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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017766
Report Date: 02/24/2023
Date Signed: 02/24/2023 10:13:51 AM

Document Has Been Signed on 02/24/2023 10:13 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:AVENDANO FAMILY CHILD CAREFACILITY NUMBER:
198017766
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 7CENSUS: 4DATE:
02/24/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Licensee Beatriz AvendanoTIME COMPLETED:
10:20 AM
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On 2/24/2023 Licensing Program Analysts (LPAs) Jeanette Estrada and Austin Estrada conducted an unannounced required 1 year inspection at the above facility. LPAs met with Licensee Beatriz Avendano and informed her of the purpose for the visit. LPAs provided Licensee with a copy of the Facility Entrance Checklist. This facility is also pending an increase in capacity. The approved fire clearance for a capacity of 14 was received on 2/15/23. During this inspection, there were 4 children and one additional staff present. The facility is in compliance for a small family child care home. All residents were noted and verified. All criminal record clearances for adults present were verified. Facility provides care to children ages 2 months to 8 years old and the facility operates Monday through Friday 7AM to 6 PM.This is a two bedroom, one bathroom home with a living room, dining room, kitchen backyard and fenced front yard. Per Licensee areas on limits to children are: The living room used as the main day care area, one bedroom which leads to the on limits bathroom and the fenced front yard. Per Licensee areas off limits to children are: One bedroom, kitchen and backyard.
All areas that are accessible to children were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection: LPAs observed required posted documentation- Facility license, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form, LIC 9040 Facility Roster and a disaster drill log. Licensee had a current copy of the facility roster and the last documented disaster drill was conducted on 2/1/23. There is an operable smoke detector and an operable carbon monoxide detector in the facility. LPA observed a 2A10BC Fire Extinguisher in the facility which indicated full and was purchased on 2/4/23. There is also a fire alarm in the home. There is a wall heater in the home which is not in use and it is blocked. Per Licensee, a portable heater is used when needed. There is a wall mounter A/C unit in the home as well. The home maintains telephone service (landline and cell phone). Food is provided by Licensee. Licensee was reminded if children bring food from home it must be labeled with the child’s name and properly stored or refrigerated. There are toys and other age appropriate materials available for children to use in the day care room. Sharp objects, detergents and cleaning compounds in the kitchen were inaccessible to children in care. Knives are kept in an upper kitchen cabinet and cleaning compounds are kept in a latched cabinet under the sink.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 02/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/24/2023
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: AVENDANO FAMILY CHILD CARE
FACILITY NUMBER: 198017766
VISIT DATE: 02/24/2023
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Page 2 LPA observed safety knobs on the kitchen stove. Per Licensee, personal medication is kept in a latched cabinet in the bathroom. Per Licensee, none of the children enrolled require medication.
Children use the bathroom that is connected to the on limits bedroom. LPA observed latched cabinets that contain personal items and cleaning supplies. Per Licensee, the children only walk through the bedroom to get to the bathroom. Per Licensee, the bedroom is also used as the isolation room in case a child becomes ill and is waiting to be picked up. Children use the fenced front yard for outdoor play. LPA observed age appropriate toys and materials for children. Per Licensee, children are supervised while playing outside.
Per Licensee there are no poisons in the home. Licensee was advised that all poisons must be locked, not only inaccessible to children. Per Licensee, there are no firearms or weapons stored in the home. There are no pools or spas, or other bodies of water.
Infant Care: Currently licensee cares for two infants. LPA observed one crib in the facility. Licensee has two additional play yards available. LPA observed that napping equipment does not block entrances or exits. Infant mattresses were observed to be firm with tightly fitted sheets. LPA did not observe loose object, bumpers, objects hanging, or objects attached to the cribs. Each infant has their own crib/ napping mat and bedding. LPA observed sleeping logs for infants enrolled.
Overnight Care: There is no overnight care provided at the moment. LPA discussed the following in case overnight care is provided: Licensee is aware that they must remain wake while children are awake. If children sleep in separate area from licensee, the door must remain open. If licensee cannot hear children when they wake up, video or audio device can be used.
Children’s records were reviewed and included (LIC) 282- Affidavit Regarding Liability Insurance, Immunizations Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, LIC 9227- Individual infant sleep plan form (0-12 months, and documentation of 15-minute Infant Sleep Check (0-24 months). Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC-501: Personnel Record, LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement of Child and Mandated Reporter Training Certificate.
Licensee and Staff 1 have Pediatric First Aid/CPR certification issued by the American Red Cross. Licensee's certification expires on 6/2/2024 and Staff 1's expires on 12/9/2024. Licensee and Staff 1 have completed the Mandated Reporter for Child Care Provider's training. Licensee's certificate expires on 7/15/23 and Staff 1's certificate expires on 12/29/2024. Both staff have proof of required immunization against pertussis, measles and flu and proof of TB clearance.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: AVENDANO FAMILY CHILD CARE
FACILITY NUMBER: 198017766
VISIT DATE: 02/24/2023
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During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.Incidental Medical Services (IMS):
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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm
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.
LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleephttps://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.
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.No deficiencies are being cited today.A Large family child care home license will be granted upon Department approval. Once licensed, the Licensee is required to comply with the terms and limitations stated on the license.
Exit interview conducted and report was reviewed with the Licensee, Beatriz Avendano. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023
LIC809 (FAS) - (06/04)
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