198020741-3-17-2021-33-CC-JMOA-BZ7R7W-20210317124700

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020741
Report Date: 03/17/2021
Date Signed: 03/17/2021 12:47:36 PM

Document Has Been Signed on 03/17/2021 12:47 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:	GALLARDO FAMILY CHILD CARE		FACILITY NUMBER:	198020741
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	03/17/2021
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Gabriela Gallardo		TIME COMPLETED:	01:00 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	This was an announced pre-licensing inspection conducted by Licensing Program Analyst (LPA) Judy Mora. Due to COVID-19 and precautionary measures, this pre-licensing inspection was conducted with Applicant Gabriela Gallardo, via a tele-inspection by use of Zoom. LPA confirmed with applicant those residing in the home consists of herself and the applicant's biological child. The applicant has obtained a criminal record clearance. The applicant will operate from Monday through Friday, from 8:00 AM to 06:00 PM. During this tele-inspection the Applicant took this LPA on a tour of the home. During this tour, the following was noted: At 11:10 am, LPA was toured through the interior and exterior of the home. This is a one- story home which consists of 3 bedrooms, 2 bathrooms, living room, dining area, kitchen, backyard (fenced), and garage. LPA did not observe any hazards inside of the home. LPA observed appropriate equipment and toys for children. LPA observed outlets to have covers and/or be child proof. Latches observed on kitchen cabinets making hazardous items inaccessible to children. There is a fire extinguisher (serviced on 01/31/21) located in the kitchen area. There is a first aid kit located in the laundry area. There are smoke detectors throughout the home and carbon monoxide detector in the living room. The backyard will be used for day care space. Backyard is adequately fenced and there is no swimming pool, spa or other bodies of water observed on the premises. There are age appropriate toys and play equipment on site. The front yard will remain off-limits to children. Children will be dropped off at front entrance and health checks will be conducted for Covid precautionary measures. All areas identified on the facility sketch were inspected. Areas that are accessible to day care children: Living room, dining area, (1) restroom, and backyard (fenced). Off-limits/inaccessible to day care children: 3 bedrooms, attached garage and 1 bathroom. *REPORT CONTINUES ON NEXT PAGE

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Judy Mora
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2021

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: GALLARDO FAMILY CHILD CARE	FACILITY NUMBER: 198020741
	VISIT DATE: 03/17/2021

NARRATIVE

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**Rooms that are off-limits need to be made inaccessible during operating hours** The applicant does understand that licensing staff may have access to off-limit areas during inspection visit if necessary.

Infant Care: Applicant states that she will care for infants. LPA advised the applicant to sleep infants where the infant can be directly supervised and advised against sleeping infants in a separate room. LPA reviewed safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. Safe sleep concepts were provided.

The applicant does have proof of Health and Safety training which includes Lead Prevention Training. Pediatric First Aid and CPR (expires on 08/28/22). The applicant has proof of immunization against influenza, pertussis, and measles. Applicant completed required mandated reporter training. Mandated reporter training must be completed every 2 years. www.mandatedreporterca.com

LPA emailed applicant Safe Sleep Concepts, Capacity Handout (Small & Large), and information regarding best practices to maintain safe and healthy environment during COVID-19 health crisis.

This home currently meets the description of a safe and healthy environment for children as described in Chapter 1, Division 12, Title 22 of California Code of Regulations and the facility will be submitted for approval for a small family child care license. LPA reminded applicant to adhere to capacity limitations and conditions listed on the license.

Exit interview was conducted with Applicant Gabriela Gallardo, via tele-inspection. A copy of this report will be emailed with a read receipt or confirmation of receipt of email, which will act as the Applicant’s signature. Applicant will also sign report and mail to the Department.

*END OF REPORT

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Judy Mora
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2021

LIC809 (FAS) - (06/04)

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