198400516-2-10-2022-54-CC-DGIS-CBHRUJ-20220210122000

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400516
Report Date: 02/10/2022
Date Signed: 02/10/2022 12:20:24 PM

Document Has Been Signed on 02/10/2022 12:20 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	MUNOZ GONZALEZ FAMILY CHILD CARE		FACILITY NUMBER:	198400516
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	02/10/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Martha Munoz-Gonzalez, applicant		TIME COMPLETED:	12:30 PM

NARRATIVE

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This was a pre-licensing inspection conducted on 2/10/22 at 10:00 AM by Denise Gibbs, Licensing Program Analysts (LPA). This pre-licensing inspection was conducted with Martha Munoz Gonzalez, applicant.

Individuals residing in the home have been discussed and noted. The applicant is requesting a small family childcare home license. Per applicant, operation hours will be Monday -Friday 8am-6pm. Applicant states that they will care for children zero to school-age.

During this inspection the applicant took LPA on a tour of the home and the following was noted:

All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a one-story home that consists of three bedrooms, two bathrooms, open layout living room/dining room/kitchen area, front yard and back yard fenced.

Main care areas include two bedrooms, one bathroom front yard and back yard.

Off limit areas include one bedroom and one bathroom which will remain locked during daycare hours. The applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary.

Outdoor play area is located in the front yard and back yard. LPA observed that both yards are fenced and free of hazards. There are toys and material for children to play with. There are no pools or spas, or other bodies of water. Applicant has small dog that will be in the home during operating hours.

Areas that will be used by children were inspected for safety, comfort, cleanliness. There is operable telephone service via cell phones. Home has central air and heating . LPA observed fire place in the living room that is

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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 02/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MUNOZ GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 198400516
	VISIT DATE: 02/10/2022

NARRATIVE

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screened. Detergents, cleaning compounds and hazardous items that can pose a danger to children are made inaccessible in the kitchen, under the sink with a child lock. Medication will be stored in the locked bedroom. The applicant was advised that any poisons must be locked, not just inaccessible. There are age appropriate toys and material available for children. Children will nap on mats in the main care area. Per applicant there are no fire arms or weapons stored in the home.

LPA observed required postings in the hallway between the main care bedrooms and in the main care bedroom.

Infant Care: Applicant states they will care for infants. Applicant states the following for nap supervision: Infants will sleep in the designated infant playroom supervised by a qualified adult at all times. LPA observed two pack n plays, visible and free of hazards. Per applicant there will always be two staff available for supervision. LPA informed applicant of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15- minute sleep check documentation for infants 0-24 months, and provided PIN 20-24-CCP.

LPA observed that the Applicant has 2A10 BC fire extinguishers in the home, purchase receipt 11/11/21. Applicant was reminded that fire extinguishers need to be purchased or serviced every year. Smoke and carbon monoxide detectors were tested and are operable.

The applicant states that meals will be provided by facility and parents will also have the option to bring food from home. Applicant was informed that any food brought from the children’s homes must be labeled with child’s name and properly stored or refrigerated.

The applicant has completed the required Health and Safety Training, Nutrition, and Lead Training, Mandated Reporter Training and Pediatric First Aid and CPR. Required immunization's are current. There are first aid supplies available.

Incidental Medical Services (IMS):
This facility may provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual -
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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 02/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MUNOZ GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 198400516
	VISIT DATE: 02/10/2022

NARRATIVE

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Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

LPA Provided COVID-19 Technical Assistance by emailing applicant COVID-19 resources and self-assessment prior to visit. LPA discussed self-assessment and answered question regarding COVID-19 procedures.

Essential Protective Equipment and Supplies- Applicant and children (24 months and older) will wear facial coverings throughout the day, excluding meal and nap times. Applicant has a contact-less thermometer, hand sanitizer, disposable gloves and disinfectant cleaning supplies in the home.
Cleaning- Per applicant, high touched areas, bathroom and toys will be disinfected at the end of the day or as needed. There is a dirty/soiled toy bin to be cleaned when applicable and high touched toys will be cleaned daily.
Hygiene- Per applicant children will be encouraged to was their hands for 20 seconds throughout the day as needed. Applicant has the advised children's hand washing and cough and germs posted. Per applicant personal items will be placed in an individual cubby. Children will bring their own blanket and sheet for nap. Bedding will be washed daily. The isolation area for a sick child waiting to be picked up will be in the living room next to the exit away from other children.
Arrival Procedures- Per applicant parents will drop off/pick up at the back gate. Daily temperature checks and health screenings are done at the gate, as parents will not be allowed to enter the facility. COVID-19 posters and resources will be posted in the back entrance accessible to parents. Parents will be made aware of the COVID-19 policies and exclusion procedures in writing and verbal.
Group Size- Children will be divide by age in two bedroom, one for older and one for younger. There will also be two staff so that children can be indoors and outdoors if needed. Facility has space to separate cots during nap time. Meal times will be conducted indoors and outdoors. Children will have the opportunity to be outdoors as much as possible.-------------PAGE 3

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 02/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022

LIC809 (FAS) - (06/04)

Page: 3 of 4

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MUNOZ GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 198400516
	VISIT DATE: 02/10/2022

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 26 27 28 29 30 31 32	A small family childcare license will be granted upon Licensing Program Manager (LPM) Approval. Once licensed, the applicant is required to comply with the terms and limitations stated on the license. Exit interview was conducted with Martha Munoz Gonzalez, applicant. This report along with a copy was provided to applicant. --------------------PAGE 4

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 02/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022

LIC809 (FAS) - (06/04)

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