195700146-8-1-2023-58-CC-SGAA-CUAQDP-20230801120505

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 195700146
Report Date: 08/01/2023
Date Signed: 08/01/2023 12:05:18 PM

Document Has Been Signed on 08/01/2023 12:05 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	LOPEZ & BAUTISTA FAMILY CHILD CARE		FACILITY NUMBER:	195700146
ADMINISTRATOR:	M.LOPEZ & S.BAUTISTA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 914-4041
CITY:	WINNETKA	STATE: CA	ZIP CODE:	91306
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS:	DATE:	08/01/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Marcela Lopez & Sulma Bautista		TIME COMPLETED:	12:15 PM

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On 08/01/2023 Licensing Program Analysts LPA (s) Sarah Garcia and Adrian Risher conducted an announced inspection with applicant (s) for the purpose of a pre licensing inspection of 20809 Bassett St Winnetka, CA 91306. The purpose of this inspection is to ensure the standards for a large family Child Care Home are being met in accordance with California Tittle 22 Regulations and California Health and Safety Codes.

Per the application, at this time, the ages the applicant(s) wish to provide services for are children 6 months to 12 years old, Monday- Friday from 6:00 am to 6:00 p.m. Applicant is available to care for children five days a week,

Fire clearance was received and completed by inspector Lindy Struek on 07/23/2023.

Applicant(s) were informed that any changes to ages, hours and days of operation shall be submitted to the department for approval prior to initiation of changes. Applicant(s) are applying for a Large Family Child Care License with a max capacity of 14. Copy of lease agreement is on file. Applicant(s) rent the property. Living in the home with applicant(s) are two adult males.

LPAs toured the home inside and outside. The facility is a single-family home with 3 bedrooms, 2 bathrooms, a living room, dining room, garage and kitchen area. The home has an enclosed front yard and back yard. LPA(s) observed a garage used as an additional play area.

Parents will access the home through the front door. The primary day care area consists of the living room and dining room. LPA observed age appropriate toys, mats for sleeping, and materials. Child size table and chairs were observed in the space. LPA (s) observed a parent board with all necessary posting outside by the front of the door. Applicant(s) confirmed children will nap and eat in the living room. Children will nap in bedroom #2.

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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023

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: LOPEZ & BAUTISTA FAMILY CHILD CARE	FACILITY NUMBER: 195700146
	VISIT DATE: 08/01/2023

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Next to the space, the bathroom that children use was observed. A toilet and sink were observed. All cabinets were observed to have safety latches making any content stored under the sink, inaccessible to the children in care. LPA(s) observed a first aid cabinet locked and inaccessible to children.

Kitchen was observed and inspected. Kitchen is OFF LIMITS to the children in care through a sliding gate. LPA(s) observed all kitchen cabinets were observed to have safety latches. Refrigerator, stove and counter space were observed and inspected. Knives and sharp objects were observed in the bottom cabinet with a safety lock and inaccessible to the children in care. Under the sink cabinet was observed with a safety latch, making the content inaccessible to the children in care. LPA(s) observed a mounted fire extinguisher in the living room area (2-A10-B-C). Licensee confirmed that facility will be providing meals and snacks. LPA (s) discuss food preparation, storage and ensuring a log and information regarding dietary restrictions and allergies are kept up to date. LPA(s) also encouraged applicants to contact their local Resource and Referral agency, CCRC, to inquiry about any food programs.

LPA observed carbon monoxide and smoke detectors throughout the home and garage space space tested during this inspection. The home is equipped with two fire extinguishers, one located in the main home next to the kitchen and the second one located in the garage space. LPA(s) observed all electrical outlets in the home covered.

Next to the living room/dining room area, LPA(s) observed a small hallway that leads to bedroom 1, bedroom 3 and bathroom. All areas have been designated as OFF LIMITS and LPA(s) reminded applicant that any area designated as OFF LIMITS, doors need to be closed and locked during the hours of operation and/or while children are present.

