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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021144
Report Date: 06/05/2024
Date Signed: 06/05/2024 02:55:10 PM

Document Has Been Signed on 06/05/2024 02:55 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:CAUDILLO FAMILY CHILD CAREFACILITY NUMBER:
198021144
ADMINISTRATOR/
DIRECTOR:		CAUDILLO, BRENDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 594-5262
CITY:LOS ANGELESSTATE: CAZIP CODE:
90033
CAPACITY: 10TOTAL ENROLLED CHILDREN: 4CENSUS: 2DATE:
06/05/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Brenda Caudillo, Licensee TIME VISIT/
INSPECTION COMPLETED:
03:25 PM
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On 06/05/2024, Licensing Program Analyst (LPA) Staicy Perry conducted an unannounced Annual inspection to the above facility. A COVID risk assessment was conducted upon entry. LPA was greeted by Licensee Brenda Caudillo whom the reason for the visit was explained. Per Licensee, there are 4 children currently enrolled. There were 2 children, and 2 adults present in the home upon arrival. Facility capacity is in compliance for a small Family Child Care Home. Per Licensee hours of operation are 6:00am-6:00pm, Monday- Friday.

All areas identified on the facility sketch were inspected. The home is located behind a home addressed 2627 Pomeroy Ave Los Angeles CA 90033. There is a side walkway to access the applicant's home. There is also a back alley entrance accessible. This home consists of 2 bedrooms, 1 bathroom, living room, kitchen, laundry room, and small yard. In the living room is an open wall heater which is screened to prevent access. Areas that are accessible to children are as follows: Bedroom 1, living room, bathroom, and small yard.

Areas off limits based on facility sketch submitted to children and parents include Bedroom 2, kitchen and laundry room.
Licensee was reminded that rooms that are off-limits need to be made inaccessible during operating hours. LPA toured all areas used by children during this visit.

During this visit, all areas identified that are accessible for children to use were inspected for the safety, comfort, and cleanliness. Licensee guided LPA on the tour of the home. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for safety and comfort. LPA observed a wall AC and Heating for the home. There are toys and other age-appropriate materials available for children. The bathroom was reviewed, LPA did not observe anything that can pose danger to the children in care. LPA did observe a diaper changing station in the living room area and is maintained clean and orderly. The kitchen was observed to be clean and organized. Knifes were seen to be placed in a locked
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE: DATE: 06/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2024
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CAUDILLO FAMILY CHILD CARE
FACILITY NUMBER: 198021144
VISIT DATE: 06/05/2024
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cabinet located in the kitchen made inaccessible to the children. The living room area was observed to be clean and orderly plenty of age-appropriate toys for the children to use. Bedroom 1 is used as an isolation area for an ill child until an authorized representative arrives to pick up the child. All equipment meets the US Consumer Product Safety Commission safety standards. Applicant had latches on cabinets with any potentially hazardous material.

Detergents, cleaning compounds, and medications were observed to be inaccessible to children. Per Licensee, there are no poisons in the home. LPA advised that any poisons should be locked under key or combination lock. Licensee states that are no firearms or weapons stored in the home.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and LPA observed proof of purchase date of 1/20/2024. Which indicates it is fully charged and in green. Smoke and carbon monoxide detectors were tested and are operable and were observed to be in the living room area.

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 5/23/24. The home is observed to be clean and orderly. There are first aid supplies available. LPA observed licensee to have a first aid kit available and is located in the living room area and in the outside area.

Per licensee, AM snack, breakfast, lunch, PM snack and dinner is provided by licensee. Licensee stated that she works with a food program called Options For Learning. Licensee was advised that food brought from the children’s homes, all containers must be labeled with child’s name and properly stored or refrigerated. Licensee does not transport the children.

LPA toured the outdoor play area and inspected its safety and condition. LPA observed perimeter fencing which is free of miscellaneous debris/hazards. All trees, shrubs and plants are maintained. Outdoor play yard was observed to have toys for the children to play. Outdoor area was observed to have turf as grass. LPA observed plants that are not poisons and or sharp to the touch. LPA did observe outside are to have adequate shade via shades.

Licensee and assistant records were reviewed. Immunizations were observed to be on file for licensee and assistant. The licensee and asistant has completed training on preventive health practices dated 10/07/2022
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CAUDILLO FAMILY CHILD CARE
FACILITY NUMBER: 198021144
VISIT DATE: 06/05/2024
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including Pediatric First Aid and CPR. Pediatric First Aid and CPR expires on 5/31/2026 for licensee and for assistant expires 5/31/2026.

LPA did observe that Licensees to have proof of Mandated Reporter AB 1207 compliant Child Care Training Certificate on file for the department to review. www.mandatedreporterca.com. Licensees training expires 7/31/24. Assistants Mandated Reporter Training expires on 7/25/24.

LPA observed children’s records were reviewed, including emergency information, and were observed to be complete.

LPAs created an LIC 857, Children’s Record Review, and LIC 811, confidential names which documents persons living in the home and children’s files reviewed during this inspection.

Per licensees, there are no pets on the premises.

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

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

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/.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CAUDILLO FAMILY CHILD CARE
FACILITY NUMBER: 198021144
VISIT DATE: 06/05/2024
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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-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.

LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at www.ccld.ca.gov.

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, Licensee, Melisa Agramon, confirmed that there are no Registered Sex Offenders living in the facility.

Currently, the licensee, Licensee, Melisa Agramon is in compliance with California Code of Regulations Title 22. No deficiencies cited.

A notice of site visit was given and must remain posted for 30 days. Appeal rights were discussed and provided.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2024
LIC809 (FAS) - (06/04)
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