304313883-3-13-2023-06-CC-STOE-CPVV33-20230313160403

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304313883
Report Date: 03/13/2023
Date Signed: 03/13/2023 04:04:24 PM

Document Has Been Signed on 03/13/2023 04:04 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	CHAVEZ, PAOLA & JESUS & MAGANA, VERONICA		FACILITY NUMBER:	304313883
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 7	CENSUS: 3	DATE:	03/13/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	03:10 PM
MET WITH:	Chavez, Paola & Jesus & Magana, Veronica, Licensees		TIME COMPLETED:	04:10 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) Stacy Torrence conducted a case management inspection, in response to licensee’s request for a capacity increase. LPA met with licensees Jesus Chavez and Veronica Magana, who guided analyst on a tour of the facility. LPA Torrence observed three children in the designated napping area. The facility was within licensed capacity and the required ratio. Licensee stated there is currently seven adults and one minor child living in the home. Licensee stated she is not currently registered with any Foster Care agency or holds a foster parent license. Licensee was reminded if changes to notify the licensing office. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. This is a single-story home with four bedrooms, two bathrooms, living room, family room, kitchen, dining room, front yard, side driveway (outdoor activity), with extended side yard with three small sheds for storage and one large wooden shed turned into an office area, laundry room, and garage (remodeled to a studio). Applicant has designated the family room, one bedroom, one bathroom, and side driveway and back yard as part of the day-care. Applicant has designated three bedrooms, one-bathroom, kitchen, dining room, living room, front yard, extended side yard, and garage, as the off-limit areas. Applicant has placed a child proof safety gate at the kitchen entrance separating the off-limit areas from the daycare area, ensuring the off-limit areas are inaccessible to the children in care. The applicant acknowledged the children may never enter the off-limit areas, during operation hours. Control of property was verified by LPA during today’s inspection. The applicant has a cell phone that is used for childcare. The applicant was informed if a cell phone is used for childcare, it must remain on the premises at all times during hours of operation. Applicant was informed and understands the home is to be free from smoking during hours of operation.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Stacy Torrence
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2023

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CHAVEZ, PAOLA & JESUS & MAGANA, VERONICA	FACILITY NUMBER: 304313883
	VISIT DATE: 03/13/2023

NARRATIVE

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The facility does have a fireplace, located in the living room, barricaded with a screen. Cleaning solutions/chemicals, utensils, and sharp knives located in the kitchen and laundry room, which is the off limit area. Poisons/Hazardous items are not stored on site, and none were observed. There are no bodies of water. The toys are age appropriate and in good condition for the potential ages served. Baby walkers, bouncers, jumpers, and similar items will not be used for children in care. The applicant stated there are no weapons or firearms on the premises. When firearms are present, they must be locked and stored separately from the ammunition. During today's inspection, the smoke detector and carbon monoxide were operable, and the fire extinguisher was charged.

Applicant will use the side driveway and back yard for children's outdoor activities. The back yard is appropriately fenced. LPA observed play equipment to be safe and free of hazards.

There is one small dog at the facility, which has completed all vaccinations.

Per applicants, provides breakfast, lunch, dinner and snacks for the children. Per applicant, she provides the children with water bottles. LPA reminded applicant, that if food is not provided and food is brought from the children’s homes; container shall be labeled with child’s name and properly stored or refrigerated.

Applicant’s Mandated Reporter Training is current. EMSA approved Pediatric CPR and Pediatric First Aide are current for two applicants, which both expires on 05/24. The other applicant’s CPR expired on 02/23.

LPA advised the licensee how to access forms, regulations and quarterly updates online at: www.ccld.ca.gov.

LPA consulted and explained Child Abuse Reporting, Updated Parent’s Rights Poster with Complaint Hotline information, Never Shake a Baby, Sudden Infant Death Syndrome (SIDS), and Safe Sleeping practices.

Fire clearance granted on 03/09/2023.

During todays’ inspection, the facility was not in compliance with Health and Safety Code. One of the licensees’ did not have a current CPR/1^st Aid card. The facility has three licensees on the license.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Stacy Torrence
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2023

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CHAVEZ, PAOLA & JESUS & MAGANA, VERONICA	FACILITY NUMBER: 304313883
	VISIT DATE: 03/13/2023

NARRATIVE

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A new license for operating a Large Family Child Care Home shall be issued upon final review and if additional information is needed, licensees shall be contacted.

An exit interview was conducted. The report was reviewed and discussed with licensee. Appeal Rights were explained. The Licensee was provided a copy of appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above. The Notice of Site Visit was posted and discussed as required by H&S Code Sec. 1596.817. The Notice of Site Visit must be posted on or adjacent to the door. Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.00.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Stacy Torrence
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2023

LIC809 (FAS) - (06/04)

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