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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015243
Report Date: 08/19/2022
Date Signed: 08/19/2022 11:40:13 AM

Document Has Been Signed on 08/19/2022 11:40 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:MADRIGAL FAMILY CHILD CAREFACILITY NUMBER:
198015243
ADMINISTRATOR:MADRIGAL, ALMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 409-9102
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 14TOTAL ENROLLED CHILDREN: 2CENSUS: 2DATE:
08/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:39 AM
MET WITH:Licensee Alma MadrigalTIME COMPLETED:
11:50 AM
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On 8/19/22 Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced required 1 year inspection at the above facility. LPA met with the Licensee Alma Madrigal and informed her of the purpose for the visit. LPA provided Licensee with a copy of the Facility Entrance Checklist. Licensee guided LPA on a tour of the facility. There were 2 children present during the inspection. All residents were noted and verified. Facility provides care to children ages 18 months to 6 years. Facility is open Monday to Friday 6:30 AM to 5:30PM.
This is a one story, 2 bedroom, 2 bathroom home, with a living room, kitchen, family room, fenced back yard, and garage.
Per Licensee areas on limits to children are: living room, kitchen, 2 bathrooms, family room and backyard.
Per Licensee areas off limits to children are: 2 bedrooms and garage.
All areas that are accessible to children were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection: LPA observed required posted documentation posted in the facility Facility license, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPA observed and reviewed a current roster LIC 9040 and a current disaster drill log. Last disaster drill was performed on 8/10/22. There is an operable carbon monoxide/smoke detector in the family room. LPA observed a 2A10BC Fire Extinguisher in the facility which was last serviced in 2/2022. The home maintains telephone service (Land line and cell phone). Food is provided by Licensee. Licensee was reminded if children bring food from home it must be labeled with the child’s name and properly stored or refrigerated.
There are toys and other age appropriate materials available for children to use. Per Licensee, children spend most of the day in the family room. Children have access to the kitchen. LPA observed safety knobs installed on the kitchen stove. Sharp objects, detergents and cleaning compounds were inaccessible to children in care. Knives are kept on a high shelf inaccessible to children, cleaning products are kept on a high shelf and under the kitchen sink in a latched cabinet. Per the Licensee, no children enrolled required medication. Personal medication is stored in a latched upper kitchen cabinet inaccessible to children in care.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 08/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/19/2022
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MADRIGAL FAMILY CHILD CARE
FACILITY NUMBER: 198015243
VISIT DATE: 08/19/2022
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There is an air conditioning unit in the family room and per the Licensee the home has central air and heating. LPA observed a wall heater in the living room. Per Licensee, the wall heater is shut off and is not used. LPA observed household items against the heater, and it appeared it was not used. Children nap in the family room and they are provided for cots for napping. Children use the restroom in the hallway and a restroom in one of the off limit bedrooms. The restroom in the hallway has latched cabinets which contain cleaning products and personal hygiene items. The second restroom the children use is accessed by the outdoor play yard and it is connected to one of the off limit bedrooms but the door to the bedroom is kept locked when children are using it. The second bathroom also has a latched cabinet with cleaning products. Additional cleaning products were observed on a high shelf, inaccessible to children. Per Licensee, this restroom is only used when the children are playing outside. No accessible hazards were observed in the restrooms.
Children use the backyard for outdoor play. LPA observed the backyard is fully fenced. There is a storage room in the backyard that is off limits and it is kept locked. There is also a dog run that is off limits and is kept locked. There are 2 dogs in the home. Per Licensee, dogs are put in the dog run when children are in the backyard. Per Licensee, backyard is cleaned up and the dogs' water and food containers are removed before the children go outside. LPA observed a laundry area in the back yard and the laundry detergent was inaccessible to children in care.
LPA observed insect poison containers in the home which are kept in the off limit dog run area. Licensee understands that all poisons must be locked, not only inaccessible to children. LPA advised Licensee to place containers in the locked storage room. Isolation area for sick children waiting to be picked up is in the living room. Per Licensee, there are no firearms or weapons stored in the home. LPA did not observe any pools or spas, or other bodies of water.
Infant Care: Currently licensee has no infants enrolled. Licensee was advised that napping equipment should not block entrances or exits. Infant mattresses should be firm with tightly fitted sheets. LPA discussed that each infant enrolled must have their own crib/ napping mat and bedding. Infants shall not be swaddles in care. Car seats shall not be used for sleeping. LPA discussedthe new Safe sleep regulation, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months, LPA advised Licensee to review PIN 20-24-CCP.
Overnight Care: There is no overnight care provided at the moment. LPA discussed the following: Licensee is aware that they must remain awake while children are awake. If children sleep in separate area from licensee, the door must remain open. If licensee cannot hear children when they wake up, video or audio device can be used.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MADRIGAL FAMILY CHILD CARE
FACILITY NUMBER: 198015243
VISIT DATE: 08/19/2022
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Children's records were reviewed. Children's records shall contained (LIC) 282- Affidavit Regarding Liability Insurance, Immunization Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights.
Licensee's record was reviewed. Licensee's Pediatric CPR/First Aid expires 5/2023. Licensee had proof of required immunizations (measles, pertussis, flu) and proof of TB clearance . Licensee has a valid Mandated Reporter training certificate which was completed on 9/16/2021. Licensee was advised Mandated Reporter training shall be renewed every two years.
During inspection the child present was observed to be treated with dignity and respect, and free from corporal and/or unusual punishment.
Incidental Medical Services (IMS): Incidental Medical Services (IMS) policy was discussed. Per Licensee, no children enrolled require medication. 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 Center 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.
LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleephttps://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.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MADRIGAL FAMILY CHILD CARE
FACILITY NUMBER: 198015243
VISIT DATE: 08/19/2022
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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.
No deficiencies were cited today.
Exit interview conducted and report was reviewed with the Licensee, Alma Madrigal. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022
LIC809 (FAS) - (06/04)
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