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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021127
Report Date: 02/10/2023
Date Signed: 02/10/2023 01:31:24 PM

Document Has Been Signed on 02/10/2023 01:31 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:THAMAS FAMILY CHILD CAREFACILITY NUMBER:
198021127
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
02/10/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:37 AM
MET WITH:Applicant Sandra ThamasTIME COMPLETED:
01:50 PM
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This inspection was conducted in Spanish

Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an announced Pre-Licensing inspection at the above facility on 02/10/23 at 08:37AM. A COVID-19 risk assessment was conducted at the facility. The purpose of the visit is to inspect and evaluate the facility for initial licensure, applicant Sandra Thamas is applying for a Small Family Child Care Home license. Applicant guided LPA on a tour of the facility. Pre-licensing Entrance Checklist (LIC9280) was provided to applicant, Sandra Thamas. Operation hours will be Monday through Friday 07:30AM to 06:00PM. Applicant states she will care for children 3 months-through school age.

All areas identified on the facility sketch were inspected, including but not limited to, off limit areas.

This is a 3-story underground home which consists of 4 bedrooms, 3 ½ bathrooms, family room with balcony, living room with balcony, dining room with balcony, kitchen, front yard (fenced), a 2-level back yard (fenced), and attached garage (converted into a playroom). Stairs going to the 2nd level of the home has a gate making it inaccessible to children. Children will be walking through the 2nd level of the home to go to the back yard. Applicant understands that all off limit rooms must always have doors closed and supervision at all times. During this inspection individuals who reside in the home were discussed and noted on Confidential Name List (LIC811) and attached to this report.

• Day care areas: entire 1st level which consists of playroom (converted garage), kitchen, family room, living room, dining room, ½ bathroom, front yard (fenced), and 1st level back yard (fenced) located on the 3rd level of the home. Applicant understands that the playroom (converted garage) does not have a permit and cannot use the playroom for napping or eating. Applicant understands that the playroom can be used only for additional play space, but day care must take place in the home.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE: DATE: 02/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/10/2023
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: THAMAS FAMILY CHILD CARE
FACILITY NUMBER: 198021127
VISIT DATE: 02/10/2023
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• Off limit areas: balconies located on the 1st level connected to the family room, living room, and dining room. Entire 2nd level which consists of 4 bedrooms, 3 bathrooms, and 2nd level back yard (fenced) located on the 3rd level of the home. Applicant has a Jacuzzi located on the 2nd level back yard (fenced) with a cover on top of the jacuzzi making it inaccessible to children. There is a gate located between 1st and 2nd level of the back yard (fenced) making it inaccessible to children. LPA observed all balcony doors to be locked. LPA observed a side entrance with stairs from the 1st level of the home with a gate located at the bottom of the stairs which leads to the back yard making it inaccessible to children. LPA took pictures of the back yard. The applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary.

Day care children and parents will enter through front gate (fenced) which leads to the day care home. Areas that will be used by children were inspected for safety, comfort, cleanliness. Front yard (fenced) was observed to have age-appropriate play equipment, floor is covered with artificial grass and the structure of the home provides some shade for children. LPA observed an Aloe Vera plant in the front yard. Applicant understands that the Aloe Vera plant must be removed. Back yard (fenced) was observed to have an awning on top to provide shade for children and floor is covered with artificial grass. LPA observed lamps on top of cement beams with lose screws. LPA observed sleeping equipment: play yard and cots. LPA observed a changing table. Per applicant, children will be napping in the family room, and living room/dining room (connected and on the 1st level). Ill children will be Isolated from other day care children in the family room until parent arrives. LPA observed a fireplace with a glass window door attached with a child latch located in the living room making it inaccessible to children. Per applicant, the fireplace is not working.

Telephone service is via cell phone and applicant will ensure there is always a phone available. There is central air and heat.

There are outlet covers throughout the home. Detergents, cleaning compounds, medicines, sharp objects, and hazardous items that can pose a danger to children were observed to be inaccessible to the children. Applicant placed locks throughout the home. Per Applicant, there are no poisons on the premises. The applicant was advised that any poisons must be locked with a key or combination lock.

The 2A-10BC fire extinguisher was fully charged and was purchased on 01/08/23 per the proof of purchase receipt.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2023
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: THAMAS FAMILY CHILD CARE
FACILITY NUMBER: 198021127
VISIT DATE: 02/10/2023
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Applicant was advised that the Fire Extinguisher must be serviced yearly or purchase a new one and keep receipt. At 09:11AM the combined smoke and carbon monoxide detector were tested and are in operable condition.

The applicant states she will not provide food but will provide snacks to children. Lunch will be provided by parents, containers shall be labeled with child’s name and properly stored or refrigerated.

The applicant has completed the required Health and Safety Training, Nutrition Training and Pediatric First Aid and CPR expires 12/20/24. There are first aid supplies and earthquake equipment available located inside the playroom (converted garage).

There are no pets on the premises.

The following was discussed with the applicant:

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR training, Immunization (TDAP, MMR,TB, and Influenza), mandated reporter training and a valid criminal record clearance associated to the facility license.

• Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License may be terminated.

• The fire extinguisher type 2A-10BC must be serviced annually or purchased annually.

• Smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.

• Reporting Requirements: Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2023
LIC809 (FAS) - (06/04)
Page: 3 of 7
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: THAMAS FAMILY CHILD CARE
FACILITY NUMBER: 198021127
VISIT DATE: 02/10/2023
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• Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. LIC624B was provided

• Fire and safety drills must be performed every six months and documented for review by the Department.

