198400627-8-17-2022-54-CC-WBIS-CHDRRQ-20220817131533

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400627
Report Date: 08/17/2022
Date Signed: 08/17/2022 01:15:44 PM

Document Has Been Signed on 08/17/2022 01:15 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:	JARDIM FAMILY CHILD CARE		FACILITY NUMBER:	198400627
ADMINISTRATOR:	JARDIM, CHELSEA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 283-4755
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90815
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	08/17/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Chelsea Jardim		TIME COMPLETED:	01:30 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 (LPAs) Warren Birks and Austin Estrada conducted a pre-licensing inspection. LPAs met with Applicant Chelsea Jardim who guided analyst on a tour of facility. The applicant is requesting a Large Family Childcare license (with a capacity of 12 to 14 children). Per applicant, the hours of operation will be Monday to Friday, 8:30AM to 4:30PM. Applicant states that she will care for children 12 months months to six years old. Entrance Checklist was provided to the applicant during inspection. Individuals residing in the home were discussed and noted. All areas identified on the facility sketch were inspected, including off limit areas. This is a single one story home comprised of three (3) bedrooms, two bathrooms, dining area, living room, sun room/daycare room, kitchen, front and back yard and detached garage. Areas used by children include: Living room (main daycare area), sun/room, dining area, one bathroom, one bedroom and back yard. Areas off limits include: two bedrooms, and one bathroom, and garage. Per applicant, the children will use the first bathroom located in the hallway and off limit rooms are made inaccessible by door knob locks. LPA inspected all areas used by children for safety, comfort, cleanliness, telephone service, ventilation and heating. The applicant was advised that any poisons must be locked with a key or combination lock. Applicant will keep poisons in areas that are inaccessible to children. LPA did not observe infant napping equipment. Applicant Jardim indicated she will provide proof at a later date. The applicant understands that licensing staff may have access to off-limit areas during inspection visits if necessary. Per applicant, there are no firearms, weapons or bodies of water on the premises and none were observed. The applicant has no pets. LPA advised Applicant if she were to have pets to provide extra care and supervision.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Warren Birks
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022

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: JARDIM FAMILY CHILD CARE	FACILITY NUMBER: 198400627
	VISIT DATE: 08/17/2022

NARRATIVE

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LPA advised the applicant how to access forms, regulations and quarterly updates on the Child Care
Licensing website at: www.ccld.ca.gov.

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.

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.

Per applicant, there are no dual licenses at this address. Applicant’s email address was obtained during this inspection.

Based on observation, documentation and inspection a Large Family childcare home will be approved once the following is submitted:

Proof of infant napping equipment (crib and/or play yard).

Once licensed, the applicant is required to adhere to the terms and limitations stated on the license.

Exit interview was conducted with Applicant Chelsea Jardim. This report along with a copy of the appeal rights was provided.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Warren Birks
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022

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: JARDIM FAMILY CHILD CARE	FACILITY NUMBER: 198400627
	VISIT DATE: 08/17/2022

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The valve on the 2A10BC fire extinguisher indicates fully charged, and is due for service or replacement by 10/27/22. LPA advised that a receipt or service tag be attached for annual proof of purchase or service. LPA observe and tested a smoke and carbon monoxide detector in the dining area and they were operable.

The applicant states that they will provide food for children in care. Some parents provide food as well. LPA informed applicant to ensure that food brought from home is labeled with child’s name and properly stored or refrigerated.

The applicant has completed the required Health and Safety Training, Nutrition & Lead Training and Pediatric First Aid and CPR which expires 06/2024. There are first aid supplies available.

Applicant was reminded of all the terms and conditions noted on the LIC 279 – Application of a Family Child Care Home that applicant signed and agreed to.

Applicant states that they will care for infants. LPA advised the applicant to sleep infants where they can be directly supervised at all times and advised against sleeping infants in a separate room. The applicant states the following is a supervision plan for infants: Applicant states that infants will sleep in a separate room and will provide supervision sometimes directly and/or document 15 minute checks. LPA emailed applicant a copy PIN 20-24-CCP and LIC 9227 to Applicant. LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage:

https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed [applicant, licensee, or facility representative] 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 discussed 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

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Warren Birks
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022

LIC809 (FAS) - (06/04)

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