198020465-12-9-2019-33-CC-CGRN-BJPQQM-20191209112234

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020465
Report Date: 12/09/2019
Date Signed: 12/09/2019 11:22:50 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:	MELO & REYES FAMILY CHILD CARE		FACILITY NUMBER:	198020465
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	12/09/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Esperanza Melo and Scarlett Reyes		TIME COMPLETED:	11:30 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 Analyst (LPA) Crystal Green conducted an announced pre-licensing inspection today. LPA met with both Applicants/Licensees, Esperanza Melo and Scarlett Reyes. This application is for a change of location, the applicants are currently licensed at 553 N. Mar Vista Ave., Pasadena, CA 91106 with license #198018360 and is requesting a change of location to 803 Morada Place, Altadena, CA 91001 as a small family child care home. Per applicants, family members residing in the home are 2 adults. Proposed hours of operation will be Monday to Friday, 6:00am to 6:00pm. Applicant states that she will care for children 0 months - 12 years of age. All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a two story home that consists of 4 bedrooms, 2 restrooms, living room (front), living room (back), kitchen, laundry room, dining area, front yard, and backyard (fenced). LPA observed a wall heater located in the back-living room that was made inaccessible using a wall heater barricade. LPA also observed the home to have a child lock gate preventing entry to the off-limit bottom level of the home. Per applicant, the children will use both living rooms, dining area, 1 restroom, and backyard (fenced). Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service. Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible in areas designated for children. The applicants were advised that any poisons must be kept locked and inaccessible to children in care. Based on the Facility Sketch submitted, areas off limits to children and parents are: Includes 4 bedrooms, 1 restroom, kitchen, laundry room, and unfenced front yard. The applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary. REPORT CONTINUES ON NEXT PAGE - 01 of 04

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2019

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: MELO & REYES FAMILY CHILD CARE	FACILITY NUMBER: 198020465
	VISIT DATE: 12/09/2019

NARRATIVE

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OUTDOOR PLAY AREA
The children will use the backyard area for outdoor play. LPA observed the backyard area to be fenced. Per applicant will provide visual supervision while children are outdoors.

Per applicant, there are no pets, no firearms, or weapons on the premises. The home shall contain a fire extinguisher which meet standards established by the State Fire Marshal. LPA observed applicant to have a 2A10BC fire extinguisher purchased on 06/2019. Smoke and carbon monoxide detectors were tested and are operable. There are toys available for children.

The applicant states that they will provide food for children in care. The both applicants have completed the required Health and Safety Training, Nutrition Training and Pediatric First Aid and CPR expires on 03/18/2020 for Esperanza Melo and 03/16/2021 for Scarlett Reyes. Applicant, Scarlett Reyes, has completed the required Mandated Reporter Training. At this time, Esperanza Melo is exempt from the required Mandated Reporter Training due to the training being only offered in English. There are first aid supplies available in the home.

The following was discussed with the applicant:
· 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.

REPORT CONTINUES ON NEXT PAGE - 02 of 04

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2019

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: MELO & REYES FAMILY CHILD CARE	FACILITY NUMBER: 198020465
	VISIT DATE: 12/09/2019

NARRATIVE

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· 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 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. Smoking on the premises is prohibited.
· 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.

Infant Care: Applicants states that they will care for infants. LPA advised the applicant to sleep infants where they can be directly supervised at all times and advised against sleeping infants in a separate room. The applicants states the following as a supervision plan for infants: Applicant states that infants will sleep in the back living room, where she will be providing supervision. LPA provided the applicant 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):
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 - 03 of 04

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2019

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: MELO & REYES FAMILY CHILD CARE	FACILITY NUMBER: 198020465
	VISIT DATE: 12/09/2019

NARRATIVE

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OTHER INFORMATION AND FORMS PROVIDED:
· Tips to Prevent Heat Related Illnesses
· AB 2370 Lead Bill Flyer

This home currently meets the description of a safe and healthy environment for children as described in Chapter 1, Division 12, Title 22 of California Code of Regulations and the facility will be submitted for approval for a small family child care license upon return to Monterey Park Regional Office. LPA reminded applicants to adhere to capacity limitations and conditions listed on the license.

Exit interview was conducted with both Applicants/ Licensees Scarlett Reyes and Esperanza Melo .

REPORT ENDS PAGE - 04 of 04

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2019

LIC809 (FAS) - (06/04)

Page: 4 of 4