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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400585
Report Date: 05/24/2022
Date Signed: 05/24/2022 12:05:29 PM

Document Has Been Signed on 05/24/2022 12:05 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:GUERRERO FAMILY CHILD CAREFACILITY NUMBER:
198400585
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
05/24/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Noe GuerreroTIME COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) Elka Chavez conducted a pre-licensing inspection for the above address on May 24, 2022 in Spanish. LPA arrived at 9:25 am, and met with Noe Guerrero, Applicant, who guided LPA on a tour of the facility. Individuals residing in the home were discussed and noted. Per Applicant, child care will be provided at all hours of the day from Monday through Friday. Applicant understands that care for a child should not exceed 24 hours. Applicant states he wants to care for children from 2 to 12 years of age.

This home consists of four bedrooms, two and a half bathrooms, kitchen located next to the front door and kitchen in the daycare room, dining room, front living room and back living room, shed, detached garage, side backyard (fenced) and backyard (fenced). The home was inspected for safety, comfort, cleanliness, telephone service (cell phone), inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children.

Areas used by children include: Bedroom #3, front living room and back living room (daycare), kitchens, dining room, detached garage and backyard (fenced).

Areas off limits include: 3 bedrooms, bathrooms next to the front living room, back side yard (fenced) and storage shed.

The applicant understand that licensing staff may have access to off-limit areas during inspection visit if necessary. ** Rooms that are off-limits need to be made inaccessible during operating hours** LPA observed child safety door knobs in the off-limit bedrooms. The garage can only be utilized as activity space. There is no eating or sleeping permitted in the garage.



At 10:30 AM LPA observed knives were in cabinets locked with safety latches as an additional safety measure. Shampoos, lotions, disinfectants, detergents, or any item that could be a hazard are inaccessible.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/24/2022
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 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: GUERRERO FAMILY CHILD CARE
FACILITY NUMBER: 198400585
VISIT DATE: 05/24/2022
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LPA observed them in the off-limit bathrooms. LPA observed the bathroom doors with child safety door knobs. The home is clean and orderly, there are outlet covers throughout the home. Smoke detector and carbon monoxide detector were observed, tested and are in operable condition. LPA observed them in the daycare room and front kitchen.

Applicant has completed the required Pediatric First Aid and CPR. Applicant has proof of Health and Safety Training with one hour of nutrition and one hour of lead training included. Applicant has proof of immunization against pertussis and measles, influenza and proof of Mandated Reporter Training on file.

The required postings were observed throughout the facility. Applicant states he will provide food for children in care. Applicant was advised to properly label and store children's food if brought from home. LPA observed age appropriate toys and learning materials. The required (2A10BC) fire extinguisher was observed in the daycare room and front kitchen. First Aid kit is also available next to the bathroom used by children in care.

Per Applicant, there are no weapons or firearms in the facility, none were observed by LPA. Applicant has one dog (German Shepherd). LPA observed the dog is kept in the side yard which is gated and inaccessible to children in care. At 9:35 LPA observed a wall heater with a barrier that is anchored to the wall. LPA observed a fire place in the front living room. LPA observed the fireplace to have a fireplace shield with a child safety latch. Safe and age appropriate toys were available. There are no bodies of water on the premises. Per Applicant, children will use the backyard (fenced) for outdoor play. Applicant stated that supervision will always be provided.

Per Applicant parents will drop off/pick up at the front door. Daily temperature checks and health screenings will be done at the entrance. Per Applicant, highly touched areas, bathroom and toys will be disinfected at the end of the day or as needed. Per Applicant children will be encouraged to wash their hands for 20 seconds throughout the day as needed. Per Applicant personal items will be placed in an individual cubby. Children will be provided their own blanket and sheet for nap. Bedding will be washed weekly or as needed. The isolation area for a sick child waiting to be picked up will be in bedroom #3 away from other children. LPA advised applicant to ensure they are following the guidance from the local health authorities to prevent and reduce the transmission of diseases.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022
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: GUERRERO FAMILY CHILD CARE
FACILITY NUMBER: 198400585
VISIT DATE: 05/24/2022
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Applicant, Noe Guerrero 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.

LPA discussed the safe sleep regulations with applicant, Noe Guerrero 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, Noe Guerrero 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, Noe Guerrero 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
Entrance Checklist was provided to the applicant.

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.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022
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: GUERRERO FAMILY CHILD CARE
FACILITY NUMBER: 198400585
VISIT DATE: 05/24/2022
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A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

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, Noe Guerrero.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4