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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020979
Report Date: 08/17/2023
Date Signed: 08/17/2023 02:04:04 PM

Document Has Been Signed on 08/17/2023 02:04 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:CUERVO-CHAVARRIA FAMILY CHILD CAREFACILITY NUMBER:
198020979
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 2CENSUS: 6DATE:
08/17/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Licensee Nicole Cuervo-ChavarriaTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA)Mary Silva conducted a Case Management - Licensee Initiated visit for the purpose of evaluating a request for a capacity increase from 8 to 14. LPA met with Licensee Nicole Cuervo-Chavarria who guided LPA on a tour. There are two adults and no minor children living in the home. LPA observed two children during this visit. Per Licensee, there are 6 children currently enrolled. The hours of operation are Monday through Saturday from 7:30 AM-5:30 PM. Fire clearance for a capacity of 14 was granted on 7/19/23.

All areas identified on the facility sketch were inspected. The facility is a one story 3 bedrooms,


2 bathrooms, kitchen, dining area, living room, daycare room(den), front yard, backyard, and garage. The areas accessible to children is a day care area in the den with a separate entrance for parents, 1 bathroom, kitchen and back yard. LPA observed a fireplace in the day care room barricaded. The areas inaccessible to children are 3 bedrooms, 1 bathroom, dining area, living room, front yard and garage.

The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. There are age-appropriate toys and equipment on the premises. Licensee stated there are no weapons or firearms in the facility. There is 1 dog on the premises. Per licensee, the dog is kept outside in off limits areas during daycare hours.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 07/12/23, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable on this day. Licensee has current CPR/First Aid certification, expires on 08/2024 and Mandated Reporter Training Certificate, expires on 01/2024. Page 1 of 3
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE: DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/17/2023
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CUERVO-CHAVARRIA FAMILY CHILD CARE
FACILITY NUMBER: 198020979
VISIT DATE: 08/17/2023
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days 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-andresources/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.
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee, Nicole Cuervo Chavarria confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CUERVO-CHAVARRIA FAMILY CHILD CARE
FACILITY NUMBER: 198020979
VISIT DATE: 08/17/2023
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At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited. The capacity increase request for a Large Family Child Care will be submitted for review. Once a capacity increase is issued, the Licensee is required to adhere to the terms and limitations as stated on the license.


A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Nicole Cuervo-Chavarria.


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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3