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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198006333
Report Date: 10/07/2021
Date Signed: 10/07/2021 02:46:59 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:MALDONADO FAMILY CHILD CAREFACILITY NUMBER:
198006333
ADMINISTRATOR:MALDONADO, LAURAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
2137489270
CITY:LOS ANGELESSTATE: CAZIP CODE:
90011
CAPACITY:14CENSUS: 3DATE:
10/07/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Laura Maldonado, LicenseeTIME COMPLETED:
02:55 PM
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On Thursday, October 7, 2021 at 11:30 AM, Licensing Program Analyst (LPA) Mayra Rivera conducted an unannounced annual inspection and met with Licensee Laura Maldonado who guided LPA Rivera on a tour of the facility.

During the inspection, 3 children were present. LPA Rivera observed 3 children eating lunch. Family members residing in the home has been discussed with licensee and are cleared. Operating hours are Monday to Friday, 6:30 AM to 6:30 PM and care for children ages 0 to 12 years.

This facility is a one story home that consists of three bedrooms, two bathrooms, kitchen, living room, dinning room, front and side yard (fenced and gated). Areas that are accessible to children and identified on the facility sketch were inspected by LPA Rivera; living room, dining room, bathroom (by the kitchen),back bedroom # 3 (daycare room) and side yard. Areas off limits to children include- Kitchen bedroom # 1 and #2 (located by the living room) and master bathroom.

At approximately 11:35 AM LPA observed LIC 610A Emergency disaster plan, PUB 394 parents rights, emergency drill with last drill conducted on 9-3-21. LPA reviewed the roster, licensee and Child #1 files. LPA observed the files and roster to be up to date.

At approximately 12:25 PM LPA Rivera inspected for safety, comfort, cleanliness, ventilation and working phone. For ventilation, LPA Rivera observed wall heater in the living room with a fire proof cover and a AC wall unit in the livingroom. LPA observed the furniture and children materials to be in good condition and age appropriate. LPA observed the stove knobs with child proof covers. LPA observed the knives stored on the kitchen wall and advised licensee to place the knives inside the kitchen cabinet and place a child proof lock to prevent school age children from reaching. The bottom kitchen cabinets, LPA observed pots and pans and other plastic dishes. LPA did not observe any materials that can pose a danger to children.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021
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 7
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: MALDONADO FAMILY CHILD CARE
FACILITY NUMBER: 198006333
VISIT DATE: 10/07/2021
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At approximately 12:45 PM, LPA Rivera entered the restroom and observed the toilet, hand washing sink, running water, paper towels and hand soap. LPA observed cleaning solutions stored in the bathroom high up on the shelf making it inaccessible to children to reach and toilet paper and diapers stored inside the bottom bathroom cabinet. LPA observed the restroom to be in good condition.

Licensee provides the meals and for drinking water, LPA observed water dispenser and individual cups.

LPA Rivera asked if there are any pets, poisons, firearms, weapons or bodies of water. Licensee stated she has fishes and no body of waters, firearms, weapons or poisons. LPA did not observe firearms, weapons, poisons nor bodies of water. Licensee was advised that if any poisons (ex; drano, rat poison or items with skull hazard symbol), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately.



At approximately 12:55 PM LPA Rivera observed the required 2A10BC fire extinguisher located in the daycare room and the valve on the green area indicating fully charged and serviced on 11/20/2019. LPA informed licensee the service tag has expired and the fire extinguisher will need to be service or purchase a new one. LPA observed the smoke detector in the daycare room and tested the alarm. LPA heard the sound of the smoke detector. LPA observed the carbon monoxide in the living room and pressed on the detector and observed the green light flash. The smoke and carbon detectors are in good condition. LPA also observed and emergency kit/first aid kit bag in the daycare room.

At approximately 12:58 PM, LPA Rivera inspected the outdoor area used by children for safety, comfort and cleanliness. LPA observed sail triangles installed and provides adequate shade. LPA observed play equipment to be in good condition and age appropriate. LPA also observed the two side gates closed with a self-latch. LPA observed a the back duplex house and a gate barrier in place to make it inaccessible to children to go up the stairs.

LPA observed licensee Pediatric First Aid/ CPR certification with expiration date 6-18-2023. Licensee has proof of immunization against Pertussis, MMR and Influenza. Licensee has completed the health and safety training and mandated reporter (AB 1207) training on 9-26-20. Licensee was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021
LIC809 (FAS) - (06/04)
Page: 2 of 7
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: MALDONADO FAMILY CHILD CARE
FACILITY NUMBER: 198006333
VISIT DATE: 10/07/2021
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The following was discussed
Safe Sleep: LPA discussed the safe sleep regulations with licensee Laura Maldonado and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee Laura Maldonado of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at also explained to licensee that car seat, stroller are only and only for https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA Rivera also reviewed Sudden Infant Death Syndrome (SIDS), Never Shake A Baby, and Lead Exposure information with licensee. LPA transportation, highchair is only and only for feeding and stated items cannot be misused. No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into this category are not permitted in a family child care facility.



Medication: 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

Criminal Record Statement: Licensee Laura Maldonado was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

A notice of site visit was given and must remain posted for 30 days.

Licensee has been given technical violation and has been advised for parent to complete the Safe Sleep Plan, create the 15 minute sleep log, service or purchase a new 2A10BC fire extinguisher and store the knives inside the top cabinet and add a child proof lock. Licensee has been given one week to complete with due date 10-15-21.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021
LIC809 (FAS) - (06/04)
Page: 3 of 7
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: MALDONADO FAMILY CHILD CARE
FACILITY NUMBER: 198006333
VISIT DATE: 10/07/2021
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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

Exit interview conducted and report was reviewed with the licensee Laura Maldonado.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021
LIC809 (FAS) - (06/04)
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