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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020212
Report Date: 04/04/2023
Date Signed: 04/04/2023 02:56:39 PM


Document Has Been Signed on 04/04/2023 02:56 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 CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:VILLAGRAN FAMILY CHILD CAREFACILITY NUMBER:
198020212
ADMINISTRATOR:GUADALUPE VILLAGRANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 818-8632
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY:14CENSUS: 4DATE:
04/04/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:49 PM
MET WITH:Licensee Guadalupe VillagranTIME COMPLETED:
03:00 PM
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On 4/4/23 Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced required 1 year inspection at the above facility. LPA met with the Licensee Guadalupe Villagran and informed her of the purpose for the visit. LPA provided the Facility Entrance Checklist to the Licensee. All residents were discussed and noted. The Licensee holds a foster license through DCFS. Facility provides care to children ages 3 months to 12 years old . Facility is open Monday to Friday 6am to 6 pm. There were four day care children present during the inspection.
This is a one story, 3 bedroom, 2 bathroom home, with a two living rooms, dining area, kitchen, laundry room, enclosed backyard, fenced pool and a garage that has been converted into an ADU.
Per Licensee areas on limits to children are: Both living room areas, one bathroom next to the laundry room, the dining room and kitchen in passing to the daycare areas and the enclosed backyard.
Per Licensee areas off limits to children are: Three bedrooms, one bathroom in an off limit bedroom, the pool and the garage/ADU. Per Licensee the ADU has it's own entrance and does not have access to the the main home. Per Licensee, individuals residing in the ADU are currently not present and do not participate in the supervision of the day care.
All areas that are accessible to children were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection: LPA observed required posted documentation- Facility license, Publication (PUB) 394- Notification of Parent Rights, LIC 9148 Earthquake preparedness checklist. LPA observed a current facility roster LIC 9040 and a disaster drill log. Last documented drill was conducted on 12/8/2022. There is an operable combination carbon monoxide detector/ smoke detector in one of the living rooms. LPA observed a 2A10BC Fire Extinguisher in the facility which indicated full. Licensee had the receipt for the fire extinguisher indicating it was purchased on 1/23/23. The home maintains telephone service (cell phone). Food is provided by Licensee. Licensee was reminded if children bring food from home it must be labeled with the child’s name and properly stored or refrigerated.
There are toys and other age appropriate materials available for children in the living room used mainly for day care activities. The first living room is used at times as an additional area.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette EstradaTELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:
DATE: 04/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/04/2023
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: VILLAGRAN FAMILY CHILD CARE
FACILITY NUMBER: 198020212
VISIT DATE: 04/04/2023
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The bathroom children use is accessible from the main day care area through the laundry room. Personal hygiene items and materials are kept in latched cabinets under the sink and the diaper changing table.
Sharp objects, detergents and cleaning compounds were inaccessible. Knives are kept in an upper kitchen cabinet, cleaning compounds are kept in a latched cabinet under the sink, personal medicines are kept in an off limits bedroom, detergent is kept in the laundry room inaccessible to children. Per Licensee, children enrolled do not require medication. Heating and ventilation was evaluated. The home has central air and heating. The fireplace in the main day care area is barricaded.
The section of the backyard accessible to children is fenced and has toys and other materials for children to play with. Per Licensee, children are supervised while playing outside. The backyard is accessible through the main day care area. There is a pool in the home.
The pool is accessible through the outdoor area the children use. It is surrounded by a 5 foot fence which does not obscure the view of the pool and has a gate that swings away from the pool and has a self- latching device. The gate to the pool is kept locked with a key lock. The home is equipped with operable door and window alarms that alert when either are opened.
Per Licensee there are no poisons in the home. Licensee understands that all poisons must be locked, not only inaccessible to children. Isolation area for sick children waiting to be picked up is in the living room away from other children. LPA observed a properly stored fire arm in the home inaccessible to children in care.
Infant Care: Currently licensee cares for two infants. LPA observed four play yards available in the facility. Napping equipment does not block entrances or exits. LPA and Licensee discussed Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months and 15-minute sleep check documentation for infants 0-24 months.
Overnight Care: There is no overnight care provided at the moment. LPA discussed the following: Licensee is aware that they must remain wake while children are awake. If children sleep in separate area from licensee, the door must remain open. If licensee cannot hear children when they wake up, video or audio device can be used.
Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, documentation of 15-minute Infant Sleep Check (0-24 months). One children's file did not contain the LIC 9227 Individual Infant Sleeping Plan.
Staff records were reviewed. Licensee's pediatric first aid/cpr certification issued by the American Heart Association was expires in March 2025. Licensee's Mandated Reporter certificate expires on 5/12/2024. Licensee had proof of required immunization against measles, pertussis and flu (flu declination).
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette EstradaTELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2023
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: VILLAGRAN FAMILY CHILD CARE
FACILITY NUMBER: 198020212
VISIT DATE: 04/04/2023
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Incidental Medical Services (IMS): 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm
Licensee was reminded that all adults 18 and over living or working in the home, 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 athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleephttps://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.
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.
No deficiencies observed during the inspection.

Exit interview conducted and report was reviewed with the Licensee, Guadalupe Villagran. A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette EstradaTELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2023
LIC809 (FAS) - (06/04)
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