The outdoor area was inspected and observed. LPA(s) observed a covered patio with age appropriate toys. The space was also observed and free from sharp or loose objects.

The following area are designated as OFF LIMITS:
1. Bedroom 1 and bedroom 3 located near the living room area.

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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: LOPEZ & BAUTISTA FAMILY CHILD CARE	FACILITY NUMBER: 195700146
	VISIT DATE: 08/01/2023

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(1) correction is needed during today’s inspections.

The following requirements shall be submitted by 08/11/2023. The licensing determination of this application will be reviewed with Licensing Program Manager for final resolution.

The following corrections need to be completed prior to licensure:
1. LPA(s) advised applicant(s) to barricade the telephone poles and make them inaccessible to children. Applicant(s) will send photos to LPA(s).

Applicant(s) were 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.

The applicant(s) provided proof of control of property. Because the applicant(s) rents/leases the home, proof of landlord notification is required. The LPA(s) observed the Property Owner/Landlord Notification form (LIC 9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

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.

LPA reviewed with applicant 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. Entrance Checklist was provided to the applicant. PIN 22-05-CCP Page Eight
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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: LOPEZ & BAUTISTA FAMILY CHILD CARE	FACILITY NUMBER: 195700146
	VISIT DATE: 08/01/2023

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LPA discussed the safe sleep regulations with applicant(s) 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, licensee, or facility representative] 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.

On this date, 08/01/2023, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant(s) were 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.

Applicant was made aware of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on childcare licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541
Email Address: childcareadvocatesprogram@dss.ca.gov

Commencing September 1, 2016, SB 792, prohibits a person from being employed or volunteering at a childcare facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the inspection.
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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023

LIC809 (FAS) - (06/04)

Page: 4 of 6

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: LOPEZ & BAUTISTA FAMILY CHILD CARE	FACILITY NUMBER: 195700146
	VISIT DATE: 08/01/2023

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Beginning on January 1, 2018, AB 1207, 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. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com. Licensee was reminded of their responsibility to report suspected child abuse.

Applicant was made reminded that it is the applicant’s, as well as anyone who assists in providing care responsibility to know the regulations. Licensee was also encouraged to read the Child Care quarterly updates every season as they come out to stay informed of any changes or updates to statutes and regulations.

Applicant was advised that regulation prohibits the smoking of tobacco in a private residence licensed as a family childcare home during the hours of operation.

Applicant was made aware that state law prohibits baby walkers, bouncy seats, exer-saucers and any other items that fall into that category. Applicant was also reminded that only children who are eating may be in highchairs and that car seats are utilized only for transportation.

Applicant was also informed that the provider is required to wash hands after every diaper change and to never shake a baby to prevent the Shaken Baby Syndrome.

In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR & Pediatric First Aid certification and a valid criminal record clearance associated to the facility license.

A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.

Annual fees must be paid promptly and by the due date or a late fee shall be assessed, and/or the License shall be terminated. (If paying by check please make sure to write facility number on check to ensure that payment is applied to your facility number)

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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023

LIC809 (FAS) - (06/04)

Page: 5 of 6

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: LOPEZ & BAUTISTA FAMILY CHILD CARE	FACILITY NUMBER: 195700146
	VISIT DATE: 08/01/2023

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The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked, and batteries should be replaced.

Changes should be reported to the Department as soon as they occur such as construction and remodeling, telephone number changes and/or if you move from home.

Reporting requirements: Applicant must report any unusual incident or injuries to the Child Care Regional office by telephone within 24 hours and in writing within 7 days. Applicant was provided with LIC 624 as a reference.

Fire and safety drills must be performed every six months and documented for review by the Department.

All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.

LPA advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov

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.

Exit interview was conducted with applicant(s) Marcela Lopez and Sulma Bautista. The licensing determination of this application will be reviewed with Licensing Program Manager for final resolution.

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SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023

LIC809 (FAS) - (06/04)

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