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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400529
Report Date: 06/20/2022
Date Signed: 06/20/2022 03:35:10 PM

Document Has Been Signed on 06/20/2022 03:35 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:ROSALES VILLAGRANA FAMILY CHILD CAREFACILITY NUMBER:
198400529
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 7CENSUS: 6DATE:
06/20/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Martha Rosales Villagrana, LicenseeTIME COMPLETED:
03:55 PM
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 THIS INSPECTION WAS CONDUCTED IN SPANISH
Licensing Program Analysts (LPA) Susann Sanchez conducted an unannounced case management inspection for an increase in capacity at the above facility on 06/20/2022 at 2:00 PM. LPA met with Martha Rosales Villagrana, Licensee who guided analysts on a tour of the facility. There were 5 children, 1 infants, and 2 adults present when LPA arrived. Facility capacity is in compliance for a Small Family Child Care Home. Per Licensee, hours of operation will be Monday through Friday, 6:00 am to 10:00 pm and does not to exceed 24 hour care at one time. Licensee states that she will care for children Infants -13 years of age. Entrance Checklist was provided to the applicant.

This is a one-story home which consists of 2 bedroom, 1 bathroom, kitchen w/ dining area, living room, front yard and backyard (fenced & divided) and garage. On limit areas are: living room, kitchen, bathroom, and part of the backyard (gated & picture was taken). Per Licensee's, areas off limits to children and parents include: all bedrooms, one bathroom, part of the backyard (to the left of the house), and the garage and front yard. All off limit rooms are were observed to be locked or blocked off by a gate were gated off. Currently this home is under construction, Licensee is making the master bedroom bigger. Construction is taking over the part of the backyard that is off limits. Per Licensee construction workers enter through the backyard. A porta potty is also in place for the construction worker. Per Licensee, construction workers do not have access to the house. Construction is scheduled to be complete by end of July.

Per Licensee's will provide food children. Knives and other sharp utensils are located in cabinet in the kitchen that has a lock. Cleaning products were located in cabinets locked with safety latches under the sink in kitchen and in the garage. The home is clean and orderly, there are outlet covers throughout the home. LPA was unable to test smoke detectors and carbon monoxide detector due to children sleeping. Licensee will test smoke and carbon detectors via Facetime with LPA on 06/21/2022.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 06/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/20/2022
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: ROSALES VILLAGRANA FAMILY CHILD CARE
FACILITY NUMBER: 198400529
VISIT DATE: 06/20/2022
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Licensee has completed the required health and safety training, the Pediatric First Aid and CPR Expires on 02/21/2024 . Licensee has proof of immunization against pertussis and measles, influenza. Proof of Mandated Reporter Training was also submitted and expires on 12/16/2023.

LPA observed age appropriate toys and learning materials. The required (2A10BC) fire extinguisher was observed in the kitchen and was purchased on 01/25/2022 as indicated on the receipt. First Aid kit is available. Per Licensee, there are no weapons or firearms in the facility, none were observed by LPA. There is central air in the home.



Infant Care: Currently licensee cares for 1 infants enrolled. LPA observed 2 cribs. Napping equipment does not block entrances or exits. LPA reviewed the following: infant mattresses need to be firm with tightly fitted sheets. Loose object, bumpers, objects hanging, or objects attached to the cribs/play yards are not allowed. There are currently no infants with pacifiers. LPA informed licensee 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. Licensee states the following a sleep supervision plan for infants: infants sleep in the living room/ daycare room and are place on there backs to sleep.

Children use part of the backyard for outdoor play. The outdoor play area was observed to be fenced. LPA's observed that the outdoor yard has toys and other materials for children to play with. Licensee also stated that she wants to start taking the children on walks to Tanaka Park. Per Google maps this park is a 4 minute walk from Licensee home. Per Licensee there are no bodies of water in this home.



LPA provided the Safe Sleep regulation and provided PIN 20-24-CCP and the Infant Sleep Plan LIC 9227 for when Applicant is ready to enroll infants. Children and infants will nap in the daycare room, cots are available.

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-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.

Licensee is following COVID-19 procedures. LPA advised Licensee to ensure they are following the guidance from the local health authorities in order to prevent and reduce the transmission of diseases.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2022
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: ROSALES VILLAGRANA FAMILY CHILD CARE
FACILITY NUMBER: 198400529
VISIT DATE: 06/20/2022
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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.

The following was discussed with the applicant:

· 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 adult/infant CPR & Pediatric First Aid certification, TB clearance, immunization, Mandated Reporter training certificate www.mandatedreporterca.gov, and a valid criminal record clearance associated to the facility license. A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.

· Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.


· Fire and safety drills must be performed every six months and documented for review by the Department.
· Smoking is prohibited in a family child care 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, No trampolines and any other item that falls into that category are not permitted in the facility.
· Inspection Authority: All adults living and working in the home shall be made of aware of the Department’s 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.
· The facility license number must be on all advertisements, publications or announcements with the intent to attract clients.
· Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information. Licensee states she does not have liability insurance.

· Never Shake a Baby, Sudden Infant Death Syndrome (SIDS) and Safe Sleeping practices.


Per applicant, there are no dual licenses at this address.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2022
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: ROSALES VILLAGRANA FAMILY CHILD CARE
FACILITY NUMBER: 198400529
VISIT DATE: 06/20/2022
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Licensee 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.

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: http://www.ada.gov/childqanda.htm



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.

There are no physical corrections needed during today's visit. LPA will submit application to the Department for final review. Exit interview conducted and report was reviewed with the Licensee Martha Rosales-Villagrana. Appeal right were given in Spanish and explained.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2022
LIC809 (FAS) - (06/04)
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