198400471-6-23-2023-54-CC-DGIS-CT3TQL-20230623145608

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400471
Report Date: 06/23/2023
Date Signed: 06/23/2023 02:56:21 PM

Document Has Been Signed on 06/23/2023 02:56 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	JIMENEZ FAMILY CHILD CARE		FACILITY NUMBER:	198400471
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS:	DATE:	06/23/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Tania Jimenez, Licensee		TIME COMPLETED:	03:15 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	Licensing Program Analyst (LPA) Denise Gibbs conducted an unannounced case management inspection to the above facility on 6/23/23 on 1:00 PM. LPA met with Tania Jimenez, Licensee. LPA toured the facility. The purpose of this inspection is due to licensee’s request for a capacity increase. There were six children present upon arrival. This facility is a small family child care home, licensed for eight children, facility can have a maximum of six children, due to no landlord consent on file. Licensee wishes to increase capacity to a large family child care home, with a capacity of 14 children. Hours of operation will remain the same, Monday to Friday Mon-Fri 7:00 AM - 6;00PM. A current children’s roster was available for review. Individuals residing in the home have been discussed and noted. All adults present in the home have obtained a criminal record clearance or exemption. This is a single-story home that consists of a foyer, two bedrooms, one bathroom, kitchen, living room, laundry area and detached garage. Main care areas include foyer, living room and back yard. Areas off-limits to children and parents include two bedrooms, kitchen, laundry room and detached garage. LPA observed a child safety gate to prevent children from access to off-limits kitchen and laundry room. Bedrooms have safety door knobs to prevent access. LPA observed all requires posting in the main entrance (foyer). Children are sighed and out. Fire extinguisher was last serviced on 5/6/23. Dual carbon and smoke detector located in living room and foyer was tested and is operable. Facility has two main care areas, the living room and the foyer. LPA observed age appropriate toys, equipment and material for children to play with. ----------------PAGE 1

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2023

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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: JIMENEZ FAMILY CHILD CARE	FACILITY NUMBER: 198400471
	VISIT DATE: 06/23/2023

NARRATIVE

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LPA observed a fireplace in the main care living room with a mounted heater unit attached sealing fireplace. Per licensee gas is shut off and the unit is inoperable. Gas shut off was confirmed during pre licensing inspection. Detergents, cleaning compounds and medication are stored in off limits kitchen, inaccessible to children. Children nap on cots in the main care area. LPA observed two play yards for younger infants in the main care area. Infant was napping in one play yard that was visible and free of hazards. The other play yard was being used as storage for children's toys because it is not needed at this time. Licensee is aware that play yard must be free of hazards if used for infant. Licensee is aware of safe sleep regulation and has implemented LIC9227, Infant Sleep Plan and 15-minute sleep log.

Children's bathroom is located off the hallway. Bathroom was observed to be safe and sanitary with operable sink and toilet. LPA observed a changing table in the living room for children with diapers.

Children will use the backyard yard for outdoor play, back yard is fenced. LPA observed a climbing structure, a sandbox, a garden and other age appropriate material for children in the outdoor space. LPA observed a fence surrounding the garden area. Per Licensee, the children will have access to the garden for planting. The Licensee states that there are no firearms, weapons or bodies of water on the premises. LPA did not observe fire arms, weapons, or bodies of water.

Licensee currently does not have an assistant. Per licensee, she is in the process of hiring someone and will not enroll more children until an assistant has been hired. Licensee has completed required Pediatric First Aid and CPR which training which expires on, 8/2023. Licensee has completed Mandated Reporter Training, expiring 9/2023. Licensee also has required immunization records on file. There are first aid supplies available. Children's files were reviewed and are complete.

No deficiencies will be cited today 6/23/23

Licensee is seeking to provide care for 14 children 0-8 years old. A fire clearance has been granted as of 6/7/23. Applicant was unable to obtain Landlord Consent (LIC 9149) and will only be able to care a maximum of 12 children. Based on today’s observation, a capacity increase will be granted.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative.

Exit interview was conducted with Tania Jimenez, Licensee. Appeal Rights provided. --------PAGE 3

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2023

LIC809 (FAS) - (06/04)

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