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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198013441
Report Date: 12/20/2023
Date Signed: 12/20/2023 12:09:09 PM

Document Has Been Signed on 12/20/2023 12:09 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:HAYES FAMILY CHILD CAREFACILITY NUMBER:
198013441
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
12/20/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Priscilla HayesTIME COMPLETED:
12:45 PM
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FCC Inspection Conducted In English

Licensing Program Analysts (LPA) Cynthia Reyes conducted an announced increase in capacity inspection on this date for the purpose of inspecting the facility to ensure the health and safety standards as required by the regulations governing childcare homes are met. The facility operating hours are from Monday through Friday 6 AM-6PM. A risk assessment was conducted upon entry- Due to COVID- 19 precautionary measures were taken during the entire inspection and all individuals present wore appropriate personal protective equipment.

Licensee guided analysts on a tour of the facility. Per Licensee, there are 8 children currently enrolled, 1 is an infant and 1 is licensee grand child. A current children’s roster was available for review.

The licensee states that 1 adult and 0 children currently live in the home. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed child care home. Licensee states that there are firearms or weapons in the home. No bodies of water.

Areas that are accessible to children are as follows: Day care room, Living room, bathroom, dinning room and back yard.

Areas off limits: 3 bedrooms, kitchen, and laundry room. **Rooms that are off-limits need to be made inaccessible during operating hours** The Licensee does understand that licensing staff may have access to off-limit areas during inspection visit if necessary.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/20/2023
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: HAYES FAMILY CHILD CARE
FACILITY NUMBER: 198013441
VISIT DATE: 12/20/2023
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The following was observed and reviewed during this inspection.

All areas identified on the facility sketch were inspected for safety, comfort, and cleanliness. There is telephone service via a land line and a cellphone that stays at the facility during operation hours. There is ventilation and heating.

Detergents, cleaning compounds, and medications were observed to be inaccessible to children. The restroom that children use was observed to be safe and sanitary.

LPA Reyes observed the valve on the required 2A10BC fire extinguisher indicates fully charged, the tag/receipt date is 06/10/2022. Smoke and carbon monoxide detectors were tested by the licensee and are operable. All Small family day care homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill documented was conducted on 11/23/2023. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted on the parent board and visible to parents and all to see.

The home is observed to be clean and orderly. There are toys available for children. Appropriate sleeping arrangements which consist of pack-n-plays for infants and mats for children in care.



Licensee states that they are currently caring for infants. LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. 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.

Continue on page 3.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: HAYES FAMILY CHILD CARE
FACILITY NUMBER: 198013441
VISIT DATE: 12/20/2023
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Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.
LPA did not observe any objects that can pose a danger to children in care. There is 2 dogs on the premises. The licensee is observed to be operating within the license capacity limitations.

The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. Pediatric First Aid and CPR expires on 05/07/2024. There are first aid supplies available.

LPA observed that the Licensees Priscilla has proof of all immunization records on file and the Mandated Reporter, AB 1207 compliant Child Care Training Certificate on file. Mandated reporter training must be completed every 2 years. www.mandatedreporterca.com.

Licensing staff consulted with licensee regarding COVID-19 health and safety guidelines on this date. LPA informed Licensee, that the usage of mask is a mandate and that every adult and child over the age of two, is still highly recommended by our department to be wearing a mask.



LPA advised the licensee to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov.
Reporting Unusual Incidents: MPROIncidentReports@dss.ca.gov. CCL Resources for Parents & Providers: https://ccld.childcarevideos.org/ Provider Information Notices (PINs): https://www.cdss.ca.gov/inforesources/community-care-licensing/policy/provider-information-notices/child-care

Infant Care: LPA discussed the safe sleep regulations with the licensee, and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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. .Continue on page 4.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: HAYES FAMILY CHILD CARE
FACILITY NUMBER: 198013441
VISIT DATE: 12/20/2023
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IMS (Not 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

Licensee was reminded that all adults 18 and over living or working in the home, 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited. The capacity increase request for a Large Family Child Care will be submitted for approval. Once a capacity increase is issued, the Licensee is required to adhere to the terms and limitations as stated on the license. Fire inspection approved on 12/04/2023.


A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Licensee, Priscilla Hayes. During the exit interview, the Licensee, Priscilla Hayes confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
LIC809 (FAS) - (06/04)
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