198400711-3-21-2023-54-CC-MAYA-CQ5NLC-20230321103319

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400711
Report Date: 03/21/2023
Date Signed: 03/21/2023 10:33:54 AM

Document Has Been Signed on 03/21/2023 10:33 AM - 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:	CAMBEROS-THARP FAMILY CHILD CARE		FACILITY NUMBER:	198400711
ADMINISTRATOR:	CASEY CAMBEROS-THARP		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 965-7302
CITY:	LAKEWOOD	STATE: CA	ZIP CODE:	90713
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 3	DATE:	03/21/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Applicant, Casey Camberos-Tharp		TIME COMPLETED:	11:00 AM

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	On March 21, 2023 at 9:00 am, Licensing Program Analyst (LPA) Monique Ayala conducted an announced inspection at the facility noted above and met with Applicant, Casey Camberos-Tharp. The purpose of the inspection was to conduct the pre-licensing inspection for a pending application. The applicant is requesting to operate a Large Family Day Care Home (up to 14 children), Monday through Friday from 6:00 am to 6:00 pm. Applicant is also open to providing overnight care; overnight care regulations were discussed. The applicant is applying to care for children ages: infant to 12 years old. Pre-licensing Entrance Checklist (LIC 9280) was provided to the applicant upon arrival. Individuals residing in the home were discussed and noted. All areas identified on the facility sketch were inspected. This facility is a single family home that consists of three (3) bedrooms, 3 bathrooms, office, living room, front room, kitchen, attached garage, and fenced backyard. Areas that are accessible to children include: one (1) bedroom, two (2) bathrooms, living room, front room, kitchen, and fenced backyard. Per applicant, the children will utilize the fenced backyard for outdoor activity. Areas off-limits to children include: 2 bedrooms, 1 bathroom, office, and attached garage. LPA observed a child safety gate installed in the hallway, making the off-limit bedrooms, bathrooms, office, and attached garage inaccessible to child in care. LPA also observed child safety knobs installed on the doors. The applicant was advised that off-limit areas must be made inaccessible during operating hours or while children are in care.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Monique Ayala
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

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: CAMBEROS-THARP FAMILY CHILD CARE	FACILITY NUMBER: 198400711
	VISIT DATE: 03/21/2023

NARRATIVE

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Areas used by children were inspected for safety, comfort, heating, cleanliness and telephone service. The home has central air and heating. The home has a fireplace located in the living room that is barricaded with a child safety gate. LPA did not observe any wall heaters. Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are made inaccessible. Applicant was advised that if any poisons are purchased, it is required to be locked with a key or combination lock.

Per applicant, there are no firearms, weapons or bodies of water on the premises. The applicant has 2 small dogs and 1 cat. LPA advised the applicant that best practice is to keep pets isolated from children in care. LPA observed age appropriate toys and napping equipment for children. The applicant was advised that if food is brought from the children’s home, all containers must be labeled with the child’s name and properly stored or refrigerated.

The facility was granted a fire clearance for the requested capacity on February 23, 2023. LPA observed the required fire extinguisher (2:A-10:BC) that is fully charged and purchased on March 21, 2023. Applicant was informed to have the fire extinguisher serviced yearly. Smoke and carbon monoxide detectors were tested and are operable. A First Aid kit and emergency supplies are available and located in the front room.

The applicant has proof of pediatric First Aid/CPR certification (expires January 2025). Applicant has proof of immunization against measles, pertussis, and a TB clearance. Applicant has a written decline statement for influenza on record. Applicant completed the Preventative Health and Safety Practices training (EMSA-approved), including the Nutrition and Lead components on June 24, 2022 and Mandated Reporter training (AB 1207) on February 1, 2023. Applicant was advised that the mandated reporter training must be completed every 2 years and is available at www.mandatedreporterca.com.

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.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Monique Ayala
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

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: CAMBEROS-THARP FAMILY CHILD CARE	FACILITY NUMBER: 198400711
	VISIT DATE: 03/21/2023

NARRATIVE

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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 provided the Forms and Records to Keep in your Family Child Care Home (LIC 311D). LPA also provided technical assistance for COVID-19.

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 (PINs), Program Quarterly Update Newsletters and other important information communication platform.

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

A final review of the application will be conducted by the Department. Once licensed, the applicant is required to adhere to the terms and limitations stated on the license.

Exit interview conducted and report was reviewed with the applicant, Casey Camberos-Tharp.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Monique Ayala
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

LIC809 (FAS) - (06/04)

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