198400860-10-31-2023-54-CC-FWHE-CX5VU2-20231031164400

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400860
Report Date: 10/31/2023
Date Signed: 10/31/2023 04:44:11 PM

Document Has Been Signed on 10/31/2023 04:44 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	ROS FAMILY CHILD CARE		FACILITY NUMBER:	198400860
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	10/31/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Somaly Ros, Applicant		TIME COMPLETED:	05:00 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 (LPA) Franchesca White conducted a pre-licensing inspection on 10/31/2023 at 2:00 p.m. LPA met with Applicant, Somaly Ros who guided analyst on a tour of the facility. During this inspection individuals who reside in the home were discussed and noted. The applicant is requesting a small family child care home license. Per applicant, operating hours will be Monday through Friday from 7:30 a.m. – 5:30 p.m.. Applicant states that she will care for children from 0 to 14 years of age. All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This facility is a single-story home which consists of 3 bedrooms, kitchen, living room, dining room, family room, 2 bathroom, front and back yard. Areas that the children will use include the Family Room, Living Room, Dining Room, Bedroom 1, and the Bathroom 1. Off limit areas include Bedroom 2 and Bedroom 3, Bathroom 2, and kitchen. LPA observed the off-limit bedroom 2 and 3 are kept locked and a key is needed to open the door. LPA observed child safety gates making the kitchen inaccessible to children in care. The Applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary. Areas that will be used by children were inspected for safety, comfort, and cleanliness. LPA observed Living Room to have sectional couches, piano, and bookcase. Applicant states Living Room will be used as an Isolation Area. Applicant will use their cell phone as the day care phone. LPA observed Living Room space to have a large flat screen tv, fireplace with a bolted screen, and barricade making it inaccessible to children in care, sectional couch, and area rug. Applicant states that she will have a reading area, arts and crafts, space for toys and cubbies. Applicant states that children will nap on mats in the living room. Applicant stated that Dining area will be used as eating space for children in care. Backyard will also be an optional eating space based on weather . LPA observed the bathroom that will be used by children to be stocked with toilet paper, paper towels and soap. Report Continued 1 of 4 Pages

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2023

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ROS FAMILY CHILD CARE	FACILITY NUMBER: 198400860
	VISIT DATE: 10/31/2023

NARRATIVE

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LPA observed detergents and cleaning compounds that can pose a danger to children are made inaccessible in storage space in the off-limit kitchen. Medications are in a cabinet above the washing machine made inaccessible by baby gate preventing entry to the off limits kitchen. Knives are stored in a cabinet with a child safety latch in the off limit kitchen. LPA did not observe hazardous items in the kitchen. Per Applicant there are no poisons in the home. The Applicant was advised that any poisons must not only be inaccessible, but locked.

Applicant has two dogs. Dogs are secured behind locked gate when children are in care Per Applicant, there are no firearms or weapons stored in the home. LPA observed that the Applicant has a 2A10 BC fire extinguisher in the home, purchased on 8/18/2023 . Smoke and carbon monoxide detectors were tested and are in the Living Room, Hallway near the Restroom, and the Kitchen.

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 influenza on file.
Applicant states that at this time they do plan to care for infants 0-24 months old. LPA informed Applicant of the new Safe sleep regulations, including the LIC 9227 Infant Sleep Plan for infants under 12 months and 15 minute sleep check documentation for infants 0-24 month

Outdoor play area is located in the backyard of the home. LPA observed the backyard play area to have ample shaded space, grass, and space for play. Applicant stated that she is going to add a playhouse, a small slide, and dramatic play kitchen to the yard.

Report Continued 2 of 4 Pages

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ROS FAMILY CHILD CARE	FACILITY NUMBER: 198400860
	VISIT DATE: 10/31/2023

NARRATIVE

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LPA observed an inoperable waterfall on the premises. The Applicant states that supervision will always be provided. Capacity and ratio was discussed with Applicant.

Applicant, Somaly Ros 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, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

The applicant, Somaly Ros provided proof of control of property. LPA White has reviewed proof of property with Applicant Somaly Ros .

LPA reviewed with applicant, Somaly Ros 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.

LPA discussed the safe sleep regulations with applicant, Somaly Ross and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPA also informed applicant, Somaly Ros 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.

Report Continued 3 of 4 Pages

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2023

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ROS FAMILY CHILD CARE	FACILITY NUMBER: 198400860
	VISIT DATE: 10/31/2023

NARRATIVE

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On this date, 09/14/2023 , the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant, Somaly Ros was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Based on the LPA’s observation, there are not needed in order to obtain a small family child care license.

A small family child care license will be issued once approved by Licensing Program Manager. 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, Somaly Ros. A Copy of the report, Appeal Rights, and Notice of Site Visit was given at the end of the report.

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 platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

End of Report 4 of 4 pages

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2023

LIC809 (FAS) - (06/04)

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