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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011174
Report Date: 06/28/2023
Date Signed: 06/28/2023 02:06:13 PM


Document Has Been Signed on 06/28/2023 02:06 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:FIALLOS FAMILY CHILD CAREFACILITY NUMBER:
198011174
ADMINISTRATOR:FIALLOS, ROSAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 232-3292
CITY:LOS ANGELESSTATE: CAZIP CODE:
90037
CAPACITY:14CENSUS: 7DATE:
06/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Rosanna FialloTIME COMPLETED:
02:12 PM
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Licensing Program Analyst (LPA) Rosaura Valenzuela conducted an unannounced annual required inspection at the above noted facility on 06/28/2023. LPA met with Licensee Rosanna Fiallo who guided analyst on a tour of the facility. There were seven daycare children (two infants and four school age) when LPA arrived. Facility capacity is in compliance for a large Family Child Care Home. This is a two-story home that consists of three bedrooms, 1 bathroom, living room, kitchen, dinning room, and front yard fenced). Main care areas include living room, dinning room, bonus room, and front yard. Per Licensee, off limit areas include the kitchen and upstairs bedrooms. Hours of operation are Monday-Friday from 6am-7pm. Currently Licensee only has children enrolled from 6:30am to 5pm. Food is provided by Licensee. Licensee was reminded that if children bring food from home that it must have a label with the child's name.

Individuals residing in the home have been discussed and noted. All adults present in the home have obtained a criminal record clearance or exemption.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection:

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Rosaura ValenzuelaTELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/28/2023
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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: FIALLOS FAMILY CHILD CARE
FACILITY NUMBER: 198011174
VISIT DATE: 06/28/2023
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LPA reviewed required posted documentation located on the entrance door which included facility License, Publication (PUB) 394-Notification of Parental Rights and Licensing Form (LIC) 9148-Earthquake Preparedness form. Facility records were reviewed for LIC 9040-Facility Roster, LIC 610-Facility Disaster Plan and Disaster drill log, last drill was conducted on 4/07/2023 . All documents were observed.

Smoke and carbon monoxide detectors located in the entrance and hallway were tested and are operable. Fire extinguisher indicated fully charged and was last serviced on 7/15/2022. The home maintains telephone service via landline and cell phone. The home was observed to be clean and orderly. There are toys and other age-appropriate material available for children. LPAs observed that detergents, cleaning compounds and medication are stored in the kitchen cabinet with a child safety latch and are inaccessible to children. Isolation area for sick children waiting to be picked up is in the bonus room, away from other children. Per Licensee, there are no firearms or weapons stored in the home.

The bathroom that children use is located off the hallway adjacent to the kitchen, was observed to be clean and free of hazards. LPAs observed cabinet under the sink had a child lock, making contents inaccessible.

Infant Care: Currently licensee has two infants enrolled. LPAs observed two cribs, visible in the main care area. Napping equipment does not block entrances or exits.

LPA did not observe loose/hanging objects, bumpers, or objects attached to the pacifiers. Per licensee wet or soiled sheets are changed as needed throughout the day. Each infant has their own crib and bedding. Bedding is washed once a week. Licensee states the following sleep supervision plan for infants: Infants nap in the main care area,

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Rosaura ValenzuelaTELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: FIALLOS FAMILY CHILD CARE
FACILITY NUMBER: 198011174
VISIT DATE: 06/28/2023
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where they are always supervised, infants are physically checked on every 15 minutes and time is documented. Licensee is implementing safe sleep regulations.

Currently, children are using the front yard for outdoor play. The outdoor play area was observed to be fenced. LPAs observed that the outdoor yard has toys and other materials for children to play with.

LPA did not observe any objects that could be hazardous to children in care. There are no pools or spas, or other bodies of water.

Children’s records were reviewed for LIC 282-Affdavit Regarding Liability Insurance, Immunization Records, LIC 700-Identification and Emergency Information, LIC 627-Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, and documentation of 15-minute Infant Sleep Check (0-24 months). All documents were observed.

Licensee records were reviewed for approved Pediatric First Aid and CPR certification, LIC 501: Personnel Record, LIC 508-Criminal Record Statement, Proof of Immunization against measles, pertussis, and influenza or influenza declination. TB clearance or risk assessment, LIC 9108-Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. All documents were observed.

During the inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Rosaura ValenzuelaTELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: FIALLOS FAMILY CHILD CARE
FACILITY NUMBER: 198011174
VISIT DATE: 06/28/2023
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Incidental Medical Services (IMS): 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 Center and the ADA, available at: http://www.ada.gov.childqanda.htm

Based on the LPA’s observations and records review no deficiencies will be cited today, 06/28/2023.

To improve the quality and value of the new inspection process, a survey will be sent to 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.

Licensee 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.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Rosaura ValenzuelaTELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: FIALLOS FAMILY CHILD CARE
FACILITY NUMBER: 198011174
VISIT DATE: 06/28/2023
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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resouces/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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

Exit interview conducted and a copy of the report was issued.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Rosaura ValenzuelaTELEPHONE: 323-981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
LIC809 (FAS) - (06/04)
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