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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016880
Report Date: 04/08/2024
Date Signed: 04/08/2024 11:02:25 AM


Document Has Been Signed on 04/08/2024 11:02 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:UGALDE FAMILY CHILD CAREFACILITY NUMBER:
198016880
ADMINISTRATOR:UGALDE, ANDREAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(213) 284-2888
CITY:LOS ANGELESSTATE: CAZIP CODE:
90057
CAPACITY:14CENSUS: 4DATE:
04/08/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Andrea Ugalde, LicenseeTIME COMPLETED:
11:25 AM
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On 04/08/2024, Licensing Program Analysts (LPA) Staicy Perry conducted an unannounced required Annual inspection to the above facility. A COVID risk assessment was conducted upon entry. LPA met with Licensee Andrea Ugalde, whom the reason for the visit was explained. Per Andrea, there are 11 children currently enrolled. There were 4 children, and 4 adults present upon arrival. Facility capacity is in compliance for a Large Family Child Care Home. Per Licensee hours of operation are Monday-Friday, 6:00am-6:00pm.

Family members residing in the home are 4 adults (criminal record clearances on file) and 0 minor child.
The home is a one story, 3 Bedrooms, 2 Bathrooms, kitchen, living room, dining area, front and back yards and detached garage. The following areas are used for day-care: Living Room, Dining Room, backyard, bathroom (adjacent to dining room). Off limit areas include: All 3 bedrooms & 1 bathroom, kitchen, front yard, and detached garage. Licensee was advised to have all off-limit areas inaccessible to day care children during hours of operation. The LPA toured all areas used by children during this visit.

Facility License, Emergency Disaster Plan, Parent’s Rights Poster, and Earthquake Preparedness Checklist were observed to be posted on the wall next to the entrance. A current children’s roster was available for review. There is telephone via cell phone that remains at the facility at all times.

During this visit, all areas identified that are accessible for children to use were inspected for the safety, comfort, and cleanliness. Licensee guided LPA on the tour of the home. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for safety and comfort. There are toys and other age appropriate material available for children. LPA observed central AC and Heating. The children utilize bedroom 1 as a walkway to bathroom. The bathroom was reviewed next, LPA did not observe anything that can pose danger to the children in care. The kitchen was observed go be clean, organized. Knifes were seen to be placed in a cabinet made inaccessible to the children. The living room was observed to have a couch, TV, and plenty of age-appropriate toys for the children to use. LPA observed plants in the home that are not poisons and or sharp to the touch.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Staicy PerryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 04/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/08/2024
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: UGALDE FAMILY CHILD CARE
FACILITY NUMBER: 198016880
VISIT DATE: 04/08/2024
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Infant Care: Per Licensee, she has no infant under 12 months at this time. LPA reviewed Safe sleep regulations / documents, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months were reviewed and on file for the department. LPA observed and inspected sleeping equipment for infants. LPA was informed by licensee that play pins are used for infants 0-12 months. LPA observed that play pin is free from loose articles and objects. There are no objects hanging above or attached to the side of the crib. LPA observed that play pins do not hinder the entrance or exit to and from the space they are sleeping in. Mattresses were observed to be firm and covered with a fitted sheet that is appropriate to the mattress size. Each infant has their individual bedding and is washed weekly as required.

Detergents, cleaning compounds, and medications were observed to be inaccessible to children. Per Licensee, there are no poisons in the home. LPA advised that any poisons should be locked under key or combination lock. Licensee states that are firearms or weapons stored in the home.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and LPA observed receipt proof of purchase date with a 4/4/24. Which indicates it is fully charged and in green. Smoke and carbon monoxide detectors were tested and are operable and were observed to be in every room in the house.

All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. Last drill documented was conducted on 4/1/2024. The home is observed to be clean and orderly. There are first aid supplies available. There are age-appropriate toys available for children.

Per licensee, parents provide food for the children in care. Licensee was advised that if food is brought from the children’s homes, all containers must be labeled with child’s name and properly stored or refrigerated. Parents provide snack, lunch and PM snack. Licensee transports children for field trips and also walks to nearby park.

LPA toured the outdoor play area and inspected its safety and condition. LPA observed perimeter fencing which is free of miscellaneous debris/hazards. All trees, shrubs and plants are maintained. Outdoor play yard was observed to have toys for the children to play.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Staicy PerryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2024
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: UGALDE FAMILY CHILD CARE
FACILITY NUMBER: 198016880
VISIT DATE: 04/08/2024
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 Licensees’ records were reviewed. The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. Pediatric First Aid and CPR expires on 3/17/25. Licensee assistant CPR expires on 3/2/25.

LPA did observe that Licensee and all household members to have proof of Mandated Reporter AB 1207 compliant Child Care Training Certificate on file for the department to review. www.mandatedreporterca.com.

LPAs observed children’s records were reviewed, including emergency information, and were observed to be complete.

LPA created an LIC 857, Children’s Record Review, and LIC 811, confidential names which documents persons living in the home and children’s files reviewed during this inspection.

Per licensee, there are 3 dogs on the premises inside, 2 bunnies outside and 2 inside cats and 1 outside cat. Animal records were provided to the department and on file.



Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that fall into these categories are not permitted in a family childcare facility.

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/.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Staicy PerryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2024
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: UGALDE FAMILY CHILD CARE
FACILITY NUMBER: 198016880
VISIT DATE: 04/08/2024
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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.

Licensee 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.

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.

LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at www.ccld.ca.gov.

Licensee 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.

During the exit interview, Andrea Ugalde, confirmed that there are no Registered Sex Offenders living in the facility.

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

SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Staicy PerryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2024
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: UGALDE FAMILY CHILD CARE
FACILITY NUMBER: 198016880
VISIT DATE: 04/08/2024
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A notice of site visit was given and must remain posted for 30 days. Appeal rights were discussed and provided.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Staicy PerryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2024
LIC809 (FAS) - (06/04)
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