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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400581
Report Date: 07/22/2022
Date Signed: 07/22/2022 03:29:51 PM

Document Has Been Signed on 07/22/2022 03:29 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:ECHEVERRIA FAMILY CHILD CAREFACILITY NUMBER:
198400581
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
07/22/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Christina EcheverriaTIME COMPLETED:
03:50 PM
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Licensing Program Analyst (LPA) Raul Navarro conducted a pre-licensing inspection on 7/22/22 at 1:40 PM. LPA met with Christina Echeverria, Applicant who guided analyst on a tour of the facility. Applicant is requesting a small family childcare home license. Per Applicant, operation hours will be Monday-Friday, 6AM to 6PM. Applicant states that she will care for children 0-12 years of age.

All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a one story home hat consists of three bedrooms, one bathrooms, dining room, living room, kitchen, detached garage, front yard (not fenced) and Backyard (fenced). Main care areas include, living room, dining room, one bedroom, one bathroom and back yard. Off limit areas include, two bedrooms, kitchen, front yard, and garage. Rooms are made inaccessible with a lock. The Applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary. Individuals in the home have been discussed and noted.

Areas that will be used by children were inspected for safety, comfort, cleanliness. LPA observed equipment, toys and age appropriate material for children in the main care areas. LPA observed operable telephone service via cell phone. Facility does have an inoperable floor heater in the living room that is barricaded. Facility has ventilation and heating. Knives, detergents and cleaning compounds that can pose a danger to children are made inaccessible in a locked cabinet under the kitchen sink. Medications are also stored in a high locked cabinet. Per Applicant the kitchen will be off limits. LPA observed that the cabinets had child locks. LPA did not observe hazardous items in the kitchen. The applicant was advised that any poisons must be locked, not only inaccessible. Children will nap on cots in the main care area.

Per Applicant there are not pets and there are no firearms or weapons stored in the home.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Raul Navarro
LICENSING EVALUATOR SIGNATURE: DATE: 07/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/22/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: ECHEVERRIA FAMILY CHILD CARE
FACILITY NUMBER: 198400581
VISIT DATE: 07/22/2022
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LPA observed that the Applicant has a 2A10 BC fire extinguisher in the home, purchased on 7/15/22. Smoke/Carbon monoxide detectors were tested and are operable.

The Applicant states that she will provide food for children in care. LPA reminded Applicant that any food brought from the children’s homes shall be labeled with child’s name and properly stored or refrigerated. Applicant was reminded that they shall be present in the home and ensure children are supervised at all times. If Applicant temporarily leaves the home they must ensure a substitute adult with required training and documents supervise the children in their absence.

The Applicant has completed the required Health and Safety Training, Pediatric First Aid and CPR and Mandated Reporter Training. Applicant has proof of immunization against measles, pertussis and flu declination on file.

Applicant states that they plan on caring for infants 0-24 months old in the future LPA informed applicant of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months and the 15-minute sleep check documentation for infants 0-24 months. Applicant states the following a sleep supervision plan for infants: Infants will nap in the main care care where applicant supervise them at all times.

Outdoor play area is located in the backyard. LPA observed that the backyard is fenced and free of hazards. The outdoor play area has equipment, toys and age appropriate material for children. LPA did not observe any pool, spas or bodies of water on the premises. Detached garage was observed to be a storage area made inaccessible by a locked door.

LPA discussed latest COVID-19 precautions and procedures with Applicant. Applicant states that temperature checks will be done at drop off, hand washing, and disinfecting of highly touched areas. Isolation area for sick children waiting to pick up by a parent will be located in the bedroom, away from other children. Capacity was discussed with applicant and handout provided.

Applicant 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.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Raul Navarro
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2022
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: ECHEVERRIA FAMILY CHILD CARE
FACILITY NUMBER: 198400581
VISIT DATE: 07/22/2022
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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.

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

LPA reviewed with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

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.

A small family childcare license will be granted upon further review.Once licensed, the applicant is required to comply with the terms and limitations stated on the license.

Exit interview conducted and report was reviewed with the applicant, Christina Echeverria..

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Raul Navarro
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2022
LIC809 (FAS) - (06/04)
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