198400185-11-4-2021-54-CC-RDEO-C8FV2P-20211104160329

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400185
Report Date: 11/04/2021
Date Signed: 11/04/2021 04:03:48 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 CARE		FACILITY NUMBER:	198400185
ADMINISTRATOR:	JOSE & SANDRA AMAYA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 285-2740
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90805
CAPACITY:	14	CENSUS: 4	DATE:	11/04/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Licensees - Jose and Sandra Amaya		TIME COMPLETED:	04:15 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 (LPA) R. Derraco conducted an unannounced required 1 year inspection to the above facility on 11/04/21. LPA arrived at the facility at 1:00 PM and met with licensees Jose and Sandra Amaya. Jose Amaya guided analyst on a tour of the facility. Per Licensee, there are 14 children that are currently enrolled. There were 4 children present upon arrival. This is a one-story home which consists of 3 bedrooms, one and a half bathrooms, kitchen, two living rooms, a detached garage, front yard and backyard (fenced). The off limit areas include one bedroom, one full bathroom, kitchen, detached garage, front yard and back yard. LPA observed construction work being done in the front yard and back yard area. Licensee states both areas will be temporarily off-limits until project is complete. LPA advised licensee to submit an updated facility sketch once construction project is complete. The main care area is located in both of the living rooms. LPA observed child sized tables, child sized chairs two Serenity Compact Stationary Cribs, a wooden baby changing stations, a sectional couch, wall mounted television, age appropriate toys and materials. A wooden gate were observed to separate the main care area and the off limits kitchen. An additional wooden gate was observed to separate both of the main care areas. Bedroom one was observed to have a wall mounted television, sleeping cot and a couch. Additional sleeping cots were observed in the closet of bedroom one. Bedroom two was observed to have a table, a sleeping mat and dresser drawer. LPA observed the half bathroom to be clean and free of defects. Child locks were observed below the bathroom sink making contents inaccessible. Cleaning products were observed beneath the locked bathroom cabinet. The licensee states that she provides food for children in care. Per licensee, isolation area for children showing signs of illness will be located in one of the two bedrooms designated for care. Individuals who reside in the home were noted and discussed. Per Licensee, they currently have one assistant. All adults present in the home have obtained a criminal record clearance or exemption prior to (page 1 of 3)

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 11/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021

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

LIC809 (FAS) - (06/04)

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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: 11/04/2021

NARRATIVE

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working, residing or volunteering in the licensed childcare home. 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.

Licensee states that there are no firearms stored in the home. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a landline. Per Licensee, the home is equipped with central heating and air conditioning.

The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked, not just inaccessible.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 07/12/21, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPAs did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs. No bodies of water or pets were observed on the premises.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. LPA observed that the Licensee and assistant do have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. File review was observed to have proper mandated immunization records. Children’s records were reviewed, including emergency information and were
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SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 11/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021

LIC809 (FAS) - (06/04)

Page: 3 of 12

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: 11/04/2021

NARRATIVE

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observed to be complete. A current children’s roster was available for review.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Incidental Medical Services (IMS):
IMS was discussed with licensee. Per licensee, there are no children enrolled that require IMS at this time. 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.

LPA advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

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/process.

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

Exit interview conducted and report was reviewed with the licensee Jose Amaya.

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SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 11/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021

LIC809 (FAS) - (06/04)

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