198015243-3-21-2022-54-CC-MAYA-CCQPSL-20220321113428

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198015243
Report Date: 03/21/2022
Date Signed: 03/21/2022 11:34:37 AM

Document Has Been Signed on 03/21/2022 11:34 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	MADRIGAL FAMILY CHILD CARE		FACILITY NUMBER:	198015243
ADMINISTRATOR:	MADRIGAL, ALMA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 409-9102
CITY:	NORWALK	STATE: CA	ZIP CODE:	90650
CAPACITY:	14	CENSUS: 0	DATE:	03/21/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Licensee, Alma Madrigal		TIME COMPLETED:	11:35 AM

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	On March 21, 2022 at 9:30 am, Licensing Program Analyst (LPA) Monique Ayala conducted an announced inspection to the facility above and met with Licensee, Alma Madrigal. The purpose of the inspection was to ensure that the facility is deemed safe to resume operation after being on inactive status. Licensee requested to be placed on inactive status as of September 9, 2021. The facility is licensed as a Large Family Day Care Home (up to 14 children). A fire clearance was granted on April 8, 2011. At the time of the inspection, individuals residing in the home was discussed and assessed. The operating hours will be Monday to Friday from 7:00 am to 5:00 pm. The licensee will be providing care for children ages, 18 months to 17 years old. All areas identified on the facility sketch were inspected. This facility is a single story home that consists of 2 bedrooms, 2 bathrooms, living room, family room, kitchen, garage and fenced backyard. Areas that are accessible to children include: living room, family room, kitchen, 2 bathrooms and the fenced backyard. Per licensee, the children will utilize the fenced backyard for outdoor activity. Areas off-limits to children include: 2 bedrooms, garage, backyard storage, and dog run. LPA observed the off-limit areas made inaccessible. Licensee was advised that off-limit areas must be made inaccessible to children during operating hours. LPA observed the following documents posted in a prominent, publicly accessible area at the facility: Facility License, Notification of Parents' Rights Poster (PUB 394), Earthquake Preparedness Checklist (LIC 9148), and Emergency Disaster Plan (LIC 610A), and COVID related posters.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Monique Ayala	TELEPHONE: (323) 246-2016
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2022

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MADRIGAL FAMILY CHILD CARE	FACILITY NUMBER: 198015243
	VISIT DATE: 03/21/2022

NARRATIVE

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Areas used by children were inspected for safety, comfort, cleanliness and telephone service. The home does not have a fire place. Per licensee, the wall heater located in the hallway is shut-off and not in use. The home has central air and heating that is operable. Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible. Licensee was advised that if any poisons are purchased, it is required to be locked with a key or combination lock.

Per licensee, the home does not have any firearms, weapons, or bodies of water. Per licensee, the 2 dogs are kept isolated from the children while in care. LPA observed age appropriate toys and napping equipment. LPA observed electrical outlet covers throughout the home. LPA observed the required fire extinguisher (2A-10BC) that is fully charged and last serviced on 02/24/2022. Smoke and carbon monoxide detectors were tested by the licensee and are operable. First Aid kits are available and located in the family room and hallway. Licensee has a no-touch thermometer readily available. Licensee was advised that if food is brought from the children’s home, all containers must be labeled with the child’s name and properly stored or refrigerated.

Licensee has proof of Pediatric First Aid/CPR certification (expires 05/2023), and immunization against pertussis (Tdap), measles (MMR), influenza and a TB clearance. Licensee completed the Child Care Prevention Health & Safety training on 08/02/2009. Licensee completed the Mandated Reporter training (AB 1207) on 09/16/2021. Licensee was advised that the mandated reporter training must be completed every 2 years and is available at www.mandatedreporterca.com.

Licensee was advised to report any possible exposures and/or positive cases of COVID-19 to the Regional Office. Licensee was also advised that staff and families must be notified immediately of any possible cases of COVID-19 while maintaining confidentiality.

Incidental Medical Services (IMS) policy was also 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 Americans with Disabilities Act (ADA) was provided: U.S. 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.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Monique Ayala	TELEPHONE: (323) 246-2016
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2022

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MADRIGAL FAMILY CHILD CARE	FACILITY NUMBER: 198015243
	VISIT DATE: 03/21/2022

NARRATIVE

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LPA advised licensee on how to access forms, regulations, quarterly updates, and Provider Information Notices (PINs) on the Department website at www.ccld.ca.gov.

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/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.

During the inspection, the licensee provided an updated Application for a Family Child Care Home License (LIC 279), Current Children in your Home (LIC 279B), and Facility Sketch (LIC 999A).

Licensee was informed that she may resume operation as soon as an updated license is issued to the provider. No further follow-up is needed.

Exit interview conducted and report was reviewed with Licensee, Alma Madrigal.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Monique Ayala	TELEPHONE: (323) 246-2016
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2022

LIC809 (FAS) - (06/04)

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