198015064-5-29-2024-33-CC-SPEY-D5QTCC-20240529143631

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198015064
Report Date: 05/29/2024
Date Signed: 05/29/2024 02:36:55 PM

Document Has Been Signed on 05/29/2024 02:36 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	AGRAMON FAMILY CHILD CARE		FACILITY NUMBER:	198015064
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS:	DATE:	05/29/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:12 PM
MET WITH:	Licensee, Melisa Agramon		TIME VISIT/ INSPECTION COMPLETED:	03:04 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	On 05/29/2024, Licensing Program Analyst (LPA) Staicy Perry conducted an unannounced Annual inspection to the above facility. A COVID risk assessment was conducted upon entry. LPA was greeted by Licensee Melisa Agramon whom the reason for the visit was explained. Per Licensee, there are 7 children currently enrolled. There were 3 children, and 1 adult present in the home upon arrival. Facility capacity is in compliance for a small Family Child Care Home. Per Licensee hours of operation are 6:00am-10:00pm, Monday- Friday. This is a one story home which consists of 2 bedrooms, 1 bathroom, kitchen, dining area, living room, laundry room, and front yard (fenced). The children use the bathroom in the hallway, the living room, the dining area, and the front yard. Licensee had latches on cabinets were any potentially hazardous material. Per Licensee, areas off limits to children include: the kitchen and the 2 bedrooms. LPA toured all areas used by children during this visit. During this visit, all areas identified that are accessible for children to use were inspected for the safety, comfort, and cleanliness. Licensee guided LPA on the tour of the home. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for safety and comfort. LPA observed central AC and Heating for the home. There are toys and other age-appropriate materials available for children. The bathroom was reviewed, LPA did not observe anything that can pose danger to the children in care. LPA did observe that the bathroom sliding door has a latch to prevent the children from opening, LPA observed medicine cabinet with mirror to be locked and LPA did observe a diaper changing station in the bathroom. The kitchen was observed to be clean and organized. Knifes were seen to be placed in a locked cabinet located in the kitchen made inaccessible to the children. The dining and living room area was observed to be clean and orderly plenty of age-appropriate toys for the children to use. The dinning room

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024

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 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: AGRAMON FAMILY CHILD CARE	FACILITY NUMBER: 198015064
	VISIT DATE: 05/29/2024

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
26
27
28
29
30
31
32

chair is used as an isolation area for an ill child until an authorized representative arrives to pick up the child. All equipment meets the US Consumer Product Safety Commission safety standards. Licensee had latches on cabinets with any potentially hazardous material around the home.

Detergents, cleaning compounds, and medications were observed to be inaccessible to children. Per Licensee, there are no poisons in the home. LPA advised that any poisons should be locked under key or combination lock. Licensee states that are no firearms or weapons stored in the home.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and LPA observed proof of service date is September 30, 2023. Which indicates it is fully charged and in green. Smoke and carbon monoxide detectors were tested and are operable and were observed to be in the dinning room area.

All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. Last drill documented was conducted on 1/2/24. The home is observed to be clean and orderly. There are first aid supplies available. LPA observed licensee to have a first aid kit available and is located in the living room area.

Per licensee, Breakfast, Lunch, PM snack and dinner is provided by licensee. Licensee stated that she works with a food program called CDA. Licensee was advised that food brought from the children’s homes, all containers must be labeled with child’s name and properly stored or refrigerated. Licensee does not transport the children.

LPA toured the outdoor play area and inspected its safety and condition. LPA observed perimeter fencing which is free of miscellaneous debris/hazards. All trees, shrubs and plants are maintained. Outdoor play yard was observed to have toys for the children to play. Outdoor area was observed to have a play house and outdoor toys for the children. LPA observed plants that are not poisons and or sharp to the touch. All plants were barricaded with a kiddy gate.

Licensees’ records were reviewed. Immunization's were observed to be on file for licensee. The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. Pediatric First Aid and CPR expires on 12/16/24.

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: AGRAMON FAMILY CHILD CARE	FACILITY NUMBER: 198015064
	VISIT DATE: 05/29/2024

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
26
27
28
29
30
31
32

LPA did observe that Licensee to have proof of Mandated Reporter AB 1207 compliant Child Care Training Certificate on file for the department to review. www.mandatedreporterca.com. Licensees training expires 2/1/26.

LPA observed children’s records were reviewed, including emergency information, and were observed to be complete.

LPA created an LIC 857, Children’s Record Review, and LIC 811, confidential names which documents persons living in the home and children’s files reviewed during this inspection.

Per licensee, there are 2 dogs that are kept locked in the room that are on the premises.

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

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that fall into these categories are not permitted in a family childcare facility.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

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.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: AGRAMON FAMILY CHILD CARE	FACILITY NUMBER: 198015064
	VISIT DATE: 05/29/2024

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
26
27
28
29
30
31
32

Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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.

LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at www.ccld.ca.gov.

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&Rs) throughout California

During the exit interview, Licensee, Melisa Agramon, confirmed that there are no Registered Sex Offenders living in the facility.

Currently, the licensee, Licensee, Melisa Agramon is in compliance with California Code of Regulations Title 22. No deficiencies cited.

A notice of site visit was given and must remain posted for 30 days. Appeal rights were discussed and provided.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024

LIC809 (FAS) - (06/04)

Page: 4 of 4