198401123-9-12-2024-54-CC-KCHE-D92PP7-20240912112905

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198401123
Report Date: 09/12/2024
Date Signed: 09/12/2024 11:29:32 AM

Document Has Been Signed on 09/12/2024 11:29 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	ARROYO FAMILY CHILD CARE		FACILITY NUMBER:	198401123
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	09/12/2024
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Mirna Arroyo, Applicant		TIME VISIT/ INSPECTION COMPLETED:	12:00 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	On 09/12/2024 at 9:00 AM, Licensing Program Analyst (LPA) Katrina Chicote conducted an Announced – Prelicensing Inspection to the above facility. Upon arrival, LPA met with Applicant, Mirna Arroyo, who granted entry to facility and guided the LPA on a tour of the facility both indoors and outdoors, including off limits areas. Adults in the home were discussed and all have criminal record clearance. The Applicant is requesting a small family child care home license max capacity of eight (has landlord consent on file). Per Applicant, operation hours will be Monday thru Friday 6:00 AM to 6:00 PM primarily 0-4 years of age but Applicant is open to taking care of children up to 12 years of age. All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a single story home that consists of two bedrooms and one bathroom, Day Care Area, and Kitchen. Facility is in located upstairs and area below is a garage/workshop. Per Applicant, the children will have access to Day Care Area and Bathroom 1. Per Applicant and Facility Sketch submitted, off limit areas of the home will be all bedrooms and Kitchen, Bedroom 1 will only be used as access to Bathroom. At 9:05 AM, LPA observed operable baby gate blocking access to Kitchen and child safety door knobs on all bedroom doors making these areas off limits at time of inspection. All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. LPA observed central air and heat through out the home. There is a working telephone maintained in the home, which will be Applicant's cellphone. LPA discussed cellphone use and to ensure communications with qualified adult left in the care of children should Applicant have to leave facility. At 9:03 AM, LPA observed Day Care Space to have storage for age appropriate toys free of loose and sharp parts, play rugs that are well maintained, diaper changing table by wall, and television hanging in corner. Applicant states they will use area of Day Care Space that is not being used as isolation area for sick children. LPA observed electrical cover outlets all through the home. Applicant states she will provide food to children in care and use Day Care Space fore eating. LPA discussed Report Continues - Page 1 of 6

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 6

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: ARROYO FAMILY CHILD CARE	FACILITY NUMBER: 198401123
	VISIT DATE: 09/12/2024

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having proper equipment needed for children eating. Applicant states she has ordered feeding chairs for infants and will obtain table and chairs for older children. LPA observed Kitchen to have operable child safety locks on low cabinets and drawers including drawer where sharp knives and utensils are stored. At 9:06 AM, LPA observed bathroom to have adequate supplies, operable equipment, and general safety and sanitation. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. At 9:10 AM, LPA observed these items stored in low Kitchen cabinet and bathroom cabinets all with operable child safety lock at time of inspection. Applicant was advised that inaccessibility of hazards must be constantly reassessed depending on the age, size, and abilities of children in care. LPA advised that poisons used to kill any kind of bugs/vermin should be locked and made inaccessible for a variety of children's size, age, and abilities.

Per Applicant, the children will have access to side yard for outdoor play which is accessible going downstairs from facility. Applicant walked LPA to route for going outside, which is downstairs and through garage/work shop. LPA discussed supervision with Applicant and that when going outside to play, children must have full supervision due to stairs and a variety of hazardous equipment that is in garage/workshop. At 9:20 AM, LPA observed side yard has half concrete and half turf surface that is maintained, and adequate perimeter fencing through-out. LPA observed a variety of age appropriate toys such as: swing set on top of turf surface and ride along toys that were free of loose and sharp parts available for the children. LPA observed all trees, shrubs, and plants are maintained at time of inspection.

LPA did not observe any pets at time of inspection and Applicant confirms she has no pets. Per Applicant, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPA observation did not see any bodies of water around the premises or firearms/weapons at time of inspection.

