198400361-3-17-2022-54-CC-RDEO-CCLR5X-20220317124348

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400361
Report Date: 03/17/2022
Date Signed: 03/17/2022 12:44:04 PM

Document Has Been Signed on 03/17/2022 12:44 PM - It Cannot Be Edited

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:	ZELAYA FAMILY CHILD CARE		FACILITY NUMBER:	198400361
ADMINISTRATOR:	ZELAYA-GARCIA, KARLA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 284-9606
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90805
CAPACITY:	14	CENSUS: 9	DATE:	03/17/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Licensee - Karla Zelaya		TIME COMPLETED:	12:55 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 Analyst (LPA) R. Derraco conducted an unannounced annual inspection to the above facility on 03/17/22. LPA arrived at the facility at 10:20 AM and met with Licensee Karla Zelaya, who guided analyst on a tour of the facility. Also present during this inspection was a assistant (S2). Per Licensee, there are 10 children that are currently enrolled. There were 9 children present upon arrival. This is a one story home which consists of two bedrooms, one bathroom, kitchen laundry room, dining room, living room, a detached garage, front yard and backyard (fenced). The off limit areas include master bedroom, living room, detached garage and front yard. The side of the home has been set up as the main care area. Children are dropped off and picked up at the front wooden gate leading into the main care area. LPA observed a board designated for required postings, cubby lockers used for personal belongings of the children in care, child sized tables, child sized chairs, a wooden baby crib with a fitted sheet, various age appropriate toys, art materials, children's play equipment and a storage shed. The side of the home leads to the back yard play area where the LPA observed perimeter fencing. LPA observed a portable sink, storage bins, a locked storage shed and a locked off limits detached garage. Shade is provided by an awning with recess lighting, a pop up tent and a table umbrella. The off limits side of the home and detached garage were observed to have a white garden fence set up to prevent access to children in care. A first aid kit was observed to be stored on top of a cubby locker. The kitchen was observed to have child locks on all cabinet doors Per licensee, cleaning supplies are kept locked beneath the kitchen sink. No sharp objects were observed to be accessible in the kitchen area. Additional cleaning supplies and laundry detergent is kept in a locked cabinet above the washing machine located in the laundry room. A Graco playpen was observed in the laundry room. An additional Foundations crib was observed next to the kitchen area against the wall. LPA observed a baby gate separating the kitchen area from the off limits living room. A child sized chair was observed next to the kitchen area. Per licensee, (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: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

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: ZELAYA FAMILY CHILD CARE	FACILITY NUMBER: 198400361
	VISIT DATE: 03/17/2022

NARRATIVE

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children showing signs of illness will be separated to the child sized chair next to the kitchen while parents are notified for pick up. LPA observed the bathroom to be clean and free of defects. The hallway entrance to the off limits living room was observed to have a mesh retractable gate making the area inaccessible to children in care. LPA observed the bedroom designated for care to have additional age appropriate toys, art supplies, a child sized table with chairs, a child sized love seat couch, cubby lockers for storage, a television and a fish tank. 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 cellphone that is used and the cellphone stays at the facility during operation hours. Per Licensee, the home is equipped with central heating and air conditioning. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs. No bodies of water were observed on the premises. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was purchased 03/2021. LPA reminded licensee to service her fire extinguisher once a year. Smoke and carbon monoxide detectors were tested and are operable. 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.

Individuals who reside in the home were noted and discussed. Per Licensee, she currently have one assistant. All adults present in the home have obtained a criminal record clearance or exemption prior to 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

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 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.
(page 2 of 3)

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

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: ZELAYA FAMILY CHILD CARE	FACILITY NUMBER: 198400361
	VISIT DATE: 03/17/2022

NARRATIVE

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The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 01/2023 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 observed to be complete. A current children’s roster was available for review.

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.

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

Exit interview conducted and report was reviewed with the licensee Karla Zelaya

(page 3 of 3)

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

LIC809 (FAS) - (06/04)

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