198020326-12-4-2020-33-CC-CGRN-BVYQ8H-20201204105647

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020326
Report Date: 12/02/2020
Date Signed: 12/04/2020 10:57:06 AM

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:	CANCHOLA & GUILLEN FAMILY CHILD CARE		FACILITY NUMBER:	198020326
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 1	DATE:	12/02/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	01:05 PM
MET WITH:	Gerardo Guillen		TIME COMPLETED:	01:40 PM

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This was an announced licensee initiated case management inspection to evaluate the facility for a capacity increase conducted by Licensing Program Analyst (LPA) Crystal Green. Due to COVID-19 and precautionary measures, this inspection was conducted with Licensee Gerardo Guillen, via a tele-inspection by use of Zoom. The purpose of the tele-inspection was due to the licensee's request to increase to a Large Family Child Care Home.

LPA confirmed with Licensee those residing in the home consists of 2 adults and 6 children, who all have obtained criminal record clearance. Per Licensee day-care hours of operation are seven days a week, 24 hours a day for less than 24 hours care. This is a two- story home that consists of 4 bedrooms, 3 restrooms, living room, dining room, family room, kitchen and garage.

During this tele-inspection, the Licensee took this LPA on a tour of the home. During this tour, the following was noted: At 1:10 PM, LPA was toured through the interior of the home of the accessible areas to children which were the living room, dining room, family room, kitchen and the restroom located on the first floor near the living room. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service, ventilation and heating (central). Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible in areas designated for children. The licensee states poisons are locked in the shed with a pad lock. The shed is located on the side of the outdoor area of the home.

Licensee showed LPA the fire extinguisher which was last services on June 12, 2019. There are smoke detectors throughout the home and a carbon monoxide detector in the living room which Licensee tested; LPA heard the alarm and found them to be operational. At 1:20 PM, LPA was toured through the back yard of the home. The LPA observed the backyard to be surrounded by fencing with adequate shade and age appropriate toys. At 1:27 PM, Licensee assisted LPA in conducting a virtual review of 1 child file who was present during the inspection. There is an approved fire clearance on file. Per Licensee, there is also a dual license at this address for Foster Family Home (LIC #197806695) with effective date of 10/10/2016 with a total capacity of 6.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 854-5730
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2020

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: CANCHOLA & GUILLEN FAMILY CHILD CARE	FACILITY NUMBER: 198020326
	VISIT DATE: 12/02/2020

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At this time, the licensee home meets the description of a safe and healthy environment for children as described in Chapter 1, Division 12, Title 22 of the California Code of Regulations, and will be submitted for approval to be licensed as a Large Family Child Care Home.

The exit interview was conducted with Licensee. 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 the email, which will act as the Licensee’s signature.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 854-5730
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2020

LIC809 (FAS) - (06/04)

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