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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400676
Report Date: 12/22/2022
Date Signed: 12/22/2022 04:38:15 PM

Document Has Been Signed on 12/22/2022 04:38 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:MAGDALENO FAMILY CHILD CAREFACILITY NUMBER:
198400676
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
12/22/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Claudia MagdalenoTIME COMPLETED:
04:52 PM
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Licensing Program Analyst (LPA) Warren Birks conducted a pre-licensing inspection. LPA Birks met with Applicant Claudia Magdaleno who guided analyst on a tour of facility. The Applicant is requesting a Small Family Child Care license (with a capacity of six to eight children). Applicant Magdaleno indicated that she will care for children ages 3 months to three months to 12 years and will operate from Monday-Friday 7:00am to 4:00pm. An Entrance Checklist was provided and all individuals residing in the home were notated.

At approximately 2:24pm all areas of the facility sketch were inspected. This is a one story home consisting of three bedrooms, three bathrooms, kitchen, living room, family room, garage, front yard and back yard.



Areas used by children include: living room, family room, one bathroom, kitchen at this time.

Areas off limits include: Three bedrooms, two bathrooms, the backyard and garage at this time.

Per applicant, the children will use the bathroom located near in the Family Room. All other rooms will be made inaccessible by door knob covers or 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. Note: LPA observed indoor has age appropriate toys, books and play equipment available. LPA observed the applicant will need to purchase cots or mats for sleeping equipment.

LPA informed applicant that licensing staff may access off-limit areas during visits if necessary. LPA noted and discussed firearms and weapons. LPA observed no bodies of water on the premises. The applicant has one medium dog and one small dog. LPA advised applicant to provide additional supervision if she allows pets to interact with ever has pets (as animals can be unpredictable around children). LPA observed lock for medicine cabinet. The applicant was informed that items such as medicine, toothpaste, nail polish, hand sanitizer, cleaners, bleach and similar items must constantly remain inaccessible.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Warren Birks
LICENSING EVALUATOR SIGNATURE: DATE: 12/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/22/2022
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: MAGDALENO FAMILY CHILD CARE
FACILITY NUMBER: 198400676
VISIT DATE: 12/22/2022
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The valve on the 2A10BC fire extinguisher indicates fully charged and is due for service by 12/21/2023. LPA advised that annual service is required or a new extinguisher must be purchased every year. LPA observed and tested a smoke and carbon monoxide detectors in the living room and kitchen and they were operable.

The Applicant states that parents will provide food for children in care and the Applicant will have snacks and back up food/snacks if necessary. 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 10/2024. LPA observed 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 supervision plan for infants: Applicant states that infants will sleep in a separate room and she 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
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Warren Birks
LICENSING EVALUATOR SIGNATURE:

DATE: 12/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2022
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: MAGDALENO FAMILY CHILD CARE
FACILITY NUMBER: 198400676
VISIT DATE: 12/22/2022
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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 documentation and inspection, the applicant will be approved for a Small Family Child Care License when she submits the following:

1. Evidence of sleeping cots or mats.

Once licensed, the applicant is required to adhere to the terms and limitations stated on the license. Exit interview was conducted with Applicant Magdaleno. 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: 12/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2022
LIC809 (FAS) - (06/04)
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