198010489-1-23-2024-54-CC-FWHE-CZRS2J-20240123122937

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198010489
Report Date: 01/23/2024
Date Signed: 01/23/2024 12:29:44 PM

Document Has Been Signed on 01/23/2024 12:29 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	CHAVARRIA FAMILY CHILD CARE		FACILITY NUMBER:	198010489
ADMINISTRATOR:	CHAVARRIA, ROSA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 753-3644
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90003
CAPACITY:	14	CENSUS:	DATE:	01/23/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Rosa Chavarria		TIME COMPLETED:	12:30 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) Franchesca White arrived at the facility listed above for the purpose of an unannounced annual inspection. LPA disclosed the purpose of the inspection and met with Licensee, Rosa Chavarria, who guided the LPA on a tour of the facility. There are two adults living in the home and all have criminal record clearance. There were three (3) day care children and one (1) infant present during today’s inspection. Licensee states that there are currently eleven (11) children enrolled. The children's roster was reviewed and is current. Emergency Disaster Plan, License, and Parents’ Rights were posted at the time of inspection. Disaster drill log was also available during today’s inspection, last disaster drill conducted on 01/05/2024. This is a single story home which consists of two bedrooms and one bathroom, kitchen, living room, dining room, and covered patio. Areas used by the children include the living room, dining room, and covered patio. Per Licensee, areas off limits to children and parents include Bedroom 1, Bedroom 2, and kitchen. LPA observed that there is an operable baby gate separating kitchen and areas used by children making it off-limits at time of inspection. Per licensee, off limit bedrooms locked during operating hours, LPA observed doors to be closed and locked. All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. LPA observed ceiling fans in Main Care Areas. There is a working telephone maintained in the home. Main Care Areas used by the children is the living room/dining room and covered patio. LPA observed covered patio to have carpet, cubbies with children's belongings, magna tiles, books, wooden blocks, and age-appropriate toys, free of loose and sharp parts. LPA observed living room/dining room area upon entry of the home, to have a large ........................................................Report Continues Page 1 of 3...........................................................

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Franchesca White	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2024

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

FACILITY NAME: CHAVARRIA FAMILY CHILD CARE	FACILITY NUMBER: 198010489
	VISIT DATE: 01/23/2024

NARRATIVE

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sectional sofa, dining table and chairs, child size table and chairs, one (1) highchair, one (1) low highchair and television. LPA observed bathroom used by the children located to the right upon entry through a hallway. LPA observed diaper changing table stocked with wipes and diapers in hallway next to bathroom. LPA observed bathroom to be free of hazards and adequately stocked with handwashing supplies and handwashing poster posted next to sink. LPA observed electrical cover outlets all through the home. Per licensee, there are no pets and LPA did not observe any pets. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. LPA observed these items in cabinets with child safety lock in off limits Kitchen area making it inaccessible to children in care. LPA observed knives and other sharp objects kept in high cabinet with child safety locks in off limit Kitchen area making it inaccessible to children in care. 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, the children will have access to front yard area for outdoor play. LPA observed front yard has turf grass and adequate perimeter fencing through-out the yard. LPA observed bicycles, small plastic play structure with slide, doll houses, chairs, and other age-appropriate toys free of loose and sharp parts available for the children in the backyard and all trees, shrubs, and plants are maintained.

Per Licensee, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPA observation did not see any bodies of water around the premises. Per licensee, they provide food for children in care.

The valve on the required 2A 10BC fire extinguisher indicates fully charged. LPA observed Smoke and carbon monoxide detectors are in operable condition at time of inspection. Per Licensee, First Aid kit is kept in Kitchen and LPA observed for supplies. The Licensee has current Pediatric First Aid and CPR. Proof of immunization against influenza, pertussis, and measles was readily available during today’s inspection. The Licensee has also taken the Mandated Reporter Training
—CPR Card valid until: 2/2025
—Fire Extinguisher was last serviced on: 5/23/2023
—Mandated Reporter AB1207 Completed: 12/14/2023
—Children records and required licensing forms were discussed as well as mandated child abuse reporting and criminal record clearance requirement. ............................Report Continues Page 2 of 3.......................

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Franchesca White	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2024

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

FACILITY NAME: CHAVARRIA FAMILY CHILD CARE	FACILITY NUMBER: 198010489
	VISIT DATE: 01/23/2024

NARRATIVE

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The following were discussed:
To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Criminal Record Clearance

Licensee Rosa Chavarria was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee Rosa Chavarria was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Rosa Chavarria confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Based on observations, record review and interview there are no deficiencies being cited today per Title 22.

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

Exit interview conducted and report was reviewed with the licensee Rosa Chavarria. A copy of the report and Appeal rights were given. ..........................................End of Report 3 of 3 Pages......................................

SUPERVISOR'S NAME: Denise Gibbs	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Franchesca White	TELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2024

LIC809 (FAS) - (06/04)

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