The facility is a single-story home with three (3) bedrooms, two (2) bathrooms, living room, dining room, kitchen, attached garage, front yard, and backyard. The on-limit areas are living room, dining room, Room 3 (infant nap room), bathroom by Room 3, and backyard. The off-limit areas are Room 1, Room 2, kitchen, garage, and sides of backyard, which will be inaccessible by closed and/or locked doors and visual supervision. The isolation area is Room 3. When a child shows signs of illness, he/she will be separated from other children here.

The inside of the home is observed to be clean and orderly, with central heating and ventilation for safety and comfort. LPA observed there are ample safe and age-appropriate toys, play equipment and materials. There is a fully charged 3A40BC fire extinguisher in living room. LPA observed one (1) working smoke detector in the living room and one (1) working carbon monoxide detector in the hallway. The home is equipped with telephone service and a fully stocked first aid kit. All toxins, cleaning products, and hazardous materials have been made inaccessible to the children. A fireplace in the living room has been made inaccessible to children with a screen door and shelf. Licensee has two large dogs that are kept in the off limit, fenced off area of the backyard when children are in care. Per licensee, there are no firearms in the home.

LPA observed (6) play yards in the on-limit bedroom with the correct size mattresses and fitted sheets used by infants. Non-infant children are provided with sleep cots in the living room during nap time. Licensee provides bedding to the children. Licensee provides AM/PM snacks, breakfast, and lunch for the children. Licensee does not transport children.

Page 1 of 3. See LIC 809C.

The licensee completed the Health and Safety training. The licensee’s Pediatric CPR/First Aid certification is current and expires on 02/13/2026. Licensee has completed the Mandated Reporter training for Child Care Providers and expires on 12/07/2025. The licensee is in compliance with the immunization laws. All adults living in the home have obtained a criminal record clearance. The licensee conducts and documents fire and disaster drills at least once every six months, and the last conducted drill was on 08/01/2024. All required documents are posted and visible for public review.

LPA reviewed 6 (six) children’s files and two (2) staff files. 1 of 2 staff files reviewed by LPA did not have proof of immunization for MMR (measles) and Tdap (pertussis). There is a current roster available for review. The licensee rents the property. The facility does not have liability insurance, and the Affidavit Regarding Liability Insurance forms (LIC 282) were reviewed. 1 of 6 children’s files reviewed by LPA did not have a signed LIC 282, and 4 of 6 children’s files contained LIC 282 but Section B was not filled out.

Licensee was reminded that California Law requires licensees to report unusual incidents or injuries to children in care, to child's parents, and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624B). Any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing. Incidents must be reported within 24 hours by phone, fax, or email. LPA informed the Licensee that all forms can be downloaded at www.ccld.ca.gov.

Licensee was also reminded that Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting https://mandatedreporterca.com/. Licensee was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years.

Licensee 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.

Page 2 of 3. See LIC 809C.

Licensee 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.

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.

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-care-licensing/subscribe and select the Child Care option to receive email communication.

Three (3) Advisory Notes were issued during today’s inspection. Please see attached advisory note pages for information on technical violations (TV) issued today. Note that technical violations are not citations.

· Outdoor play equipment are not maintained in good condition

· 1 of 2 staff file's reviewed by LPA did not have proof of immunization for measles (MMR) and Tdap (pertussis)

· 1 of 6 children's files reviewed by LPA did not have a signed LIC 282 on file. 4 of 6 children's files have a signed LIC 282 but Section B was not filled out.

A Notice of Site Visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Katia Perez Palma. LPA provided licensee a copy of the Appeal Rights.

Page 3 of 3. End of Report.