198019966-8-6-2020-33-CC-ACAS-BS8SC7-20200806134504

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019966
Report Date: 08/06/2020
Date Signed: 08/06/2020 01:45:26 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: 8	DATE:	08/06/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Gloria Villalobos		TIME COMPLETED:	01:45 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	This was a case management inspection conducted by Licensing Program Analyst (LPA) Ariel Cazares due to COVID-19 and precautionary measures. This case management inspection was conducted with Licensee Gloria Villalobos in Spanish via FaceTime to address a request for a capacity increase to a Large FCCH license. This is a home that consists of 3 bedrooms, 1 ½ restrooms, kitchen, living room, back yard (fenced). Family members residing in the home are 2 adults and 3 minor child. Per licensee operating hours will be Sunday-Saturday 6:00am- 11:30pm. LPA inquired into the status of firearms in the home, which licensee stated she does not have any in the home. LPA inquired about pets, which licensee stated she does 1 dog in the home. During this tele-inspection the Licensee took this LPA on a tour of the home. At 1:02pm, LPA was toured through the interior starting with the living room where children were napping. LPA observed a total of 8 children and 1 additional assistant. LPA was then guided through the kitchen which is kept off-limits via a half door with a latch. The bedrooms and full bathroom were observed but are kept off-limits to children. LPA did not observe any hazards or immediate risks. At 1:07 pm, LPA was guided to the outdoor area where children play. LPA observed toys and play equipment the back patio area is secured via a gate that prevents access to the driveway and front of home. The children are escorted from the living room to the entrance of the house in order to access the back yard. No hazards or immediate risks were observed. There is a detached garage, which licensee showed LPA was locked by testing the door knob.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Ariel Cazares	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2020

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: 08/06/2020

NARRATIVE

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At 1:09 pm, LPA was guided back into the interior of the home and into the children’s restroom which is adjacent to the living room. The restroom was observed to be clean and free of any cleaning products or medication. The restrooms was observed with supplies needed for children’s toileting needs. The licensee showed LPA the fire extinguisher in the kitchen which was serviced 8/6/2020 as noted on service tag. Another extinguisher was observed in the living room and was serviced 2/29/2020. The smoke and carbon monoxide detectors located in the living room were tested by licensee and the alarms sounded, showing they are operational.

Areas accessible to children: living room, 1/2 bathroom, backyard. Off-limit areas: 3 bedrooms, 1 bathroom, front yard/driveway, and detached garage.

COVID-19 related guidelines and procedures were discussed with licensee. LPA inquired into licensee's daily operation as relates to drop off/pick up for children, social distancing, cleaning and disinfecting, application has been reviewed. Missing documents requested from licensee by LPA C. Reyes will be sent by licensee. There is a fire clearance on file for the home. Based on this inspection, the facility is in compliance.

Exit interview was conducted with Licensee Gloria Villalobos, via tele-inspection, during which appeal rights were explained. This report along with a copy of the appeal rights will be sent to the Licensee via email with a read receipt or confirmation of receipt of email, which will act as the Licensee’s signature.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Ariel Cazares	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2020

LIC809 (FAS) - (06/04)

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