198012993-6-24-2021-54-CC-RDEO-C4AQ2D-20210624114657

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198012993
Report Date: 06/24/2021
Date Signed: 06/24/2021 11:47:07 AM

Document Has Been Signed on 06/24/2021 11:47 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	ALVAREZ FAMILY CHILD CARE		FACILITY NUMBER:	198012993
ADMINISTRATOR:	ALVAREZ, EVELYN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 612-3513
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90805
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 9	DATE:	06/24/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Licensee - Evelyn Alvarez		TIME COMPLETED:	12:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) R. Derraco and Licensing Program Manager (LPM) Trevino Cochran conducted an unannounced annual inspection to the above facility on 06/24/21 LPA arrived at the facility at 9:00AM and met with Licensee, Evelyn Alvarez, who guided analyst on a tour of the facility. Also present during this inspection was her assistant. Per Licensee, there are 14 children that are currently enrolled. There were 9 children present upon arrival. This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen, living room, den, front yard and backyard (fenced). The den is being used as the main care area. At 9:05 AM, LPA observed age appropriate toys, play equipment and materials in the indoor main care area along with a fireplace that is screened and locked. Sleeping cots were observed to be stored in front of the fireplace. LPA observed required posting in the main care area. A deep freezer was observed in the main care. LPA advised licensee to use a zip tie or latch to secure the opening of the deep freezer. A Graco Pack and Play with a fitted sheet was observed in the indoor main care area. A fire extinguisher was observed on the wall next to the facility's required postings. The valve on the required 2A 10BC fire extinguisher was observed to be fully charged and was serviced on 02/22/21 as indicated on service tag. Smoke and carbon monoxide detectors were observed in the main care and they were tested and are operable. A door was observed to separate the main care area from the off limits area. At 9:10 AM LPA observed the outdoor play area to contain age appropriate toys, play equipment, and materials. A bathroom designated for children in care was observed to be clean, sanitary and located in the outdoor play area. Cleaning supplies were observed to be locked in a cabinet located in the outside care area. A storage area for the home was observed to be locked in the outdoor play area. LPA observed an off-limits detached garage that has been converted as a living space. Licensee's brother was observed to occupy the space and is associated to the facility. Two wooden posts were observed between the detached garage and storage space. Licensee states that they are currently working on building a gate to separate the space from Page 1 of 3

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ALVAREZ FAMILY CHILD CARE	FACILITY NUMBER: 198012993
	VISIT DATE: 06/24/2021

NARRATIVE

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the outdoor care area. Licensee states she uses trash cans as a temporary barrier to make the space inaccessible. Construction materials, bicycles and a propane tank was observed in this space. No bodies of water were observed in the back yard play area. There are no pets on the premises. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Individuals who reside in the home were noted and discussed. Per Licensee, they currently have one assistant. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed childcare home. Licensee states that there are no firearms stored in the home

All areas identified on the facility sketch that are accessible for children to use were inspected for safety,

comfort, and cleanliness. There is telephone service via a landline. Per Licensee, the home is equipped with central heating and air conditioning. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked.

Licensee is currently not caring for infants under 12 months. Safe sleep guidelines were discussed with licensee. LPA provided licensee a flyer on proposed safe sleep regulations.

LPAs did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 06/2023. LPA observed that the Licensee and assistant do have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. File review was observed to have proper mandated immunization records. Children’s records were reviewed, including emergency information and were observed to be complete. A current children’s roster was available for review.

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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ALVAREZ FAMILY CHILD CARE	FACILITY NUMBER: 198012993
	VISIT DATE: 06/24/2021

NARRATIVE

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Incidental Medical Services (IMS):
IMS was discussed with licensee. Per licensee, there are no children enrolled that require IMS at this time. 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.

LPA advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov. LPA also discussed the Provider Information Notices (PINS) on Safe Sleep Awareness: PIN 19-02-CCP, COVID FAQ - PIN 20-11-CCP, and Guardian User Account Access - PIN 20-20-CCLD.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

Exit interview was conducted with Evelyn Alvarez Licensee, including, but not limited to Appeal Procedures. LPA issued confirmation of Site Visit and Initial Appeal Rights.

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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

LIC809 (FAS) - (06/04)

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