by children during this visit. Areas accessible to children were inspected to ensure they are clean and orderly with ventilation and heating; wall heater observed inaccessible in rear children's room. There is a working telephone service maintained in the home. Family members currently residing in the home include Licensee and Spouse (criminal record clearances on file) Licensee states there are no pets in the facility. Detergents, cleaning compounds, medications and other items which can pose a danger to children were observed inaccessible. Licensee states that there are no poisons in the home. The licensee does understand that poison must be locked with a key or combination lock. Per licensee, there are no weapons, firearms or bodies of water on the premises. LPA did not observe the aforementioned. There were safe toys, play equipment and materials observed for children. Emergency Disaster Plan, License and Parents Rights poster were observed posted. Children’s records were reviewed to ensure that each child has an Identification and Emergency form.

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Reiko Jones	TELEPHONE: (323) 558-2739
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: SANDOVAL FAMILY CHILD CARE	FACILITY NUMBER: 198001079
	VISIT DATE: 03/05/2020

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

Front children's area was observed with some toys as well as sleeping equipment including one standard crib and two Cosco Pack-n-Plays. Entrance to off limits bedroom observed locked and inaccessible. In the rear children's area LPA observed more toys and equipment as well as the children's bathroom. Children's bathroom was observed clean and sanitary with cabinets made inaccessible. LPA also observed a large changing table in the children's bathroom.

Children's area (enclosed patio) was observed safe with lots of toys, books and children's play equipment. Enclosed patio also included two locked storage sheds. In rear patio, LPA observed a locked garage with hazards made inaccessible to children. Front yard observed safe with toys and playground equipment accessible to children.

LPA observed a small first aid kit in the living room. Kitchen was observed safe and sanitary with knives and detergents made inaccessible to children.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and serviced August 2019 with receipt attached. Smoke detector and carbon monoxide detector were tested and operable. The licensee has current Pediatric First Aid and CPR, which will expires 5/2021.

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

The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed.

No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Reiko Jones	TELEPHONE: (323) 558-2739
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: SANDOVAL FAMILY CHILD CARE	FACILITY NUMBER: 198001079
	VISIT DATE: 03/05/2020

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

item that falls into that category are not permitted in the facility. Effective January 1, 2010, licensees of family child care homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.

LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

Exit interview was conducted with Licensee Yolanda Sandoval. The Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Reiko Jones	TELEPHONE: (323) 558-2739
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020

LIC809 (FAS) - (06/04)

Page: 3 of 3