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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018639
Report Date: 04/04/2022
Date Signed: 04/04/2022 03:49:23 PM

Document Has Been Signed on 04/04/2022 03:49 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:TRUJILLO FAMILY CHILD CAREFACILITY NUMBER:
198018639
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
04/04/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:14 PM
MET WITH:Maria Trujillo, LicenseeTIME COMPLETED:
04:10 PM
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On Monday, April 4 2022 at 1:14 PM, Licensing Program Analyst (LPA) Mayra Rivera conducted an unannounced case management for a capacity increase inspection and met with Licensee Maria Trujillo who guided LPA Rivera on a tour of the facility.

During the inspection, 4 children were present. LPA Rivera observed the child playing in the living room. Family members residing in the home has been discussed with licensee and are cleared. Operating hours are Monday to Sunday 12:00 AM to 11:59 PM and care for children ages 0 to 12 years.

This facility is a one story home that consists of 3 bedrooms, 1 bathroom, kitchen, living room and front yard (fenced and gated). Areas that are accessible to children and identified on the facility sketch were inspected by LPA Rivera; living room, kitchen, bathroom and front yard.

Areas off limits to children include 3 bedroom, and backyard.

At approximately 1:20 PM LPA Rivera entered the facility to inspect for safety, comfort, cleanliness, ventilation and working phone (cell phone). For ventilation, LPA Rivera observed wall AC unit and for heater LPA observed portable fan in the bedroom and LPA informed the portable heater must be inaccessible to children. LPA Rivera observed a wall heater and per licensee, the wall heater is disconnected and not working. LPA observed a furniture and children materials to be in good condition and age appropriate.

At approximately 1:27 PM, LPA Rivera entered the restroom and observed the toilet, hand washing sink, hand washing soap and toilet paper. LPA observed bottom cabinet with child proof lock and did not observe hazards in the restroom and observed the restroom to be in good condition.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE: DATE: 04/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/04/2022
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: TRUJILLO FAMILY CHILD CARE
FACILITY NUMBER: 198018639
VISIT DATE: 04/04/2022
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At approximately 1:30 PM LPA observed cleaning compounds items stored inside the bottom kitchen sink cabinet. LPA observed child proof lock in place making it inaccessible to children to open the bottom sink cabinet. Knives and sharp objects, LPA observed the items inside the kitchen drawer with child proof locks making it inaccessible for children to open the drawers. For drinking water, licensee provides sippy cups and water bottles.

LPA Rivera asked if there are any pets, poisons, firearms, weapons or bodies of water. Licensee stated she has no pets and no body of waters, firearms, weapons or poisons. LPA did not observe pets, firearms, weapons, poisons nor bodies of water. Licensee was advised that if any poisons (ex; drano, rat poison or items with skull hazard symbol), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately. Licensee understands that any poisons or firearms must be locked with a key or combination lock.



At 1:35 PM LPA Rivera observed the required 2A10BC fire extinguisher located in the living room and the valve on the green area indicating fully charged and serviced on 4/23/21. LPA observed the smoke detector in the living room and the carbon monoxide detector in the hallway and tested and heard the sound of the detectors. The smoke and carbon detectors are operable. LPA observed the emergency drill log with last drill conducted on 3/29/22.

At approximately 1: 45 PM, LPA Rivera inspected the outdoor area used by children for safety, comfort and cleanliness. LPA observed trees and provides adequate shade. LPA observed play equipment to be in good condition and age appropriate. LPA observed a baby walker and informed licensee baby walkers are not allowed in daycare. Licensee removed the baby walker.

LPA observed licensee Pediatric First Aid/ CPR certification with expiration date 4/5/2023 . Licensee has proof of immunization against Pertussis, MMR and Influenza. Licensee has completed the mandated reporter (AB 1207) training on 2/27/21. and the 8 hour health and safety on 6/27/2016. Licensee was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

At approximately 1:55 PM LPA reviewed the children roster, and observed LIC 610A Emergency disaster plan, PUB 394 parents rights and child #1 file. LPA did not observe safe sleep log for child #1 and LPA Rivera provided LIC 279b to add her minor children.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2022
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: TRUJILLO FAMILY CHILD CARE
FACILITY NUMBER: 198018639
VISIT DATE: 04/04/2022
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Safe Sleep: LPA discussed the safe sleep regulations with licensee Maria Trujillo 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 Maria Trujillo of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at also explained to licensee that car seat, stroller are only and only for 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 Rivera also reviewed Sudden Infant Death Syndrome (SIDS), Never Shake A Baby, and Lead Exposure information with licensee. Car seats is only used for transportation, highchair is only and only for feeding and stated items cannot be misused. No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into this category are not permitted in a family child care facility.



Medication: Incidental Medical Services (IMS) policy was discussed with Licensee Maria Trujillo. 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 Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Criminal Record Statement: Licensee Maria Trujillo 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 Rivera will recommend the increase in capacity (14) as the licensee meets requirements for an increase and fire clearance approved on 3/15/22 for 14 children. Technical violation were given during the visit for baby walker and for not having safe sleep log. Baby walker removed during visit and safe sleep log due date 4/8/22.


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

Exit interview conducted and report was reviewed with the licensee Maria Trujillo.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2022
LIC809 (FAS) - (06/04)
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