198020462-1-15-2020-33-CC-LGOZ-BKUPKB-20200115102253

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020462
Report Date: 01/15/2020
Date Signed: 01/15/2020 10:23:08 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:	MONTIEL FAMILY CHILD CARE		FACILITY NUMBER:	198020462
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	01/15/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:43 AM
MET WITH:	Miriam Montiel		TIME COMPLETED:	10:37 AM

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	Licensing Program Analysts (LPAs) Lissete Gonzalez and Alanna Gontarek conducted a relocation pre-licensing inspection in Spanish. LPAs met with Miriam and Hector Montiel, applicants who guided analysts on a tour of the facility. Additional family members residing in the home are 1 adult child and 3 minor children. The applicants are requesting a small family child care home license. Per applicants, operation hours will be Monday to Friday, 6:00AM to 6:00PM. Applicants state that care will be provided to children from age birth to 12 years. All areas identified on the facility sketch were inspected. This is a one-story home that consists of 4 bedrooms, 2 restrooms, dining room, living room, kitchen and detached garage. Per applicant, the children will use the living room, dining room, kitchen, one restroom in the hallway, diaper changing station located in the hallway, and the front yard for outdoor play. Based on the Facility Sketch submitted, areas off limits to children and parents are: 4 bedrooms and 1 bathroom, kitchen (child safety gate located at entrance), garage (locked), and back yard. The applicants understand that licensing staff may have access to off-limit areas during inspection visit if necessary.Per applicants, off limits rooms will be maintained locked during operating hours. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service (cellular telephone), ventilation and heating (central air conditioning). Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children were observed to be inaccessible in the areas designated for children. There is an alarm in the home that alerts applicants when the doors are opened. The applicants state that there are no poisons on the premises. The applicants were advised that any poisons must be locked with a key or combination lock. The children will use the front yard for outdoor play (fully fenced). LPAs observed a cactus tree, aloe vera plants, and a bush with thorns that were accessible to children in the front yard. REPORT CONTINUES ON NEXT PAGE 1 of 5

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Lissete Gonzalez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

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 5

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: MONTIEL FAMILY CHILD CARE	FACILITY NUMBER: 198020462
	VISIT DATE: 01/15/2020

NARRATIVE

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Per applicants, there are no pets in the home, there are no bodies of water, fire arms or weapons in the home. The value on the 2A10BC fire extinguisher indicates fully charged and was last serviced on 6/25/2019. Combination smoke and carbon monoxide detectors were tested and are operable. There are age appropriate toys available for children. The applicants state that she will be providing food for children. Applicants were advised that if food is brought from the children’s homes, all containers must be labeled with child’s name and properly stored or refrigerated.

The applicants have the required Health and Safety Training, Nutrition Training. Applicant Miriam Montiel’s Pediatric First Aid and CPR is valid through 8/16/2021. Applicant Hector Montiel’s Pediatric First Aid and CPR are valid through 12/2021. There are first aid supplies available.

UPDATE: Health and Safety Code 1596.7995: Beginning January 1, 2018, all licensed providers, applicants, directors and employees to complete training as specified on mandated reporter duties. Training is available at: www.mandatedreporterca.com

Infant Care: Applicants state that they will care for infants. LPAs advised the applicants to sleep infants where they can be directly supervised at all times and advised against sleeping infants in a separate room. The applicants state the following: Applicants state that she will sleep infants in a common area where they can be directly supervised. LPAs provided the applicants with a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. Online copy can be downloaded at: https://www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

Incidental Medical Services (IMS): Applicants will wait until facility opens to determine IMS Needs. 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 Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

REPORT CONTINUES ON NEXT PAGE: 2 OF 5

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Lissete Gonzalez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: MONTIEL FAMILY CHILD CARE	FACILITY NUMBER: 198020462
	VISIT DATE: 01/15/2020

