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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020449
Report Date: 11/18/2021
Date Signed: 11/18/2021 02:45:08 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:SOTO & JONES FAMILY CHILD CAREFACILITY NUMBER:
198020449
ADMINISTRATOR:DAISY SOTO&ROSALIND JONESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 717-8446
CITY:MONROVIASTATE: CAZIP CODE:
91016
CAPACITY:14CENSUS: 6DATE:
11/18/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Rosalind Jones & Daisy Soto, LicensessTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Bardo Baluyot conducted an unannounced required annual inspection on this date. Upon arrival LPA Baluyot met with Licensees Daisy Soto & Rosalind Jones. LPA conducted a COVID risk assessment prior to entering the home. Licensee Jones stated that they provide care for children ages 4 months to 11 years old. Day care hours are Monday - Friday, 6:30 AM - 6:00 PM. Residents that live in the home include both Licensees and 3 adults who are fingerprint cleared.

This is a one story home that consists of 4 bedrooms 2 bathrooms, kitchen, living room, dining area, and back yard with a detached garage. The detached garage has been converted to a room to provide care for children. The day care takes place in the living room, 1 bedroom, dining room area, 1 bathroom, the detached garage, and the backyard. Per Licensees and LPA's own observation, most activities except for eating and napping are done outside or in the converted garage. The kitchen, 3 bedrooms, 1 bathroom are off limits. LPA observed the backyard had an HVAC unit that has been fenced off to prevent access. Licensees stated that children will eat and nap in the living room of the home and not in the converted garage which the LPA observed. The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children.

The back yard area is adequately fenced and there is NO swimming pool, spa or other bodies of water observed on the premises. There are age appropriate toys and napping equipment on the premises.

There are operational smoke and carbon monoxide detectors throughout the home. Both Licensee's CPR expire on 06/2023. Fire extinguisher was observed in the home with a purchase date of 12/1/2020 per receipt.
PG 1 OF 4
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo BaluyotTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
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 4
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: SOTO & JONES FAMILY CHILD CARE
FACILITY NUMBER: 198020449
VISIT DATE: 11/18/2021
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LICENSEES WERE REMINDED OF REQUIRED FORMS: (TO BE POSTED:) LIC6101A Emergency Disaster Plan, PUB394 Notification of Parents Rights Poster, Facility License

Facility Records: LIC 624B Unusual Incident/Injury Report,LIC 9040 Child Care Facility Roster, LIC9052 Employee Rights,LIC9108 Statement Acknowledging Requirement to Report Child Abuse,



Staff Forms/Records - any assistant present must have the following on file: Proof of TB clearance (within one year), Immunization records. Notice of Employee Rights (LIC 9052), Criminal Record Statement (LIC 508), Statement Acknowledging Requirements to Report Suspected Child Abuse (LIC 9180).

Children’s records requirements: LIC 700 Identification And Emergency Information, LIC 627 Consent For Emergency Medical Treatment, LIC 282 Affidavit Regarding Liability Insurance, LIC 9150 Parent Notification Additional Children In Care, Immunization record, PUB 72- Family Child Care Consumer Guide, LIC 995A Notification of Parent’s Rights

The following was discussed with the Licensee:
·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.

·In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR & Pediatric First Aid certification, TB clearance, and a valid criminal record clearance associated to the facility license.

·A current roster of children enrolled LIC 9040 must be available and maintained for a period of three years, even after children no longer are attending the facility.
PG 2 OF 4
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo BaluyotTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: SOTO & JONES FAMILY CHILD CARE
FACILITY NUMBER: 198020449
VISIT DATE: 11/18/2021
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  • The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should be checked and batteries replaced as needed.
·Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.
·Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. Mandated reporter requirements was reviewed and explained.
·Fire and safety drills must be performed every 6 months and documented for review by the Department.
·Smoking is prohibited in a family child care home, 24/7.
·Children and Staff records must be maintained and updated as needed and must be available for review by the Department.
·No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility.
·All adults living and working in the home shall be made of aware of the Departments right to inspection authority.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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
Applicants were told that this report along with the application will be submitted for review and approval. Care for children can begin after the License has been granted.

PG 3 OF 3

SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo BaluyotTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: SOTO & JONES FAMILY CHILD CARE
FACILITY NUMBER: 198020449
VISIT DATE: 11/18/2021
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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/inspection-process.

Licensee's email was obtained today and stipend information was discussed.

A notice of site visit was given and must remain posted for 30 days.


Exit interview conducted and report was reviewed with the licensee, Rosalind Jones.

PG 4 OF 4
END OF REPORT
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3351
LICENSING EVALUATOR NAME: Bardo BaluyotTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4