• Smoking is prohibited in a family childcare home.

• Children and Staff records must be maintained and updated as needed and must be available for review by the Department.

• No infant walkers, No Johnny jumpers, No saucer chairs, and any other item that falls into that category are not permitted in the facility.

• The facility license number must be on all advertisements, publications, or announcements with the intent to attract clients.

• Isolation for ill children: When a child is ill, he/she shall be separated from other children (reference 102417(e) Operation of a Family Child Care Home).

• Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information.

Per applicant, there are no firearms or weapons.

Inspection Authority: All adults living and working in the home shall be made of aware of the Departments right to inspection the home, which includes, but is not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.

Immunization Requirement: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The applicant has proof of immunizations.

Mandated Reporter Training: H&S 1596.8662: Beginning January 1, 2018, all licensed providers, applicants, directors, and employees to complete training as specified on mandated reporter duties. Mandated Reporter Training must be taken every two years. Training is available at: www.mandatedreporterca.com

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2023
LIC809 (FAS) - (06/04)
Page: 4 of 7
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: THAMAS FAMILY CHILD CARE
FACILITY NUMBER: 198021127
VISIT DATE: 02/10/2023
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Infant Care: Applicant states that she will care for infants. LPA discussed and provided the applicant with a copy of the Child Care Provider’s Guide to Safe Sleep, Never Shake a Baby, and SIDS by American Academy of Pediatrics. Online copy can be downloaded at: https://www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf 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 applicant 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. LPA provided consultation regarding safe sleep regulation, 15-minute documentation and LIC 9227 Infant Safe Sleep Plan. Per applicant, infants will be napping in a play yard and in the same floor as other napping children. Applicant understands that the mattress of the play yard must have a fitted sheet and free from lose articles and objects. Applicant understands that play yard and cots do not hinder the entrance or exit to and from the space they are sleeping in.

Will determine later depending on IMS needs:

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

LPA reviewed with applicant the LIC 311D, Forms/Records To Keep in Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Forms were provided during this inspection.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2023
LIC809 (FAS) - (06/04)
Page: 5 of 7
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: THAMAS FAMILY CHILD CARE
FACILITY NUMBER: 198021127
VISIT DATE: 02/10/2023
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CHILDREN FORMS/RECORDS - Children’s files must contain the following documents/information:
Identification and Emergency Information (LIC 700), Consent for Emergency Medical Treatment (LIC 627), Notification of Parent’s Rights (LIC 995A), Caregiver Background Check Process (LIC 995E), Family Child Care Consumer Awareness Information (LIC 9212), Consent/Verification for Nebulizer Care (LIC 9166), California School Immunization Record, Parent Notification for Additional Children in Care (LIC 9150), Affidavit Regarding Liability Insurance (LIC 282), Acknowledgment of Receipt of Licensing Reports (LIC 9224, if applicable).

FACILITY FORMS/RECORDS - Facility files must contain the following documents/information:
Personnel Records: As required in Title 22 Regulations 102416.1, Unusual incident/Injury Report (LIC 624B): Child Care Facility Roster (LIC 9040), Notice of Employee Rights (LIC 9052), Statement Acknowledging Requirement to Report Suspected Child Abuse (LIC 9108), Property Owner/Landlord Consent (LIC 9149), Property Owner/Landlord Notification Form (LIC 9151).

INFORMATION TO BE POSTED IN YOU FAMILY CHILD CARE HOME – You are required by Law to post the following: Facility License (LIC 203), Emergency Disaster Plan (LIC 610A), Earthquake Preparedness Checklist (LIC 9148), Notification of Parent’s Rights (PUB 394). A Notice of Site Visit (LIC 9213) must be posted for 30 days after each site inspection by a Licensing Representative. Any Licensing Report documenting a Type “A” deficiency must be posted for 30 days during the hours that children are in care. Any Licensing Report or other document verifying compliance or non-compliance with the Department’s order to correct a Type “A” deficiency must be posted for 30 days during the hours that children are in care.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2023
LIC809 (FAS) - (06/04)
Page: 6 of 7
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: THAMAS FAMILY CHILD CARE
FACILITY NUMBER: 198021127
VISIT DATE: 02/10/2023
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Per applicant, she does not carry liability insurance or a bond in accordance with standard established by Family Child Care statue. Signed statements (LIC282) will be on children’s files. The law requires Family Child Care provider to carry liability insurance or bond in the amount of $300,000 annually or to maintain the signed statement in the facility file.

The following corrections need to be corrected prior to obtaining a small family child care license. Corrections are due by 03/10/23:

1. Applicant will remove Aloe Vera plant from the front yard.

2. Applicant will not use the playroom (converted garage) as the main day care area and will remove most toys and equipment from the playroom to the family room. Applicant understands that a permit must be granted for a converted garage to be used as a play room by the city or applicant will apply for an ADU.

3. Applicant will remove or fix lamps with lose screws on top of cement beams located in the back yard.

A small family child care license will be granted upon receipt of proof of corrections for the above. Once licensed, the applicant is required to adhere to the terms and limitations stated on the license.

The applicant’s signature on this report acknowledges that they have signed the Application for a Family Child Care Home License (LIC 279) under the penalty of perjury that the statements on the application and any attachments are correct.

Exit interview conducted and report was reviewed with applicant Sandra Thamas.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2023
LIC809 (FAS) - (06/04)
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