<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400185
Report Date: 12/13/2019
Date Signed: 12/13/2019 12:36:54 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:AMAYA FAMILY CHILD CAREFACILITY NUMBER:
198400185
ADMINISTRATOR:JOSE & SANDRA AMAYAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 285-2740
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY:14CENSUS: 0DATE:
12/13/2019
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Jose AmayaTIME COMPLETED:
12:53 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
Licensing Program Analysts (LPAs) Raul Navarro and Katrina Chicote conducted an Announced Pre-Licensing Inspection to inspect the facility for initial licensure in Spanish. Upon arrival LPAs met with licensee Jose Amaya. Licensee is requesting a change of location of their large family child care license. The facility is a one story, three bedroom and two bathroom home. Individuals residing in the home are two adults, husband and wife, Sandra Amaya, both of which are Licensees.

Licensee guided LPAs on a tour of the facility indoors and outdoors. The home was inspected for safety, comfort, cleanliness, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. Per Licensee, child care will be provided at all hours of the day from Monday through Sunday. Licensee understands that care for a child should not exceed 24 hours.

Per Licensee, the following areas will be used for day-care: Living room/Day care room, two restrooms, two bedroom, and the back yard.

Per Applicant, Off-limits areas include: master bedroom, kitchen, detached garage, and front yard. There is a gate to prevent access to the kitchen. The kitchen cabinets have latches for added security. The doors to the bedrooms will remain closed and have a child proof knobs on them.

The Licensee, has all appropriate forms posted. LPAs confirmed with the Licensee that all adults residing/working in the home have obtained criminal record/TB clearances. Per Licensee, they will use their personal cell phone as the day care phone. Licensees and their assistant's 8 hour First Aid/CPR certificate is valid thru 01/2020. Proof of immunization against influenza, pertussis, and measles for the Licensees and assistant were readily available during today's inspection. Licensees and assistant have not completed the Mandated Reporter Training due to training not being available in their primary language.


Report continues- Page 1 of 4
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019
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 3
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: AMAYA FAMILY CHILD CARE
FACILITY NUMBER: 198400185
VISIT DATE: 12/13/2019
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
26
27
28
29
30
31
32
There is an operational smoke and carbon monoxide detector and required fire extinguisher maintained in the home, purchase 11/2019. The home has electrical outlet covers throughout and maintains a First Aid Kit. There are some age appropriate materials available for children to be enrolled in care. Per Licensee, there are no firearms, ammunition, or weapons present on the premises. The outdoor play area is a fenced front yard, which is free of hazards. LPAs did not observe any bodies of water on the premises.

The Licensee was advised they shall be present in the home and shall ensure children in care are supervised at all times. Licensee was also advised children shall not be left in parked vehicles at any time.

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. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.
· 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 and a valid criminal record clearance associated to the facility license.
· 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. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. The family day care home shall maintain documentation of the required immunization or exemptions from immunization, as set forth in this section, in the person’s personnel record that is maintained by the family day care home.
· A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.
· Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License shall be terminated.
· The fire extinguisher type 2A10BC must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should 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.
Report continues- Page 2 of 4
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: AMAYA FAMILY CHILD CARE
FACILITY NUMBER: 198400185
VISIT DATE: 12/13/2019
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
26
27
28
29
30
31
32
· 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.
· Saucer chairs, bouncers, walkers, or any similar items are 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.
· Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are required to be posted.

LPAs advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. The LIC 311D Forms/Records to Keep in Your Family Child Care Home .A hard copy of A Child Care Provider’s Guide to Safe Sleep was provided.

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

After a tour and review of this home the facility was in accordance with the California Code of Regulations Title 22 to protect the Health & Safety of child that will be in care. After further review by the department, Licensee will be notified if/when License is granted. Once licensed, the licensee is required to adhere to the terms and limitation as stated on the license. Exit interview was conducted with Jose Amay . This report was read and Licensee is in agreement with the above. A copy of this report and all other Licensing reports must be made available to the public for 3 years.

Report continues- Page 3 of 4
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3