198021350-12-21-2023-33-CC-MJAA-CYQN8L-20231221091431

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021350
Report Date: 12/21/2023
Date Signed: 12/21/2023 09:14:39 AM

Document Has Been Signed on 12/21/2023 09:14 AM - 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:	ROSAS FAMILY CHILD CARE		FACILITY NUMBER:	198021350
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	12/21/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:	Maria Rosas, Applicant		TIME COMPLETED:	09:30 AM

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	On December 21, 2023 Licensing Program Analysts (LPAs) Monique Ayala and Staicy Perry conducted an announced Prelicensing Inspection. A COVID-19 risk assessment was conducted prior to entering the facility. LPAs met with applicant, Maria Rosas who guided LPAs on a tour of the facility. Also present in the home was applicant minor child. This is a single story home with 2 bedrooms, 1 bathroom, living room, dinning room, kitchen, laundry room, fenced in rear yard, fenced in rear yard and detached garage. Days and hours of operation will be Monday to Friday from 7am to 5pm. Main care is provided: Living room, dinning room, kitchen, bathroom and front yard. Off limit areas: Bedrooms 1 and 2, laundry room, rear yard and detached garage. The doors leading to the bedrooms and laundry room are made inaccessible by a child proof knob. The rear yard is only accessible through the laundry room. The detached garage will remain locked at all times. The children and parents with enter through the front door. The infants will sleep in the living room and will be placed in playpens during nap time. The fenced outside play area is free from defects or dangerous conditions. Per Applicant, there are no weapons or firearms on the premise. LPAs did not observe any in the home. There are age-appropriate toys (blocks, dramatic play area, dolls). Age appropriate napping equipment (cots). The required fire extinguisher (2A10BC) and smoke detector are in operable condition. The home has a Carbon Monoxide detector. Home has an A/C unit. CPR/First Aid expire 11/16/2025. The First Aid kit was observed and is complete.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:	DATE: 12/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023

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: ROSAS FAMILY CHILD CARE	FACILITY NUMBER: 198021350
	VISIT DATE: 12/21/2023

NARRATIVE

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The following was discussed with the Applicant:
Capacity requirements, Notification of Parent's Rights, Roster requirements (keep updated names and blue sheet), Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children’s files and provider’s files, Safe Sleep and information on shaking baby syndrome. The role and responsibilities of being a mandated reporter were reviewed. Applicant was advised on how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov. Applicant was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care. Applicant advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility’s phone number; if the phone number is changed, licensing must be notified. Regulation prohibits the smoking of tobacco in a private residence that is licensed as a family child care home and in those areas of the family day care home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category.

Requirements for fingerprint clearances and associations were discussed with the Applicant. Applicant was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the on the form LIC624B (Same day/ASAP or within next business day within normal business hours 8-5 and written report within 7 days). Pamphlet providing Information regarding, Seat Belt Safety and Notification of Parent's Rights poster (Monterey Park Regional Child Care Office) was provided. The "Notification of Parent's Rights" poster must be posted in an area of the home accessible to parents. The information regarding new legislation with regards to exemptions and Parent’s Rights was also discussed.

Applicant was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent when a serious deficiency, Type A, is cited (LIC9224).

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:	DATE: 12/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023

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: ROSAS FAMILY CHILD CARE	FACILITY NUMBER: 198021350
	VISIT DATE: 12/21/2023

NARRATIVE

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--Applicant was advised visit www.shotsforschool.org for Immunization information.
--Applicant was informed of responsibility to report suspected Child Abuse, 1-800-827-8724
--Family Child Care Providers (Disaster Planning information): https://ccld.family-child-care-providers/disaster-planning-and-fire-safety/https://ccld.family-child-care-providers/disaster-planning-and-fire-safety/
--Child Care Videos: https://ccld.childcarevideos.org
--Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

--Applicant was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.

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.html (Plan is on file or currently no plan on file).

LPA discussed the safe sleep regulations with applicant 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 [or facility representative] 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.

Applicant is ready for licensure. An exit interview was conducted, and a copy of this report was provided to the applicant on this date, 12/21/2023.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Monique Jessica Ayala
LICENSING EVALUATOR SIGNATURE:	DATE: 12/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023

LIC809 (FAS) - (06/04)

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