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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 136610484
Report Date: 09/30/2021
Date Signed: 10/05/2021 02:01:53 PM

Document Has Been Signed on 10/05/2021 02:01 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:PAZOS, MONICA FAMILY CHILD CAREFACILITY NUMBER:
136610484
ADMINISTRATOR:MONICA PAZOSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 556-1156
CITY:BRAWLEYSTATE: CAZIP CODE:
92227
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 8DATE:
09/30/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Monica PazosTIME COMPLETED:
10:45 AM
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On 09/30/2021, at 9:45 a.m., Licensing Program Analyst (LPA), Adrian Castellon conducted an unannounced Annual Required Inspection and met with licensee Monica Pazos. LPA discussed the purpose of the inspection and was granted entry into the facility by Licensee Pazos. There were eight children present in the facility during this inspection. Also present was the licensee's cleared assistant. The following areas are used for daycare purposes: dining area and the daycare area. Licensee accompanied LPA Castellon inside and out of the facility during this inspection. A fully fenced backyard will be used for daycare purposes. The fire extinguisher, smoke detector and carbon monoxide detector meet requirements. All hazardous items were inaccessible to children. The storage area for poisons is locked. The licensee has toys, play equipment and materials available. No bodies of were water observed on the premises during the inspection. Licensee stated there are no weapons in the home. Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Licensee’s First Aid and CPR certifications are valid thru 5/2023. Licensee has required immunization's. Emergency disaster drill requirement was met. Children's files reviewed on this date. Required facility postings were observed on this date. LPA Castellon provided and discussed the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, and ensure that all adults residing or working in the home have criminal background clearances or exemptions. Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers and/or similar equipment are not allowed in daycare.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Adrian Castellon
LICENSING EVALUATOR SIGNATURE: DATE: 09/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/30/2021
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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: PAZOS, MONICA FAMILY CHILD CARE
FACILITY NUMBER: 136610484
VISIT DATE: 09/30/2021
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Safe Sleep Regulations/SIDS, Lead exposure and Shaken Baby Syndrome was discussed. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.
LPA discussed and provided Licensee with the following: child care advocates email address: childcareadvocatesprogram@dss.ca.gov. In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.

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. Licensee Pimentel does not provide IMS.

SAFE SLEEP PLAN and documentation was discussed. The licensee was advised to physically check on sleeping infants every 15 minutes. An Individual Infant Sleeping Plan [LIC 9227 (3/20)] is maintained for each infant up to 12 months of age and shall be available to the Department for review. The licensee must place infants up to 12 months of age on their backs for sleeping.

Mandated Reporter training requirement was met.

An exit interview was conducted with the licensee. The licensee will be provided a copy of this report via email. No citations issued on this date.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Adrian Castellon
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2021
LIC809 (FAS) - (06/04)
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