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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015243
Report Date: 08/22/2023
Date Signed: 08/22/2023 03:07:35 PM

Document Has Been Signed on 08/22/2023 03:07 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, 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: 3CENSUS: 3DATE:
08/22/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Licensee Alma Madrigal TIME COMPLETED:
03:15 PM
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On 8/22/23 Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced required 1-year inspection at the above facility. LPA met with Licensee Alma Madrigal and informed her of the purpose for the visit. Licensee was provided a copy of the Facility Entrance Checklist. There were 3 children present during the inspection. All residents were noted and verified. Facility provides care to children ages 1 to 12 years old. The hours of operation for the facility are 6:30 AM to 5:30 PM. The facility is open Monday through Friday.
This is a one story, two bedroom, two bathroom home.
Per Licensee areas off limits to children are: Two bedrooms and one bathroom. Off limit areas are kept locked.
Per Licensee areas on limits to children are: Living room, hallway bathroom, kitchen (in passing), family room (used as main day care area) and the backyard.
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- 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. There is disaster drill log available for review. The last documented drill was conducted on 4/28/23. There is a combination smoke/carbon monoxide detector in the facility. LPA observed a 2A10BC Fire Extinguisher in the day care area which was serviced in June 2023 as indicated on the service tag. The home maintains telephone service (landline and cell phone). The Licensee provides food for children in care. 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 in the day care areas. Children nap in the day care room and are provided appropriate napping equipment. Sharp objects, detergents and cleaning compounds were inaccessible to children in care. Per Licensee, knives are kept inaccessible to children in care on an upper shelf near the kitchen window, cleaning products are kept in a locked upper cabinet and a locked cabinet under the kitchen sink, laundry detergent is kept out of reach in the backyard, and personal medicine is kept in an upper cabinet in the kitchen.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 08/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/22/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: 08/22/2023
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Per Licensee, none of the children enrolled require medication at this time. There is central air and heating in the facility. There is a wall heater in the living room. The wall heater is not in use. LPA did not observe any fireplaces in the facility. Children use the restroom in the hallway. Cleaning products in the restroom are kept in a latched cabinet under the sink.
Per Licensee, children use the enclosed backyard for outdoor play. Per Licensee, children are supervised while playing outside. There are two pet dogs in the home. Dogs are kept inaccessible to children in care in a dog run on the side of the house when children are outside. Per Licensee there are no poisons in the home. Licensee was advised that all poisons must be locked, not only inaccessible to children. Isolation area for sick children waiting to be picked up is in the day care area or an area separated from other children while under adult supervision. There are no pools, spas or bodies of water in the facility. Per Licensee, there are no weapons in the home.
Infant Care: Currently there are no infants enrolled in the facility. The following was discussed with the Licensee, infants shall not be swaddled in care, infants heads shall not be covered, there shall be no items in cribs or play yards, bumper pads shall not be used, Car seats shall not be used for sleeping. LPA advised Licensee about 15 minute sleeping log for children 0 to 24 months.
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.
Children's records were reviewed: Children's records 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
Staff records were reviewed: Licensee’s pediatric first aid/cpr issued by the American Heart Association expires in May 2025. Licensee had proof of required immunizations on file. Licensee’s mandated reporter training for child care providers was completed on 9/16/21. Licensee was advised mandated reporter training shall be completed every two years.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023
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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MADRIGAL FAMILY CHILD CARE
FACILITY NUMBER: 198015243
VISIT DATE: 08/22/2023
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Incidental Medical Services (IMS): Incidental Medical Services (IMS) policy was discussed. Per Licensee, no children enrolled require medication at this time. 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. 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 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: 08/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023
LIC809 (FAS) - (06/04)
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