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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495031
Report Date: 04/27/2022
Date Signed: 04/27/2022 02:31:47 PM

Document Has Been Signed on 04/27/2022 02:31 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:VILLA FAMILY CHILD CAREFACILITY NUMBER:
197495031
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
04/27/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Patricia Villa, Applicant and and Applicant's DaughterTIME COMPLETED:
02:35 PM
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On 04/27/2022 at 10:20 AM, Licensing Program Analyst (LPAs) Denise Miranda and Suzette Ornelas conducted an announced Pre-Licensing inspection at 2136 Louella Avenue, Venice, CA 90291. The purpose of the visit is to ensure that health, safety and personal rights, as required by Title 22 Regulations governing California Family Child Care Homes. This is an application for a Small Family Child Care Home. Per application, the facility hours will be from 8:00AM to 5:00pm Monday - Friday and Applicant has applied to provide care for children age: 6 weeks to 10 years. Applicant will submit a revised form LIC279 no later than 5/2/2022.

LPA Miranda and Ornelas met with applicant, Patricia Villa, Applicant and Applicant’s daughter Monica Espinoza and was guided on a tour of the indoor and outdoor of the home. LPAs did not observe any children in care during this inspection. Per applicant, the resident in the home is herself. LPAs observed all adults obtained criminal record clearances and are associated to the facility.

The home is a one story dwelling with 3 bedrooms, 2 bathrooms, living room, dining room, kitchen, Jacuzzi area, back yard, detached garage with one bathroom, 2 storages sheds located on the back of the garage (detached) and back yard area, located on the right side of the house, behind the garage, it was observed with a fence and locked with key.
The primary childcare area of the home is the living room, dining room, bedroom#1&2, bathroom#1.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE: DATE: 04/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/27/2022
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: VILLA FAMILY CHILD CARE
FACILITY NUMBER: 197495031
VISIT DATE: 04/27/2022
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Safe toys and play equipment are observed. The fireplace in the living room is screened and is stable on the floor and wall.
LPA’s inspected the bathroom and observed shampoos, lotions, air fresheners accessible, would pose a risk to children in care, applicant agreed to remove all those items and submit photos to LPA Miranda.
Outdoor play area was observed at the back yard of the facility and observed drive way that was fully fenced with a gate giving access to the alley. Per applicant, that gate will not be used as a main entrance or exit, parents and children will use the front door of the home.
The off-limit areas of the home area: bedroom#3, bathroom#2, kitchen, detached garage with bathroom, 2 storages sheds, back yard located on the right side of the house, behind of the garage, jacuzzi area and drive way. LPAs observed at the kitchen area with a child safety gates and latches on the drawers, making it inaccessible to the children in care.

During this inspection, LPAs observed a small dog. LPAs advised applicant to maintain the pets on off-limit during the operation hours of the family child care.

Applicant 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.

LPAs discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-rrresources/safe-sleep as an additional resource. LPA also informedapplicant of the

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2022
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: VILLA FAMILY CHILD CARE
FACILITY NUMBER: 197495031
VISIT DATE: 04/27/2022
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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.

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 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.

The following is needed priory to licensure:


LIC9999A – Facility Sketch (Floor plan and yard), need to be revised.
LIC279 – Application for Family Child Care Home License – need to be revised, due the age to be served.
Living Room: A latch need to be placed on the piano.
Dining: Secure the bamboo divider by the sliding door.
Proof of Fire Extinguish purchased no later than 1 year.
Hall way: Wall heater – need a barricaded.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2022
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: VILLA FAMILY CHILD CARE
FACILITY NUMBER: 197495031
VISIT DATE: 04/27/2022
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Bathroom#1: Applicant will remove all lotions, shampoos, air freshener and make inaccessible to the children.
Documents must to be post: Applicant needs to fill out the form PUB394. Post it on the hall way.
Bedroom#1: Closet door, applicant needs to place a latch or safety Knob. A declaration will be submitted due a bouncer observed during this inspection, that was removed to off limit area. Per applicant she will donate the bouncer.
Bedroom#2: Secure the book shelf and closet need to place a latch.
Applicant will buy cots or mats to accommodate children during the napping time. Laundry area by the deck, applicant will place a latch on the box that she keeps her laundry detergent and chemicals.
Jacuzzi: per applicant, the jacuzzi is not working. Applicant agreed to remove the water inside of the jacuzzi, to avoid infestation.
Applicant will make the open space located on the outside of the jacuzzi room, make inaccessible to the children in care, by covering with wood and/or screen.
Side walk of the house: LPAs observed that applicant using the side walk of the house as a storage. Applicant will place a gate or strong barricade, to make inaccessible to the children in care.
A barbecue grill, was observed on the back of the jacuzzi area. Per applicant, the barbecue grill will be removed this weekend.
Drive way, separating the on limit to off limit area. Need a lock.
Detached garage: LPAs observed a gap between garage and wall, that needs to be barricade. During this inspection visit, LPAs observed that garage has a small room and a bathroom. Per applicant, this area is using only for storage. A declaration will be provided by applicant.
Backyard: LPAs observed plants such as roses and lemons tree without fence, making this area accessible to the children. Applicant agreed to place a fence to make this area inaccessible to the children in care. Applicant will make the grass area even, per applicant she will place sand or wood chips or any material that will make this area without hazard and even, without holes.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2022
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: VILLA FAMILY CHILD CARE
FACILITY NUMBER: 197495031
VISIT DATE: 04/27/2022
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Storage: Sheds – Store shade one, located behind of the garage, need a lock or latch.
LPAs observed gaps between shade #1 and #2 and shade#2 and backyard fence, that needs to be barricade.
Back yard located on the right side of the house, behind of the garage: This area, needs to be clean and orderly. Per Applicant she will clean this area and maintain as a off-limit to the children.
LPAs observed non-Emergency Disaster supplies. Applicant will review the form lic9148 and create her emergency disaster supplies.
LPAs inspected the first aide and observed that a thermometer was missed. Applicant will buy a thermometer.
Applicant agreed to provide copy of the immunization card of her pet.
Per Applicant, she agreed to provide photos of all corrections that was recommended during this prelicensing to Licensing Program Analyst (LPA) Miranda no later May 13th, 2022.

Applicant agreed to submit all plan of corrections via email to Licensing Program Analyst (LPA) Miranda no later than 05/13/2022.

Exit interview conducted and a copy of this report was provided to Applicant.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Denise Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2022
LIC809 (FAS) - (06/04)
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