At 9:08 AM, LPA did not observe the required 2A-10BC fire extinguisher, LPA observed 1A-10BC fire extinguisher at time of inspection. LPA discussed required size and requirement to get fire extinguisher serviced annually or obtain a new one annually and keep receipt. At 9:09 AM, LPA tested smoke and carbon monoxide detectors which were observed to be operable at time of inspection. LPA observed First Aid kit stored in Day Care Space. The Applicant has current Pediatric First Aid and CPR valid until 10/2025 and required AB1207 Mandated Reporter training completed on 01/04/2024. Applicant provided proof of immunization against influenza, pertussis, and measles to Department. LPA discussed requirement to have these documents readily available during inspections for herself and all qualified adults.
Report Continues - Page 2 of 6

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024

LIC809 (FAS) - (06/04)

Page: 2 of 6

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: ARROYO FAMILY CHILD CARE	FACILITY NUMBER: 198401123
	VISIT DATE: 09/12/2024

NARRATIVE

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The following was discussed with the Applicant:
· In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR training, Immunizations (TDAP, MMR, Influenza), mandated reporter training and a valid criminal record clearance associated to the facility license.
· Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License may be terminated.
· Smoke and carbon monoxide detectors should be checked and batteries replaced as needed.
· Reporting Requirements: Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.
· Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.
· Fire and safety drills must be performed every six months and documented for review by the Department.
· Smoking is prohibited in a family child care home.
· Children and Staff records must be maintained and updated as needed and must be available for review by the Department for a minimum of 3 years.
· No infant walkers, No Johnny jumpers, No saucer chairs, No incline sleepers or any other item that falls into that category are not permitted in the facility.
· Inspection Authority: All adults living and working in the home shall be made of aware of the Department’s right to inspection the home, which includes, but is not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.
· The facility license number must be on all advertisements, publications or announcements with the intent to attract clients.
· Isolation for Ill children: When a child is ill he/she shall be separated from other children (reference 102417(e) Operation of a Family Child Care Home).
· Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information.
· Immunization Requirement: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The licensee and all adults working with children have proof of immunizations.
Report Continues - Page 3 of 6

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024

LIC809 (FAS) - (06/04)

Page: 3 of 6

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: ARROYO FAMILY CHILD CARE	FACILITY NUMBER: 198401123
	VISIT DATE: 09/12/2024

NARRATIVE

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· Mandated Reporter Training: H&S 1596.8662: Beginning January 1, 2018, all licensed providers, applicants, directors and employees to complete training as specified on mandated reporter duties. Training is available at: www.mandatedreporterca.com

OTHER INFORMATION AND FORMS PROVIDED:

· Capacity Handout for a Small Family Child Care Home and Large Family Child Care Home was provided.
· Examples for Safe Sleep Logs & Fire Drill Logs
· PIN 20-24-CCP Safe Sleep Regulation
· Forms referenced on LIC 311D

Incidental Medical Services (IMS):
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 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.

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

LPA reviewed 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. Entrance Checklist was provided to the Applicant.
Report Continues - Page 4 of 6

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024

LIC809 (FAS) - (06/04)

Page: 4 of 6

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: ARROYO FAMILY CHILD CARE	FACILITY NUMBER: 198401123
	VISIT DATE: 09/12/2024

NARRATIVE

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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.

The Applicant provided proof of control of property.
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).

On this date, 08/07/2024, 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 athttps://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

Per Applicant, there are no dual licenses at this address. Applicant was advised that email may be public information.
Report Continues - Page 5 of 6

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024

LIC809 (FAS) - (06/04)

Page: 5 of 6

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: ARROYO FAMILY CHILD CARE	FACILITY NUMBER: 198401123
	VISIT DATE: 09/12/2024

NARRATIVE

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Based on the LPA’s observation, the following correction needs to be corrected prior to obtaining a small family child care license. Corrections are due by end of day 09/12/2024.

· Applicant states that they will obtain the correct 2A-10BC fire extinguisher and provide photo to LPA via email.

A small family child care licensee will be granted upon receipt of proof of corrections for the above. Once licensed, the applicant is required to comply with the terms and limitations stated on the license. A copy of this report was reviewed and provided to the applicant.

Exit interview was conducted with Applicant, Mirna Arroyo.

Report Ends - Page 6 of 6

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024

LIC809 (FAS) - (06/04)

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