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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494366
Report Date: 12/10/2021
Date Signed: 12/10/2021 03:38:39 PM

Document Has Been Signed on 12/10/2021 03:38 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:ESPANA FAMILY CHILD CAREFACILITY NUMBER:
197494366
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 4CENSUS: 4DATE:
12/10/2021
TYPE OF VISIT:Required - 1 YearANNOUNCEDTIME BEGAN:
01:19 PM
MET WITH:Blanca Espana-LicenseeTIME COMPLETED:
03:57 PM
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On 12/10/2021 Licensing Program Analyst (LPA), Jillinda Chandler conducted an unannounced Annual Rando/1year required visit for The Espana Family Child Care Home. Present in the home were Blanca Espana - licensee, licensee's minor son and 4 infant day care children. All adults in the home have criminal background clearance. The home is converted from a duplex to a single family home. The home was inspected inside and out for health and safety compliance per Title 22 according to the facility sketch on file.
LPA observed the following:
Adequate care and supervision was being provided
The homes capacity was within the scope of the license
Appropriate size fire extinguisher carbon and smoke detector present & operable.
Detergents, and knives were inaccessible, Toxins were locked and inaccessible.
Licensee's husband has gun present in the home the gun was observed stored in an off limits room to the right of the eating room.The gun was properly stored in a combination storage container and ammunition was stored separately.
SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE: DATE: 12/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/10/2021
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ESPANA FAMILY CHILD CARE
FACILITY NUMBER: 197494366
VISIT DATE: 12/10/2021
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The home has a properly working telephone
License, facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights Poster and California Safety Seat Law are posted
Pediatric CPR and First Aid Card was current expiring 11/2023
No bodies of water were observed on the premises, the rear yard is inaccessible to children. Children play in the front yard, the yard is fully enclosed with a four foot or higher gate.
Children records available and in good order.
A roster was provided, the roster was current and readily available
The home was not providing Incidental Medical Services (IMS) at the time of todays visit, IMS was discussed with licensee.
Toys, equipment and materials available and in good order.
Parents or authorized adults signed children in and out using their original signatures.
Licensee did not have current Mandated Reporter Training; licensee was advised to have the training renewed at mandatedreporterca.com

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.

SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2021
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ESPANA FAMILY CHILD CARE
FACILITY NUMBER: 197494366
VISIT DATE: 12/10/2021
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Family Child Care Homes

Licensee Blanca Espana 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.

Safe Sleep

LPA discussed the safe sleep regulations with licensee [or facility representative] 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.

licensee was provided the departments website for resources and updates.www.cdss.ca.gov

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

An exit interview was conducted and report was reviewed with the licensee Blanca Espana.

SUPERVISORS NAME: Peter Flores
LICENSING EVALUATOR NAME: Jillinda Chandler
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2021
LIC809 (FAS) - (06/04)
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