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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020589
Report Date: 05/05/2022
Date Signed: 05/05/2022 04:45:21 PM

Document Has Been Signed on 05/05/2022 04:45 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:MOTTA FAMILY CHILD CAREFACILITY NUMBER:
198020589
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
05/05/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Licensee, Olivia MottaTIME COMPLETED:
05:00 PM
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At 1:30 pm Licensing Program Analyst (LPA) Lilli Babcock conducted an unannounced Case Management – Licensee Initiated visit to the above facility for the purpose of evaluating the Licensee’s request for a capacity increase from 8 to 14. Fire clearance for a capacity of 14 was granted on 3/17/22. A risk assessment was conducted upon entry and appropriate COVID-19 Personal Protective Equipment was used during the visit. LPA met with Licensee, Olivia Motta, to whom the reason for the visit was explained. Per Licensee, there are 8 children currently enrolled. There was one child, an infant, present upon arrival. The licensee was observed to be operating within the license capacity limitations.

The licensee states that 4 adults and 4 children currently live in the home. Licensee has a dual license for foster care. All adults living in the home have obtained a criminal record clearance.

This is a two-story home. The first floor consists of 4 bedrooms, 3 bathrooms, kitchen, formal dining room, living room, dining area next to kitchen, family room, laundry room, garage, front yard, and backyard with in-ground swimming pool. The second story consists of one bedroom and an office.

Per licensee, areas off limits to children and parents currently include 4 bedrooms, 2 bathrooms, laundry room, garage, entire second floor consisting of one bedroom and an office, formal dining
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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE: DATE: 05/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/05/2022
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MOTTA FAMILY CHILD CARE
FACILITY NUMBER: 198020589
VISIT DATE: 05/05/2022
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room, living room and front yard. The children currently have access to kitchen, dining area in kitchen, family room, one bathroom, and backyard which is fenced.

Licensee is requesting to have formal dining room and living room made accessible to children.

Licensee guided analyst on a tour of the facility at 1:45 pm. During this visit, all areas identified on the facility sketch that are accessible to children to use were toured and inspected, as well as the formal living room and dining room which licensee is requesting be made accessible to children. The following was observed:

Facility License, Parent’s Rights Poster, and Earthquake Preparedness Checklist were observed to be posted in the entry way of the home. A current children’s roster was available for review.

There is telephone service via a cellphone and landline. Hours of operation are Monday through Sunday, 1 am – 12:59 pm. There is central air conditioning and central heating in the home. LPA observed a fireplace in the living room that has a glass screen and child-proof latch, making it inaccessible to children.

Detergents, cleaning compounds, and medications were observed to be inaccessible to children. Poisons are locked with a key lock in the shed in the off-limits area of the backyard, which has a locked fence between the accessible area for children. LPA advised that any poisons should be locked under key or combination lock. Licensee states that there are no firearms or weapons stored in the home.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022
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: MOTTA FAMILY CHILD CARE
FACILITY NUMBER: 198020589
VISIT DATE: 05/05/2022
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The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 3/8/22, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable.

All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. Last drill documented was conducted on 4/6/22.

The home is observed to be clean and orderly. There are first aid supplies available. There are age-appropriate toys available for children. Appropriate sleeping arrangements in form of a playpen were observed.

Licensee states that she is currently caring for one infant, aged 15 months. LPA Babcock observed a sleep log for the infant.

Currently, children are using the back yard for outdoor play time. The outdoor play area was observed to contain a built-in swimming pool. The fencing around the swimming pool measured 63 ½ inches tall. The gate swings away from the pool, however LPA observed the gate does not self-close and latch. LPA observed that the bottom of the fence to the soft grass surface is more than the 2-inch maximum per regulation. Licensee stated she will adjust the spring on the gate to make it self-close and latch and will add dirt under metal fence to make it no more than 2 inches from the ground to the bottom of the pool fence. LPA observed outdoor yard has toys and other materials for children to play with.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: MOTTA FAMILY CHILD CARE
FACILITY NUMBER: 198020589
VISIT DATE: 05/05/2022
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At 2:30 pm children’s records were reviewed, including emergency information and were observed to be complete.

At 2:40 pm Licensee and staff records were reviewed, including mandated reporter

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 7/25/22.

LPA observed that the Licensee does have proof of immunization record and the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file with expiration on 8/19/20. www.mandatedreporterca.com

LPA issued an LIC 857, Children’s Record Review, and LIC 859, Staff Record Review to the licensee which documents staff and children’s files reviewed during this inspection.

There is 1 dog and 1 cat on the premises. Per licensee, the dog and cat are kept in off limits areas during daycare hours.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, trampolines, Saucer Chairs, and/or any other item that fall into these categories are not permitted in a family child care facility.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: MOTTA FAMILY CHILD CARE
FACILITY NUMBER: 198020589
VISIT DATE: 05/05/2022
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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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

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 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.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: MOTTA FAMILY CHILD CARE
FACILITY NUMBER: 198020589
VISIT DATE: 05/05/2022
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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.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No citations were being issued today. The capacity increase request for a Large Family Child Care will be submitted for review. Once a capacity increase is issued, the Licensees are required to adhere to the terms and limitations as stated on the license.



Exit interview conducted and report was reviewed with the licensee Olivia Motta.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022
LIC809 (FAS) - (06/04)
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