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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197413712
Report Date: 02/21/2024
Date Signed: 03/19/2024 03:35:03 PM

Document Has Been Signed on 03/19/2024 03:35 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:MELGAR FAMILY CHILD CAREFACILITY NUMBER:
197413712
ADMINISTRATOR:MELGAR, ANA L.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 923-1163
CITY:LOS ANGELESSTATE: CAZIP CODE:
90066
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
02/21/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:ANA MELGAR, LICENSEETIME COMPLETED:
03:00 PM
NARRATIVE
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On 02/21/2024, Licensing Program Analyst (LPA) Lisa Clayton made an unannounced visit to the Melgar Family Child Care Home to conduct the Required 3-year Inspection. LPA was greeted by Licensee Ana Melgar. LPA Clayton observed 4 children in care, being supervised and cared for appropriately by licensee and fingerprint cleared assistant. Hours of operation are Monday through Friday, 8:30am – 4:30pm. Licensee provides breakfast, lunch, pm snacks and water.

LPA Clayton toured the home inside and outside for a Health and Safety inspection. The home is neat and clean with heating and ventilation for safety and comfort.

LPA confirmed that the single-family home consists of living room/dining room, kitchen, 2 bedrooms, 2 ½ bathrooms, family room, attached converted garage, fenced backyard and detached converted shed (converted into a bedroom and bathroom).

The ON LIMIT AREAS are as follows: living room/dining room (daycare napping area), kitchen, ½ bathroom, family room (main daycare room) and fenced back yard.

The OFF-LIMIT AREAS are as follows: bathroom #1, bedroom #1, bedroom #2, bathroom #3, attached garage/ storage room, and converted shed all of which are inaccessible to children in care by closed and/or locked doors and visual supervision.

LPA Clayton observed a fully charged 2A:10B:C Fire Extinguisher.

There are no firearms or ammunition on the premises. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible to children in care.
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Lisa Clayton
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 03/19/2024 03:35 PM - It Cannot Be Edited


Created By: Lisa Clayton On 02/21/2024 at 01:26 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MELGAR FAMILY CHILD CARE
FACILITY NUMBER: 197413712

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/21/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.543
Licensure Requirements
Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA Clayton observation, the licensee did not comply with the section cited above in which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/22/2024
Plan of Correction
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Licensee will provide proof of a working carbon monixide detector no later than 02/22/2024.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Karren Starks
LICENSING EVALUATOR NAME:Lisa Clayton
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2024


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Document Has Been Signed on 03/19/2024 03:35 PM - It Cannot Be Edited


Created By: Lisa Clayton On 02/21/2024 at 01:42 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MELGAR FAMILY CHILD CARE
FACILITY NUMBER: 197413712

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/21/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.3(a)(2)


This requirement is not met as evidenced by:
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following:(2) Room additions to the family child care home.
Deficient Practice Statement
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Based on LPA Clayton observation of the conversion of a "Shed" in the backyard to a bedroom with a bathroom, where licensees fingerprint cleared son resides, the licensee did not comply with the section cited above in which posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/21/2024
Plan of Correction
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Licensee acknowledges that she is required to inform the Department of the above mentioned alterations or additions to the family child care home or grounds prior to the changes being made, including but not limited to: Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Karren Starks
LICENSING EVALUATOR NAME:Lisa Clayton
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2024


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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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MELGAR FAMILY CHILD CARE
FACILITY NUMBER: 197413712
VISIT DATE: 02/21/2024
NARRATIVE
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There are no pools, ponds or other bodies of water on the premises.

LPA observed age-appropriate toys, books and furnishings. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts.

LPA reviewed 5 children’s files and observed them to be in compliance as they contained current contact information for authorized representatives and/or relatives who can assume responsibility for the child, and authorization for medical treatment, signed Parent’s Rights.

LPA Clayton reviewed staff and Licensees files. LPA Clayton reminded Licensee Ana that all staff are to have Mandated Reporter training which is to be updated every 2 years.


LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page 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.


Incidental Medical Services (IMS) are NOT currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA reminded Licensee of the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Lisa Clayton
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024
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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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MELGAR FAMILY CHILD CARE
FACILITY NUMBER: 197413712
VISIT DATE: 02/21/2024
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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 was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&R) throughout California.


During the exit interview, Licensee Ana confirmed that there are no Registered Sex Offenders living in the home and LPA completed the RSO profile in FAS.

Licensee will mail the following document to the Department no later than 02/26/2024:
· MMR and Tdap/Dtap records for assistant Elvira
· Mandated Reporter Training Certificate for licensee and assistant Elivra
· Completed Disaster Plan
· Picture of Parent board
· Proof of working Carbon Monoxide Detector
· Proof of working smoke detector in the day care area

Per Title 22 Regulations and Health and Safety Codes, Deficiencies were cited and Technical Advisory notes were issued today (see LIC 809D and LIC 9102).

An exit interview was conducted, a copy of this report was read and provided to licensee Ana and will be made available to the public upon request.

LIC 9213 Notice of Site Visit was provided and required to be posted for 30 days.

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Lisa Clayton
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024
LIC809 (FAS) - (06/04)
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