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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700082
Report Date: 03/21/2023
Date Signed: 03/22/2023 11:01:52 AM

Document Has Been Signed on 03/22/2023 11:01 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:GALLEGOS FAMILY CHILD CAREFACILITY NUMBER:
195700082
ADMINISTRATOR:GALLEGOS,MARICELA & EMILIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 720-7917
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91605
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
03/21/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:MARICELA GALLEGOS, LICENSEETIME COMPLETED:
01:30 PM
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On 3/21/2023, Licensing Program Analyst (LPA) Loyce Phillips conducted an announced Pre-Licensing inspection with Licensee, Maricela Gallegos. This inspection is due to an application received for a relocation of a large family childcare license. Licensee guided LPA on a tour of the facility and intends to operate 24 hours. Licensee is aware when children are awake, Licensee must be awake. Licensee will provide breakfast, lunch, am/pm snack and dinner to children in care.

Licensee does not have child-care insurance. Licensee resides in the home with mother ( 2nd Licensee). The areas identified on the facility sketch were inspected. This is a 2 bedroom, 1 bathroom home with living room, dining area, kitchen, den and detached garage. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition stored on the premises.

Areas that are accessible to children are as follows: Living room, dining area, den and garage for daily activities only. Licensee is aware that children will only do daily activities in the garage. Eating, sleeping and toileting are conducted in the main house. Children have access to the backyard area for outdoor activities.

The off-limits areas are as follows: Bedroom #1, #2 and kitchen. Rooms are made inaccessible by children safety door knobs and kitchen made inaccessible by safety gate.

The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation. LPA observed age appropriate safe toys inside and outside the home. Licensee advised; children will nap on cots. Licensee has a carbon monoxide and smoke detector that was tested and operating. The fire extinguisher is located in the kitchen service on February 22, 2023. Medications are stored in kitchen upper cabinet inaccessible to children. Knives were observed in a kitchen drawer inaccessible to children. Cleaning products are kept in the hallway closet inaccessible to children.

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE: DATE: 03/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/21/2023
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: GALLEGOS FAMILY CHILD CARE
FACILITY NUMBER: 195700082
VISIT DATE: 03/21/2023
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LPA reviewed with Licensee 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.

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, 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.

LPA discussed the safe sleep regulations with Licensee 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 resources. LPA also informed licensee 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 provided Recently Approved Safe Sleep Regulations PIN 20-24-CCP.

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

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletter and other important information communication platform.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website athttps://www.cd.ss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Based on today's inspection, the facility is approved for a License pending managers approval.

Exit interview conducted and report was reviewed with Licensee, Maricela Gallegos.

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 03/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023
LIC809 (FAS) - (06/04)
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