198020418-2-18-2021-33-CC-CGRN-BYD342-20210218165425

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020418
Report Date: 02/18/2021
Date Signed: 02/18/2021 04:55:41 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:	MEDRANO FAMILY CHILD CARE		FACILITY NUMBER:	198020418
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 5	DATE:	02/18/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Maria Medrano and Ruby Medoza		TIME COMPLETED:	03:30 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	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 Maria Medrano, via a tele-inspection by use of FaceTime. Also present was co-applicant, Yolanda Orozco, and License's son, Ruby Mendoza, who assisted with translating due to the licensee's primary language being Spanish. The purpose of the tele-inspection was due to the licensee's request to increase to a Large Family Child Care Home and add Yolanda Orozco as co-licensee. LPA confirmed with Licensee those residing in the home consist of both licensee and co-applicant, who all have obtained criminal record clearance. This is a one-story home that consists of 3 bedrooms, 1 restroom, living room, dining room, family room, kitchen, laundry room, and garage (detached). During this tele-inspection, the Licensee took this LPA on a tour of the home. During this tour, the following was noted: At 2:00 p.m., LPA was toured through the exterior of the home. Licensee showed LPA the front yard which is accessible to the children in care. The front yard was observed to be surrounded by fencing with adequate shade and age-appropriate toys. At 2:06 p.m., LPA observed the interior of the home of the accessible areas to children which were the living room, dining room, laundry room, (2) bedrooms, (1) restroom, kitchen. LPA observed (2) children napping in the living room area, (2) infants in the kitchen area under the supervision of the assistant, and (1) child napping in the bedroom with the door open. 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. Ruby Mendoza showed LPA the fire extinguisher which was last serviced in November 2020. There are smoke detectors throughout the home and a carbon monoxide detector in the living room. REPORT CONTINUES PAGE 1 of 2

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 854-5730
LICENSING EVALUATOR SIGNATURE:	DATE: 02/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

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: MEDRANO FAMILY CHILD CARE	FACILITY NUMBER: 198020418
	VISIT DATE: 02/18/2021

NARRATIVE

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At 2:16 p.m., Ruby assisted LPA in conducting a virtual review of (2) children’s files who were present during the inspection. LPA observed the children’s file to be complete. There is an approved fire clearance on file. LPA was shown the Disaster Drill log, the last drill was completed on 1/14/2021.

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 and Licensee Son. 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.

REPORT END - PAGE 2 of 2

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 854-5730
LICENSING EVALUATOR SIGNATURE:	DATE: 02/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2021

LIC809 (FAS) - (06/04)

Page: 2 of 2