198004470-4-18-2022-33-CC-SLEE-CDHUK8-20220415153842

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198004470
Report Date: 04/15/2022
Date Signed: 04/18/2022 10:25:16 AM

Document Has Been Signed on 04/18/2022 10:25 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	EGOAVIL FAMILY CHILD CARE		FACILITY NUMBER:	198004470
ADMINISTRATOR:	EGOAVIL, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 458-9021
CITY:	ALHAMBRA	STATE: CA	ZIP CODE:	91801
CAPACITY:	13	CENSUS: 6	DATE:	04/15/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Maria Egoavil		TIME COMPLETED:	03:45 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) Seung Lee conducted an unannounced Annual/random inspection. LPA met with licensee, Maria Egoavil, who guided analyst on a tour of the facility. There were 6 children present, 1 being an infant. Children's roster was reviewed and is current. Disaster drill log was available, last drill documented was 03/11/2022 This is a one story home which consists of 3 bedrooms, 1 bathrooms, kitchen, living room, garage and backyard (fenced). The children usually use one bedroom, the bathroom, living room, and backyard. The garage is also used as an activity space. Per licensee, areas off limits to children and parents include: 2 bedroom and the kitchen. There is a kiddie gate blocking the kitchen entrance. The children are currently not using the back yard or garage space. The Licensee is taking the children to the local park for outside play. The Licensee supervises children at all times. Licensee was advised to notify the department when construction of spa area and fence are complete. The LPA toured all areas used by children during this visit. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for safety and comfort. There is a working telephone service maintained in the home. Family members residing in the home are 2 adults (Licensee and adult daughter). There are 2 dogs kept in the off limits kitchen and bedroom. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible in all areas of the home. The 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 on the premises. There were safe toys, play equipment and materials observed for children. Emergency Disaster Plan was observed

SUPERVISOR'S NAME: Guangorena Claudia	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung Lee	TELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2022

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: EGOAVIL FAMILY CHILD CARE	FACILITY NUMBER: 198004470
	VISIT DATE: 04/15/2022

NARRATIVE

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Children’s records were reviewed to ensure that each child has an Identification and Emergency form. The valve on the required 2A 10BC fire extinguisher indicates fully charged. Smoke detector and carbon monoxide detector were tested and are in operable condition. The licensee has current Pediatric First Aid aid CPR, which will expire 01/2023.

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

Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed.

The following was discussed: 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.

No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other 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 to continue to comply with the latest guidelines from the CA department of health regarding large family child care homes.

SUPERVISOR'S NAME: Guangorena Claudia	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung Lee	TELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2022

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: EGOAVIL FAMILY CHILD CARE	FACILITY NUMBER: 198004470
	VISIT DATE: 04/15/2022

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

LPA provided email address in order to be placed on quarterly update subscription: ChildCareAdvocatesProgram@dss.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. The Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

*END OF REPORT

SUPERVISOR'S NAME: Guangorena Claudia	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung Lee	TELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2022

LIC809 (FAS) - (06/04)

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