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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198401081
Report Date: 06/14/2024
Date Signed: 06/14/2024 11:18:47 AM

Document Has Been Signed on 06/14/2024 11:18 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:JOHNSON - VIGIL FAMILY CHILD CAREFACILITY NUMBER:
198401081
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
06/14/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:25 AM
MET WITH:Stephanie Johnson & Jeremiah Vigil, ApplicantsTIME VISIT/
INSPECTION COMPLETED:
11:35 AM
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Licensing Program Analysts (LPAs) Susann Sanchez and Ashley Calderon conducted an announced Prelicensing Inspection and met with Applicants, Stephanie Johnson & Jeremiah Vigil. LPAs disclosed the purpose of the inspection and was granted entry into the facility by the Applicant. The purpose of this inspection is to inspect and evaluate the facility for a new small license. Operating hours will be Monday to Friday 6:30AM to 6:00PM and care will be provided for children ages 3 years old to to 13 years old. All residents living in the home were discussed and verified and have obtained a criminal record clearance.

The day care facility is a 4 bedroom, 2 1/2 bathroom home with a living room, dining room area, kitchen, enclosed backyard, garage and backroom located in the backyard. Off Limit areas: All bedrooms, bathroom located in master bedroom and bathroom located in the garage, and back detached room in the backyard. On Limit areas: Living room, dining room area, kitchen, bathroom (located in the hallway), and backyard.

The day care areas that will be used by children were observed for safety, comfort, cleanliness, telephone service (cell phone). The facility has central air/heating. No wall heaters were observed. Fireplace is blocked and the gas is shut off.

Per Applicants, children will have access to the living room and dining room area which will be used for day care activities, meals and napping. Per applicants, garage will only be used for activities such as art n crafts. Per Applicant a section of the living room will be used for ill/sick children. LPAs observed age appropriate materials and toys available for children. LPA observed napping equipment available. LPAs reviewed requirements (LIC 311D) with Applicant. Per Applicants, facility will use "Angels" food program for children in care. Applicant was advised that if food is brought from the children’s homes, the container shall be labeled with the child’s name and properly stored or refrigerated.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/14/2024
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: JOHNSON - VIGIL FAMILY CHILD CARE
FACILITY NUMBER: 198401081
VISIT DATE: 06/14/2024
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Kitchen detergents, cleaning compounds, sharp objects and hazardous items that can pose a danger to children are inaccessible to children in care. Knives and sharp objects are kept in an a locked cabinet on the kitchen island. Per Applicants, there are no poisons in the home. LPAs advised that if any other poisons are kept in the home at a later date to keep them in a locked cabinet or container. LPA observed an operable combination smoke/ carbon monoxide detector in the hallway. LPA observed a 2A10BC fire extinguisher was serviced on 6/13/24. LPAs observed electrical outlets covered throughout the home. Children will have access to the bathroom in the hallway next to the off limit bedrooms. Per Applicants, bedrooms will remain locked while children are in care. No cleaning compounds were observed in the bathroom. No hazards were observed in the bathroom. Per Applicants, they will escort children to the restroom. Applicants completed the required Health and Safety Training with nutrition Training and lead training on 6/2/24. Pediatric First Aid and CPR training issued by the American Heart Association was completed on 4/17/2023 (expires 04/17/25). Mandated Reporter Training for child care providers was completed on 5/24/24 (expires 05/24/26). Applicant has proof of the required immunization to measles, pertussis and flu. Applicant was reminded that pediatric first aid and cpr and mandated reporter shall be renewed every two years.

Children will play in the backyard. Backyard access is located through the kitchen/dinning area and the garage. Children will be escorted to access the backyard. Per applicants, children will be supervised while playing outside. Per the Applicants there are no bodies of water on the premises such as pools/ hot tubs or spas. LPA did not observe any bodies of water. Applicants stated that facility will go on walks to Zimmerman park from time to time. Applicant stated there are no weapons or firearms in the home.

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, 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.


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: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2024
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: JOHNSON - VIGIL FAMILY CHILD CARE
FACILITY NUMBER: 198401081
VISIT DATE: 06/14/2024
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On this date, 06/14/2024, 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 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. 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.

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) or (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.

The applicant provided proof of control of property. Because the applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

There are no physical corrections needed at this time. LPAs will submit application for final review. Exit interview conducted and report was reviewed with the Applicants Stephanie Johnson & Jeremiah Vigil.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2024
LIC809 (FAS) - (06/04)
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