198019518-9-6-2022-33-CC-SLEE-CHZT32-20220906142137

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019518
Report Date: 09/06/2022
Date Signed: 09/06/2022 02:22:13 PM

Document Has Been Signed on 09/06/2022 02:22 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	MONTIEL-CAJINA FAMILY CHILD CARE		FACILITY NUMBER:	198019518
ADMINISTRATOR:	DIANA MONTIEL CAJINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(213) 531-7343
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90004
CAPACITY:	14	CENSUS: 4	DATE:	09/06/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Diana Montiel Cajina		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) Seung Lee conducted an unannounced required site inspection to ensure the health & safety standards as required by regulations governing family child care homes. Upon arrival, LPA met with Licensee, Diana Montiel Cajina and toured the facility.There were 4 children present. Individuals residing in the home is the licensee. Licensee’s operating hours are Monday-Friday 8am-5pm. All areas identified on the facility sketch were inspected. This is a one story apartment which consists of 2 bedrooms, 1 restroom, kitchen, dining room, laundry room, and living room. The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. Per Licensee, the complex does not have an outside area that is appropriate for children at this time. There are age appropriate toys and napping equipment on the premises. Areas off limits include: 2 bedrooms, kitchen, and laundry room. Areas used by children include: Living room, Dining room, and bathroom The required fire extinguisher (2A10BC) is operational and was serviced 07/21/2021 as indicated on the Tag. Smoke detectors and carbon monoxide detectors are were located in the dining room, and are in operable condition. Per Licensee there are no weapons, firearms in the facility at this time. Licensee has two small dogs that reside in the off limits area of the facility during business hours. Licensee has Pediatric First Aid CPR renewed on 11/2020 and is good for two years.

SUPERVISOR'S NAME: Guangorena Claudia	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung Lee	TELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2022

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MONTIEL-CAJINA FAMILY CHILD CARE	FACILITY NUMBER: 198019518
	VISIT DATE: 09/06/2022

NARRATIVE

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Children's Roster is readily available and updated . Children’s Files were reviewed.

The following were 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. No smoking, No infant walkers, No baby bouncers, No Johnny jumpers, No exersaucers and any other item that falls into that category. LPA discussed disaster drills, posting requirements, children records requirements, mandated child abuse and injury/death reporting.

LPA reviewed SIDs, Never Shake A Baby, and safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space.

A qualified Assistant must be present and actively involved in caring for children whenever nine (9) or more children are present at the facility in a large family child care home.

Incidental Medical Services are not provided at this time. Licensee was informed to contact the department 30 days prior to enrolling any child with IMS needs.

LPA advised the Licensee to access forms and regulations on line at: www.ccld.ca.gov

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Licensee. Appeal rights discussed and expla

SUPERVISOR'S NAME: Guangorena Claudia	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung Lee	TELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

LIC809 (FAS) - (06/04)

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