<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198007594
Report Date: 04/27/2023
Date Signed: 04/27/2023 03:42:56 PM


Document Has Been Signed on 04/27/2023 03:42 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:ESQUIVEL FAMILY CHILD CAREFACILITY NUMBER:
198007594
ADMINISTRATOR:ESQUIVEL, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 807-3037
CITY:PASADENASTATE: CAZIP CODE:
91104
CAPACITY:14CENSUS: 11DATE:
04/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:07 PM
MET WITH:Maria Esquivel - LicenseeTIME COMPLETED:
03:57 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) Nolan Tcheng conducted an unannounced annual random inspection to the above facility. At 2:07pm, LPA met with licensee, Maria Esquivel. Also present during this inspection was Licensee's Assistant. The licensee states that she currently has 12 children enrolled. 11 Children were present during today's inspection. A current children’s roster is available and is current. Licensee’s hours of operation are 7am-5pm, Monday-Friday.

This is a one-story home which consists of 2 bedrooms, 1 bathroom, kitchen, dining room, living room, laundry room, garage and side yard (fenced). The children use bedroom #1 (infant room), bathroom, living room, kitchen, dining room area and side yard. Per licensee, areas off limits to children and parents include: Licensee's bedroom, laundry room, and garage. The licensee provides food for children in care.

The licensee states that 2 adults and 1 child currently live in the home. Licensee states that she currently has Two assistants. Staff are identified on the attached LIC859 All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. Per licensee, there are no weapons, firearms or bodies of water on the premises.

PHYSICAL PLANT


At 2:15pm, LPA was lead on a tour of the facility by the licensee. Upon entry, LPA reviewed the living room where the main day care area is. There were age appropriate toys and equipment for children in care. Behind the front door, Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are observed to be posted. The dining area is next to the living room and has a small library area and child sized tables/chairs for children. LPA observed above the doorways in the dining area, a carbon monoxide and smoke detector. Both tested to be functioning. The infant room was observed to have two cribs and the storage of cots for children's nap time. There was a changing table also available in the infant room. Per licensee, the infant room will be used as an area for an ill child until an authorized representative comes to pick up child.
REPORT CONTINUES PAGE 1 of 3
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Nolan TchengTELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:
DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/27/2023
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ESQUIVEL FAMILY CHILD CARE
FACILITY NUMBER: 198007594
VISIT DATE: 04/27/2023
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
The bathroom is connected to the infant room. Detergents, cleaning compounds, medications, and other items which could pose a danger are inaccessible to children, placed up high. Bathroom was observed to be clean, safe, and free of hazards. Cabinets in the bathroom were observed to have safety latches/locks on them. The tour continued into the kitchen, back through the dining area. The sharp knives are kept out of reach of children on the counter. At 2:30pm, a fire extinguisher was observed. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 02/28/2023, as indicated on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock. There are first aid supplies available. The licensee states that a cell phone is used and stays at the facility during operating hours but they do have a landline as well on the premises.

At 2:35pm, LPA observed the side yard area. The outdoor play area was observed to be fenced. At this time, children are using the back yard for outdoor play time. There is a playhouse, bikes, and equipment/toys for children to use. There is a EZ-Up tent for shade. The licensee is observed to be operating within the license capacity limitations.

FACILITY RECORDS:


The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 03/2024. Licensee and other personnel have complete mandated reporter training that expires on 01/19/2024. The licensee does have proof of immunization against influenza, tuberculosis, pertussis, and measles. Children’s records were reviewed, including but not limited to, a copy of the emergency information card that contains all the information specified by regulation.

The following was discussed:


-Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being in the presence of the children in care. Individuals within one month of their 18th birthday must be fingerprinted immediately.
-There are no pets on the premises. There is a turtle that observe but do not handle/touch.
-Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that falls into these categories are not permitted in a family child care facility.
-Smoking is prohibited in a license family child care home.
REPORT CONTINUES PAGE 2 of 3
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Nolan TchengTELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ESQUIVEL FAMILY CHILD CARE
FACILITY NUMBER: 198007594
VISIT DATE: 04/27/2023
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
Infant Care: Licensee states that they are currently caring for infants. LPA advised the licensee to sleep infants where they can be directly supervised at all times and advised the licensee against sleeping infants in a separate room. Licensee states that infants sleep in the infant room. LPA provided the licensee with a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics and Helping you to reduce the risk of SIDS. LPA consulted and explained Child Abuse Reporting, Updated Parent’s Rights Poster with Complaint Hotline information, Never Shake a Baby, Sudden Infant Death Syndrome (SIDS), and Safe Sleeping practices. PIN 20-24-CCP was provided and explained during the inspection.

Incidental Medical Services (IMS):


The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS at this time. 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.

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

LPA advised the licensee how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov. AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com/

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative.

Exit interview was conducted with Licensee Maria Esquivel, at 3:40pm. Copy of report provided.


END OF REPORT PAGE 3 of 3
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Nolan TchengTELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3