NARRATIVE

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The following was discussed with the applicants:
· Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Civil Penalties will be assessed if not in compliance.
· 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 Pediatric First Aid and CPR certification and a valid criminal record clearance associated to the facility license.
· Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License may be terminated.
· The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked and batteries replaced as needed.
· Reporting Requirements: 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.
· Fire and safety drills must be performed every six months and documented for review by the Department.
· Smoking is prohibited in a family child care home.
· Children and Staff records must be maintained and updated as needed and must be available for review by the Department.
· 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, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.
· Licensees shall reveal each facility license number in all advertisements, publications or announcements with the intent to attract clients.
· Never Shake a Baby, Sudden Infant Death Syndrome (SIDS) and Safe Sleeping practices
REPORT CONTINUES ON NEXT PAGE: 3 OF 5

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Lissete Gonzalez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: MONTIEL FAMILY CHILD CARE	FACILITY NUMBER: 198020462
	VISIT DATE: 01/15/2020

NARRATIVE

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· Capacity Handout for a Small Family Child Care Home and Large Family Child Care Home was provided.
· UPDATE: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The licensee and all adults working with children have proof of immunization.
· Liability Insurance: Per applicants, she will be obtaining liability insures. LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information.

LPAs advised the applicants how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. LPA reviewed and issued the Forms/Records to Keep in Your Family Child Care Home (LIC 311D) and provided the following forms:

CHILDREN FORMS/RECORDS - Children’s files must contain the following documents/information:
Identification and Emergency Information (LIC 700), Consent for Emergency Medical Treatment (LIC 627), Notification of Parent’s Rights (LIC 995A), Caregiver Background Check Process (LIC 995E), Family Child Care Consumer Awareness Information (LIC 9212), Consent/Verification for Nebulizer Care (LIC 9166), California School Immunization Record, Parent Notification for Additional Children in Care (LIC 9150), Affidavit Regarding Liability Insurance (LIC 282), Acknowledgment of Receipt of Licensing Reports (LIC 9224).

FACILITY FORMS/RECORDS - Facility files must contain the following documents/information:
Personnel Records: As required in Title 22 Regulations 102416.1, Unusual incident/Injury Report (LIC 624B): Child Care Facility Roster (LIC 9040), Notice of Employee Rights (LIC 9052), Statement Acknowledging Requirement to Report Suspected Child Abuse (LIC 9108), Property Owner/Landlord Consent (LIC 9149), Property Owner/Landlord Notification Form (LIC 9149).

INFORMATION TO BE POSTED IN YOU FAMILY CHILD CARE HOME – You are required by Law to post the following:
Facility License (LIC 203), Emergency Disaster Plan (LIC 610A), Earthquake Preparedness Checklist (LIC 9148), Notification of Parent’s Rights (PUB 394). A Notice of Site Visit (LIC 9213): Must be posted for 30 days after each site inspection by a Licensing Representative.
Any Licensing Report documenting a Type “A” deficiency must be posted for 30 days during the hours that children are in care. REPORT CONTINUES ON NEXT PAGE: 4 OF 5

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Lissete Gonzalez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: MONTIEL FAMILY CHILD CARE	FACILITY NUMBER: 198020462
	VISIT DATE: 01/15/2020

NARRATIVE

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Per applicants, there are no dual licenses at this address. Applicants’ email address was obtained during this inspection. The applicants were advised that email may be public information. Applicants were provided with a copy of PIN 20-01-CCP Required lead testing for drinking water in Licensed Child Care Centers and the provision of lead exposure information to parents and guardians by all Licensed Child Care facilities. Effects of Lead Exposure handout was provided to applicants.

The following corrections need to be corrected prior to obtaining a small family child care license.
Corrections are due by 01/29/20.
I. Applicants will barricade the cactus tree located in the front yard.
II. Applicants will remove aloe vera plants, and the bush with thorns from the front yard.

A small family child care licensee will be granted upon receipt of proof of corrections for the above. Once licensed, the applicants are required to adhere to the terms and limitations stated on the license. A copy of this report and all other Licensing reports must be made available to the public for 3 years.

Exit interview was conducted with applicant Miriam Montiel.

END OF REPORT PAGE: 5 of 5

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Lissete Gonzalez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020

LIC809 (FAS) - (06/04)

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