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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020101
Report Date: 05/03/2024
Date Signed: 05/03/2024 03:21:27 PM

Document Has Been Signed on 05/03/2024 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:ARAYA FAMILY CHILD CAREFACILITY NUMBER:
198020101
ADMINISTRATOR/
DIRECTOR:		ANGELA ARAYAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 212-8601
CITY:LAKEWOODSTATE: CAZIP CODE:
90713
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
05/03/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:50 AM
MET WITH:Licensee Angela ArayaTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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 Licensing Program Analysts (LPAs) Jonnisha Culbert and Jeanette Estrada conducted an unannounced random/annual inspection at the facility noted above and met with Licensee, Angela Araya. The operating hours of the facility is Monday through Friday from 7:00 AM to 5:00 PM. Entrance Checklist (LIC 126) was provided to the Licensee upon arrival. Individuals residing in the home were discussed and noted. At the time of the inspection, the Licensee, Licensee's husband/Assistant (S1), Staff (S2) and ten children were present. All adults present have obtained a criminal record clearance or exemption.

LPAs were guided by licensee on a tour around the facility. This facility is a single family home that consists of three (3) bedrooms, one (1) bathroom, living room, dining room, kitchen, enclosed patio (located in backyard), detached garage, and fenced backyard.

Areas that are accessible to children include: two (2) bedrooms, 1 bathroom, living room, dining room, kitchen, enclosed patio, and fenced backyard. Per Licensee, the children utilize the fenced backyard and front yard for outdoor activity. Licensee was advised that direct visual supervision must be provided at all times while using the front yard for outdoor activity.

Areas off-limits to children include: 1 bedroom, and detached garage. LPAs observed the door to the off-limit bedroom closed, making the area inaccessible to children in care. LPAs also observed the inside of the garage inaccessible to children in care. Licensee was advised that off-limit areas must be made inaccessible during operating hours or while children in care are present.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE: DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/03/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ARAYA FAMILY CHILD CARE
FACILITY NUMBER: 198020101
VISIT DATE: 05/03/2024
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The following documents were posted, Facility License, Notification of Parents' Rights (PUB 394), Earthquake Preparedness (LIC 9148), Emergency Disaster Plan (LIC 610A), and Facility Roster (LIC 9040). Licensee also had verification of Disaster and Fire Drills posted. The last documented drill was conducted on February 15,2024.

Areas used by children were inspected for safety, comfort, heating, cleanliness and telephone service. The home does not have any wall heaters or fireplaces. The home is equipped with central air and heating. Detergents, cleaning compounds, and medicines were made inaccessible to children. Per Licensee, poisons are kept in the garage. Licensee was advised that if any poisons are purchased, it is required to be locked with a key or combination lock.

Per Licensee, the home has 1 dog. Per Licensee, there are no bodies of water, firearms, or weapons on the property. LPAs observed age appropriate toys, napping mats, and two play yards. At the time of visit, LPAs observed both play yards in use by child 1 and child 2. LPAs observed Child 2 in a play yard in the front room. LPAs observed door was left shut not entirely closed and door was not left open enough for visual observation. LPAs advised licensee that room door should remain open during naps. Upon entering the room, LPAs observed Child 2 was covered with a blanket. LPAs immediately advised licensee to remove blanket from play yard and informed licensee of safe sleep regulations. Licensee immediately removed blanket. Child 1 was also observed in the kitchen with a blanket covering them. LPAs advised licensee to remove blanket from Child 1. Licensee was provided with a copy of regulation 102425 infant safe sleep.
Per Licensee, snacks and meals are provided to the children by the facility and that one child in care has an allergy to peanuts and egg and one child has a vegan diet and parent provide meals. Licensee was reminded that any food that is brought from the child's home shall be labeled with the child’s name and properly stored or refrigerated.

LPAs observed the required fire extinguisher (2-A:10-B:C) that is fully charged. Licensee provided evidence of purchase by receipt with a receipt date of 05/03/2024. Licensee was reminded to have the fire extinguisher serviced yearly. Smoke detector and carbon monoxide detector was not tested during inspection due to children sleeping.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024
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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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ARAYA FAMILY CHILD CARE
FACILITY NUMBER: 198020101
VISIT DATE: 05/03/2024
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LPAs conducted a record review of nine children's records, and 3 personnel records. Based on the children's record review, the children's records had all of the required documents per licensing regulations. Based on the personnel record review, Staff 2 did not have proof of immunization for measles and pertussis (or documentation of exemption), and a TB clearance (or risk assessment). Mandated reporter training for Staff 1 expires 10/25/24 and licensee's expired 04/14/2024. Per licensee Staff 2 did not take mandated mandated reporter training prior to employment. LPA's advised licensee to have Staff 2 complete mandated reporter training and that the training is available in Spanish. LPAs checked staff records for current Pediatric First Aid, and Child/infant CPR. Licensee has training that does not state Pediatric First Aid and Staff 1 and Staff 2 does not have Pediatric, First Aid, and CPR training. Licensee was advised that training should state Pediatric, First Aid, and Child/Infant CPR and be EMSA approved.

Currently Licensee does have infants enrolled. LPA discussed the safe sleep regulations with the 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. 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.
LPAs 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.
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
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024
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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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ARAYA FAMILY CHILD CARE
FACILITY NUMBER: 198020101
VISIT DATE: 05/03/2024
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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 informed of the Mychildcareplan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and resource and referral agencies (R&Rs) throughout California.
During the exit interview, the Licensee Angela Araya confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO in FAS.
California Code of Regulations, (Title 22, Division 12, Chapter 1), are being cited on the attached LIC 809 D


The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
Appeal rights provided to Licensee.
Exit interview was conducted and report reviewed with the Licensee (or facility representative), Angela Araya.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024
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Document Has Been Signed on 05/03/2024 03:21 PM - It Cannot Be Edited


Created By: Jonnisha Culbert On 05/03/2024 at 02:31 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ARAYA FAMILY CHILD CARE
FACILITY NUMBER: 198020101

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/03/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(g)
Infant Safe Sleep
An infant’s head shall not be covered while sleeping.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in 1 out of 2 infants present. LPA's Child 2 head covered with a blanket upon entering the room which poses a potential safety risk to persons in care.
POC Due Date: 05/03/2024
Plan of Correction
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Licensee immediately removed blanket from play yard.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Valarie Cook
LICENSING EVALUATOR NAME:Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2024


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