198400514-3-15-2022-54-CC-RDEO-CCJPN5-20220315112721

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400514
Report Date: 03/15/2022
Date Signed: 03/15/2022 11:27:29 AM

Document Has Been Signed on 03/15/2022 11:27 AM - 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:	ARROYO FAMILY CHILD CARE		FACILITY NUMBER:	198400514
ADMINISTRATOR:	PATRICIA ARROYO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(951) 322-5597
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90805
CAPACITY:	14	CENSUS: 1	DATE:	03/15/2022
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Applicant - Patricia Arroyo		TIME COMPLETED:	11:40 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) Randy Derraco conducted an announced case management inspection to the above mentioned address on 03/15/22 at 09:15 AM. The purpose of this visit is to conduct a pre-licensing inspection for a change of location. LPA met with applicant, Patricia Arroyo who guided LPA on a tour of the home. LPA observed one adults and one children present during inspection. Per applicant, the child and adult present in the home do not live at the facility and are only there so that applicant can drive her to a doctor's appointment. Individuals residing in the home have been discussed and noted. The applicant is requesting a large family childcare home license. Per applicant, operation hours will be Monday thru Friday, 6 AM - 6PM. Applicant states that they will care for children 2 years old to 13 years old. All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a one story manufactured home that consists of 2 bedrooms, 2 and 1/2 bathrooms, 2 living room, kitchen, laundry area, front yard (fenced) and a car port. The home is located in a mobile home community that includes a community pool area. Per licensee, day care children will not be using the community pool area. LPA observed the pool area to be approximately 500 feet from the facility. LPA observed the pool to be fully fenced with locks on each entrance. A "pool closed" sign was observed on one of the entrances. Off limit areas include a living room, kitchen, 2 bathrooms, 2 bedrooms, laundry area, kitchen, part of the front yard area and the car port. Main care areas include one living room, a bathroom and the front yard area, . Parents will enter the facility through front gate. LPA observed sleeping cots, a Cosco pack and play, a child sized cubby locker to store personal belongings, wall mounted television, 2 Graco feeding high chairs, child sized table and chairs, toy bins with a rack, age appropriate toys and materials. A 3A-40BC fire extinguisher was observed to be full with a service tag dated 12/15/21. A smoke detector was observed in the main care area to be operable. A carbon monoxide detector was observed in the off limits kitchen area to be operable. A space on the wall in the main (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: 03/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022

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: ARROYO FAMILY CHILD CARE	FACILITY NUMBER: 198400514
	VISIT DATE: 03/15/2022

NARRATIVE

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care area was observed to have required postings. A retractable fabric gate was observed to separate the main care area from the off limits kitchen. Outdoor play area is located in the front yard. LPA observed perimeter fencing, areas for shade, age appropriate toys and materials, a wooden gate, and a child gate separating the front yard play area from the off limits front yard area.

Areas that will be used by children were inspected for safety, comfort, and cleanliness. LPA observed operable telephone service, ventilation and heating (central). Detergents, cleaning compounds and hazardous items that can pose a danger to children are made in accessible in the cabinet of the off limits laundry room. The children's bathroom was observed to be clean free of hazards. Applicant does not plan on enrolling infants.

LPA discussed the safe sleep regulations with applicant 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 applicant 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.

Per applicant there are no pets, there are no firearms or weapons stored in the home. The applicant states that they will provide food for children in care. Any food brought from the children’s homes shall be labeled with child’s name and properly stored or refrigerated.

The applicant has completed the required Health and Safety Training, Nutrition, and Lead Training, Mandated Reporter Training and Pediatric First Aid and CPR. Applicant has proof of required immunizations. LPA observed a Johnson and Johnson first aid kit stored in the off limits kitchen area.

Incidental Medical Services (IMS):
This facility may provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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) (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: 03/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022

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: ARROYO FAMILY CHILD CARE	FACILITY NUMBER: 198400514
	VISIT DATE: 03/15/2022

NARRATIVE

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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 applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.cdss.ca.gov.

Applicant is requesting a large family child care. Fire clearance was approved on 02/23/22.

A large family childcare license may be granted upon Licensing Program Manager (LPM) Approval. Once licensed, the applicant is required to comply with the terms and limitations stated on the license.

Exit interview conducted and report was reviewed with the applicant Patricia Arroyo.

(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: 03/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022

LIC809 (FAS) - (06/04)

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