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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364846276
Report Date: 09/02/2022
Date Signed: 09/02/2022 01:29:44 PM

Document Has Been Signed on 09/02/2022 01:29 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:ANGELES FAMILY CHILD CAREFACILITY NUMBER:
364846276
ADMINISTRATOR:ANGELES, JUDITHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 728-2050
CITY:FONTANASTATE: CAZIP CODE:
92337
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
09/02/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:TIME COMPLETED:
01:30 PM
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On date and time listed, Licensing Program Analyst (LPA) Diana Brasel arrived at the facility to conduct a pre-licensing inspection. The applicant has applied for a Large Family Child Care and and a granted Fire Clearance was obtained. Present during this inspection were: The applicant and LPA. LPA toured the facility, inside and out and the following was observed and/or discussed: Normal days and hours of operation are: Monday - Friday 6:00 am - 6:00 pm. OFF-LIMIT AREAS INCLUDE: The entire upstairs and garage.
· Not an appropriate fire extinguisher was present at time visit- See corrections needed.
An appropriate smoke detector and carbon monoxide detector are present.
· Not all All hazardous items inaccessible- see corrections needed
· Not all Toxins locked- see corrections needed.
· No guns or weapons present as of this date.
· The licensee has a child gate for the stairs which is located 3 stairs up, a gate or barrier shall be
put into place on the ground level of the stairs. See corrections needed.
· Verification of control of property on file (a rental agreement on file)
· Facility Sketch and Emergency Disaster Plan are posted
· Pediatric CPR and First Aid Card - expire 01/22/2024
· Health & Safety Certificate - completed on 01/28/22 to include Nutrition and Lead training.
There are no bodies of water as of this date. Applicant understands all bodies of water including ponds, above ground pools and spas, in-ground pools and spas, and some fountains must be properly covered or fenced per title 22 regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position when not in use.
·Clean, safe and age appropriate toys
·There are no toxic plants observed at this time
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Diana Brasel
LICENSING EVALUATOR SIGNATURE: DATE: 09/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/02/2022
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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: ANGELES FAMILY CHILD CARE
FACILITY NUMBER: 364846276
VISIT DATE: 09/02/2022
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·Applicant will wait until facility opens to determine IMS needs. 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
- AB 1207 – Mandated Child Abuse Reporting: Child Day Care Personnel Training, beginning January 1, 2018 – In accordance with California Health and Safety Code Section 1596.8662 – requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. Existing licensees must meet requirements by March 30, 2018. New employees shall have 90 days to complete training as required. This training requirement may be directly met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/ and are provided in English and Spanish. If no training is made available in a required person’s primary language then those persons shall be exempt from this requirement. A certificate for the General training completed on 08/31/2020 and the the Child Care Provider on 06/24/2022 was provided.
AB 2370 – Effective January 1, 2019 – Lead Poisoning – providers are required to provide a lead toxicity prevention handout to parents/guardians of newly enrolled and newly re-enrolled children with information on risks and effects of lead poisoning; blood lead testing recommendations and requirements; and options for obtaining blood lead testing, including free and/or discounted testing. There will be a training component of this added to the Preventative Health Training beginning July 1, 2020.
LPA provided a copy of the Safe Sleep regulations to the 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, Judith Angeles of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC)
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Diana Brasel
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2022
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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: ANGELES FAMILY CHILD CARE
FACILITY NUMBER: 364846276
VISIT DATE: 09/02/2022
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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.
The Licensee was informed of their reporting requirements and was provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov

The Licensee can submit transfer forms to associate new individuals or to disassociate someone from the facility at: Associations_Disassociations858@dss.ca.gov

The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at:
1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200.

LPA provided 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
Applicant Judith Angeles was reminded that all adults 18 and over living or working in the home, 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 (PIN), Program Quarterly Update Newsletters and other important information communication platform.


To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.
- Pre-Licensing Visit Packet provided (children’s/staff records & posting requirements included)
- Failure to meet the posting requirements shall result in an immediate $100 civil penalty.
- Documentation of fire & earthquake drills to be conducted every six months
- Responsibilities of being a mandated reporter
- Access to forms & Regulations for Family Child Care online at www.ccld.ca.gov
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Diana Brasel
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2022
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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: ANGELES FAMILY CHILD CARE
FACILITY NUMBER: 364846276
VISIT DATE: 09/02/2022
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- Responsibility to know the regulations for anyone providing care
- Inaccessibility of hazards must be constantly reassessed depending on the children in care
- Current facility’s phone numbers must be on file with the licensing office at all times
- Baby walkers, bouncy seats, exer-saucers and other similar items are prohibited
- The applicant is urged to visit the U.S. Consumer Product Safety Commission web-page at www.cpsc.gov to ensure that equipment purchased for the day care has not been recalled.

Please subscribe at www.childcareadvocatesprogram@dss.ca.gov to receive Department updates. They will be sent directly to your e-mail account once you have set up an account. This website can also be accessed through www.ccld.ca.gov

Before licensure, the following needs to be corrected/completed:
1. Proof of obtaining a 2-A:10- B:C fire extinguisher shall be submitted.
2. Proof that all poisons and toxins have been key locked shall be submitted.
3. Proof that either the splintered wood gate located in the backyard accessible to children has been
repaired, made inaccessible or removed.
4. Proof that the stairs have been made inaccessible to children in care shall be submitted.

Once licensed, the Notice of Site Visit must be posted at the entrance of the facility for a period of
30 days. If a serious violation is cited, a copy of the licensing report (LIC809/LIC9099) must also
be posted for 30 days. A civil penalty of $100 per violation will be assessed for noncompliance.
Access to forms & Regulations for Family Child Care Homes online at www.ccld.ca.gov.

An exit interview was conducted and the report was reviewed with the applicant Judith Angeles on this date.

A copy of this report was left with the Applicant and a copy must be made available upon request, to the public, for 3 years.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Diana Brasel
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2022
LIC809 (FAS) - (06/04)
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