198019635-5-6-2022-33-CC-STUG-CE6U89-20220506152110

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019635
Report Date: 05/06/2022
Date Signed: 05/06/2022 03:21:26 PM

Document Has Been Signed on 05/06/2022 03:21 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	ANGELICOLA FAMILY CHILD CARE		FACILITY NUMBER:	198019635
ADMINISTRATOR:	CHIARA ANGELICOLA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(831) 345-0362
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90029
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 12	CENSUS: 9	DATE:	05/06/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:51 AM
MET WITH:	Chiara Angelicola - Licensee		TIME COMPLETED:	03:40 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	At 11:51AM, Licensing Program Analyst (LPA) Steven Tung conducted an unannounced annual inspection. A risk assessment was conducted prior to entering the facility. Due to COVID- 19 precautionary measures were taken, licensing staff present during inspection wore appropriate personal protective equipment. LPA met with licensee Chiara Angelicola who guided analyst on a tour of the facility. The licensee's 2 assistants, Staff #1 and Staff #2, were present. There were 9 children present. Licensee states that there are currently 12 children enrolled. This is a one-story home which consists of 2 bedrooms, 2 bathrooms, kitchen, 2 living rooms, permitted ADU with separate address, and backyard (fenced). The children use the bathroom in the hallway next to the living room. LPA observed a washer and dryer in the hallway closet next to the bathroom of the main day care area. Applicant had latches on cabinets with any potentially hazardous material. Per licensee, areas off limits to children and parents include: the master bedroom, master bathroom, bedroom, and permitted ADU. Licensee provided an updated facility sketch and Parent Handbook (2022-2023) to LPA. The LPA toured all areas used by children during this visit. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for safety and comfort. There were safe toys, play equipment and materials observed for children. There is a working telephone service maintained in the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. Licensee states that there are no poisons in the home. The licensee does understand that poison must be locked with a key or combination lock. Page 1

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Steven Tung
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2022

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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Document Has Been Signed on 05/06/2022 03:21 PM - It Cannot Be Edited

Created By: Steven Tung On 05/06/2022 at 02:10 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
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ANGELICOLA FAMILY CHILD CARE	FACILITY NUMBER: 198019635
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/06/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102370(d)(1)

Criminal Record Clearance

(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in 1 out of 2 staff members in that Staff #1's criminal background was not cleared and Staff #1 was not associated to the facility which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 05/13/2022
	Plan of Correction
1 2 3 4	After LPA deteremined that Staff #1 was not cleared and associated, Licensee had Staff #1 immediately vacate the facility premises. Licensee registered for Guardian and submitted necessary paperwork to have Staff #1 cleared and associated to the facility. Licensee will have parents of each enrolled child (and those who will enroll within the next 12 months of this report date) fill out and sign a LIC 9224 and email each copy to LPA by POC Due Date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Brandi VanOosten

LICENSING EVALUATOR NAME:

Steven Tung

LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2022

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ANGELICOLA FAMILY CHILD CARE	FACILITY NUMBER: 198019635
	VISIT DATE: 05/06/2022

NARRATIVE

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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.

Per licensee, there are no weapons or firearms on the premises. Children’s records were reviewed to ensure that each child has an Identification and Emergency form. At 12:22PM, LPA observed the required 2A 10BC fire extinguisher to be expired. Per Licensee, there was current proof of service.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

SB792 (Immunization Requirements for Staff and Employees) was discussed with the Licensee. The Licensee does have immunization documentation.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018 any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers .

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Steven Tung
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2022

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ANGELICOLA FAMILY CHILD CARE	FACILITY NUMBER: 198019635
	VISIT DATE: 05/06/2022

NARRATIVE

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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.

· The Licensee shall be present in the home and shall ensure that children are supervised at all times.
· Children shall not be left in park vehicles.
· The capacity specified on the license shall be the maximum number of children for whom care can be provided.
· Car seats shall only be used for transportation purposes and shall not be used for sleeping.
· All children in care have the right to receive safe, healthful, and comfortable accommodations, furnishings and equipment.
· When a child shows signs of illness, they will be separated from other children until the nature if the illness is determined.

LPA reviewed Forms/Records to Keep in Your Family Child Care Home. Children’s Forms/Records, Facility Forms/Records and Information to be posted, disaster drills, posting requirements, children records requirements, mandated child abuse and injury/death reporting, and criminal record transfer requirements were discussed.

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

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Steven Tung
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2022

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ANGELICOLA FAMILY CHILD CARE	FACILITY NUMBER: 198019635
	VISIT DATE: 05/06/2022

NARRATIVE

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LPA Steven Tung informed licensee Chiara Angelicola that this report dated 5/6/2022 documents 1 Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Steven Tung informed the licensee to provide a copy of this licensing report dated 5/6/2022 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with the licensee Chiara Angelicola.

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/ction-process.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Steven Tung
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2022

LIC809 (FAS) - (06/04)

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