198020569-7-27-2021-33-CC-FVAZ-C5BQKS-20210727121448

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020569
Report Date: 07/27/2021
Date Signed: 07/27/2021 12:15:22 PM

Document Has Been Signed on 07/27/2021 12:15 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:	MONROE FAMILY CHILD CARE		FACILITY NUMBER:	198020569
ADMINISTRATOR:	BRIA MONROE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 298-5201
CITY:	TEMPLE CITY	STATE: CA	ZIP CODE:	91780
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 6	DATE:	07/27/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Bria Monroe		TIME COMPLETED:	12:30 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	Licensing Program Analyst (LPA) Fabiola Vasquez contacted the facility via telephone due to COVID-19 and precautionary measures LPA conducted the screening procedures and received the clearance to go into facility at 09:30. LPA conducted an unannounced random inspection. LPA met with licensee, Bria Monroe who guided analyst on a tour of the facility. Present were Licensee and 2 children, Per Licensee S1 was on a walk with 3 children. Shortly after S1 returned with 3 children., at the same time C4 walked in with the parent. Licensee states that there are currently 10 children enrolled. Days and hours of operation are seven days a week, 24 hours a day for less than 24 hours care. The Licensee is within the conditions, limitations, and capacity specified on the license. The children's roster was reviewed and is current. Licensee is the only adult residing in the home (criminal record clearances on file), LPA observed two pet dogs during the inspection. Per licensee one of the dogs belongs to the mother and comes to visit. Dogs are keep in the Licensee's bedroom. This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, living room (Fireplace inaccessible), garage that has been converted to a playroom, front yard and backyard (fenced). On 6/14/21 Licensee reported to CCLD the renovation of the garage. LPA advised licensee that children can not eat or sleep in the converted garage. It can only be used only as a play room. LPA provided an LIC 999A form to licensee for an update. Areas accessible to children were inspected as follows: Kitchen, living room, dinning room, two bedrooms, 1 bathroom, back yard, and the converted garage. Areas off limits include: One bedroom, One bathroom located at the end of the left side of the hallway, and front yard. Rooms that are off-limits need to be made inaccessible during operating hours PAGE 1 OF 4

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Fabiola Vasquez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2021

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MONROE FAMILY CHILD CARE	FACILITY NUMBER: 198020569
	VISIT DATE: 07/27/2021

NARRATIVE

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Areas accessible to children were inspected to ensure that they are clean and orderly. The facility has central ventilation and heating (LPA did not observe a wall heater) for safety and comfort. There were safe toys, play equipment and materials observed for children. LPA did not observe stairs. 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. The licensee does understand that poison must be locked with a key or combination lock.
There are safe toys, play equipment and materials observed for children.
Per licensee she is not caring for infants 0-12. She is caring for infants 12 to 24 months. LPA observed and inspected sleeping equipment. LPA did not observed any cribs or play yards.

Licensee was advised and provided the LIC 9227 (Individual Sleeping Plan) for infants up to 12 months was explained along with PIN 20-24-CCP was issued to the Licensee. Title 22 Regulation Section 102425(j) Infant Safe Sleep was discussed with the Licensee, including but not limited to documentation that shall be maintained.

Rooms that are off-limits need to be made inaccessible during operating hours. No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility. Car seats shall only be used for transportation purposes and shall not be used for sleeping.

Per licensee, there are no weapons, firearms or bodies of water on the premises. LPA observed one large inflatable pool and two small hard plastic pools. LPA did not see any bodies of water inside the pools. Licensee was advised that the water has to be taken out immediately after each use. Children’s records were reviewed to ensure that each child has an Identification and Emergency form. The valve on the required 2A 10BC fire extinguisher indicates fully charged purchased 7/15/21 receipt attached. Smoke detector and carbon monoxide detector in the hallway were tested, and are in operable condition. The licensee has current Pediatric First Aid and CPR, which will expire 05/22.

Proof of immunization against influenza, pertussis, and measles for the Licensee and Assistants was readily available during today’s inspection.
Licensee has also taken the Mandated Reporter Training.
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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Fabiola Vasquez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2021

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MONROE FAMILY CHILD CARE	FACILITY NUMBER: 198020569
	VISIT DATE: 07/27/2021

NARRATIVE

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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 Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
SB792 (Immunization Requirements for Staff and Employees) was reviewed and discussed with the Licensee.
AB1207 Mandated Child Abuse Reporting – was reviewed and discussed, 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 Licensee completed training on .

The following was discussed:
Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty. 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 off illness, they will be separated from other children until the nature if the illness is determined. Effective January 1, 2010, licensees of family child care homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.

LPA reviewed and issued the LIC 311 - 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.

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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Fabiola Vasquez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2021

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MONROE FAMILY CHILD CARE	FACILITY NUMBER: 198020569
	VISIT DATE: 07/27/2021

NARRATIVE

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LPA provided a Safe Sleep Awareness Campaign (PIN) 19-02-CCP dated February 20, 2019 packet, Never Shake a Baby (Pub 271), A Child Care Providers Guide to Safe Sleep (SIDS) American Academy of Pediatrics and California Child Passenger Safety Law during today’s inspection. PIN 21-02-CCLD Updates to the implementations of guardian.

The licensee’s email address was obtained during this visit. The licensee was advised that email is public information.
LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

Exit interview was conducted with Licensee. The Licensee was provided a copy of the report and their appeal rights (LIC 9058) their signature on this form acknowledges receipt of these forms.

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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Fabiola Vasquez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2021

LIC809 (FAS) - (06/04)

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