198019966-2-28-2020-33-CC-JCHZ-BM92SU-20200228163944

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019966
Report Date: 02/28/2020
Date Signed: 02/28/2020 04:39:48 PM

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:	VILLALOBOS FAMILY CHILD CARE		FACILITY NUMBER:	198019966
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 7	DATE:	02/28/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:10 PM
MET WITH:	Gloria Villalobos, Licensee		TIME COMPLETED:	05:00 PM

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AN ANNUAL INSPECTION CONDUCTED IN SPANISH

Licensing Program Analyst (LPA), Janeth Chavez conducted an unannounced Annual site inspection to ensure the health & safety standards as required by regulations governing family child care homes are being met. Upon arrival, LPA met with licensee, Gloria Villalobos who guided LPA on a tour of the facility indoors and outdoors. There are 7 children (2 infants) present and 2 adults. Individuals residing in the home are the licensee, spouse and 3 minor children. All adults present have obtained a criminal record clearance. Licensee’s operating hours are from 6:00am-11:30pm (M-Sat).

Licensee provides care for two infants. Licensee was advised to sleep infants where they can be directly supervised and advised against sleeping infants in a separate room. LPA provided the Licensee with a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. Online copy can be downloaded at: https://www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf. http://www.sidsandkidsshop.org/

The home is a one-story, 3-Bed, 1 ½ Restroom home. The following areas are used for day-care: Living room, 1/2 Restroom adjacent to living room and backyard (fenced). Off-Limit areas: 3 Bedrooms, Kitchen, Full Restroom and front yard (fenced). LPA observed a wood door that separates the living room from the rest of the house. As per licensee the children eat and nap in the living room area. LPA inspected the children’s bathroom and is free of hazards. LPA inspected the backyard and is free of hazards.

Licensee has the Parent’s Rights poster and other appropriate forms posted on wall in the living room area. Licensees Pediatric First Aid/CPR certificates are valid thru 06/2020. Licensee Gloria stated that she has practiced fire/emergency drills with day-care children on 01/02/20 & 02/05/20, providing LPA Chavez with disaster drill log. Licensee has a working landline and cell phone. Detergents and cleaning supplies were inaccessible to children and are kept in the garage in the backyard. Fire extinguisher has been serviced in the last year, card on extinguisher notes June 2020. There is an operational smoke & carbon monoxide detector in the living room area. Licensee was advised to change the batteries as often as needed and to make sure the smoke & carbon detectors are operating properly. The home has electrical outlet covers throughout and maintains a First Aid Kit. There are adequate age appropriate toys, books, and games.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) -98-3417
LICENSING EVALUATOR NAME: Janeth Chavez	TELEPHONE: (323) 981-3376
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2020

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: VILLALOBOS FAMILY CHILD CARE	FACILITY NUMBER: 198019966
	VISIT DATE: 02/28/2020

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There are no firearms present on the premises as stated by licensee Gloria. There are no bodies of water, pools, or jacuzzies in the home. There are no pets in the home as stated by licensee Edith. LPA did not observe any bodies of water, firearms, or pets in the home. Children's Roster is readily available and updated. Children’s Files were reviewed.

Licensee stated she has applied for a Large Family childcare home and has not been granted the fire clearance. Licensee has completed Health & Safety Training including 1-hour Nutrition on 06/24/2018. Licensee has an active Pediatric First Aid CPR that expires on 06/2020. Licensee completed an in-person Family Child Care Home Orientation on 03/20/2018. Licensee has complied with SB 792 Immunization Requirements. Licensee is exempt from AB 1207 Mandated Reporter Online training because the training is not provided in the licensee’s primary language, Spanish.

The following were discussed: Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty. All adults working or living in the home must have their criminal record clearances on file PRIOR to working or living in the home. If finger print cleared, their clearances must be associated to facility PRIOR to working or living in the home. Failure to comply will result in an immediate Civil Penalty being assessed.

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 LIC 311D with licensee, reminding her of required forms.

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 Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

There are no deficiencies cited during today’s inspection. 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, Gloria Villalobos, and appeal rights provided.

Report LIC 809C page 2 of 2

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) -98-3417
LICENSING EVALUATOR NAME: Janeth Chavez	TELEPHONE: (323) 981-3376
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2020

LIC809 (FAS) - (06/04)

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