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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015772
Report Date: 12/05/2024
Date Signed: 12/05/2024 01:21:41 PM

Document Has Been Signed on 12/05/2024 01:21 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:AMAYA FAMILY CHILD CAREFACILITY NUMBER:
198015772
ADMINISTRATOR/
DIRECTOR:		AMAYA, JOSEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 507-0697
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 1DATE:
12/05/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Licensee- Jose Amaya TIME VISIT/
INSPECTION COMPLETED:
01:35 PM
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On December 5, 2024 at 11:45a.m., Licensing Program Analyst (LPA) Keneisha Dunlap arrived at the above facility for the purpose of an unannounced Annual Inspection. LPA Dunlap announced the purpose of the visit and was granted entry into the facility by Licensee- Jose Amaya. There are 10 children enrolled, and 1 child present at the time of inspection. Hours of operation are Monday- Sunday from 6:30am-6:00pm (overnight care when needed). All adults in the home were discussed and background and fingerprinted cleared. License, Facility sketch, earthquake preparedness list, disaster plan and PUB 394 posted. Licensee does have a current disaster log with the date of 7/10/24. Licensee does have current LIC 9040 (facility roster).

This is a one-story home which consists of 2 bedrooms, 1 bathrooms, kitchen/dining room, living room, a garage, front yard and backyard (fenced). The off limit areas include 1 bedroom, garage, front yard and backyard.

The main care area is located in the living room. LPA observed a cubby locker for children's personal belongings, a wall mounted television, age appropriate furniture, and a wooden crib. Bedroom 1 is also being used for children in care. The main care area has a wall mounted television, a couch, another baby crib, and age appropriate toys.

The bathroom designated for children in care has an operable sink and toilet. The cabinets and drawers have safety latches making them inaccessible to children in care.

The hallway has cabinets with safety latches making it inaccessible to children in care.

The kitchen was observed to be clean and free of defects. The kitchen area has baby gates making it inaccessible to children in care. The stove has stove cover knobs making it in inaccessible to children in care. The cleaning Page 1 of 4
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE: DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/05/2024
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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: AMAYA FAMILY CHILD CARE
FACILITY NUMBER: 198015772
VISIT DATE: 12/05/2024
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cabinets and drawers have magnetic locks. LPA observed beneath the sink where the Licensee keeps supplies and detergents with safety latches. LPA Dunlap observed knives in a cabinet above the counter making it inaccessible to children in care.

At 12:00p.m., LPA Dunlap observed a wall heater in the hallway. LPA Dunlap asked the Licensee if the wall heater was operable. The Licensee stated that the heater is not operable. The Licensee then showed LPA Dunlap a mini split in the secondary room that provides heat and air.

The play area has an age appropriate picnic table, and toys are kept inside and brought out for playtime. The play area is free of sharp, not loose, and/or pointed parts.

LPA observed the carbon monoxide and smoke detector to be operable in the hallway area, and additional smoke detector was operable in main care area.

LPA observed a fire extinguisher with service date of 8/20/24.

Staff # 1

Files have required licensing documents including immunization's and TB in folders.

CPR expiration date of 9/25/25

Mandated Reporter expiration date of 3/18/26

Staff # 2

Files have required licensing documents including immunization's and TB in folders.

CPR expiration date of 9/25/25

Mandated Reporter expiration date of 9/12/25

Children Files

Child # 1- all required licensing documents are in file.

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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024
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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: AMAYA FAMILY CHILD CARE
FACILITY NUMBER: 198015772
VISIT DATE: 12/05/2024
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The Licensee stated that they communicate with parents in person.

The Licensee has a cell phone that they use.

The Licensee stated they do not have any children that they administer medication to at this time.

The Licensee states that when children are in sick, they are placed in the main care area by the door.

The Licensee stated there are no firearms in the home.

The Licensee stated that there are no smokers in the home.

The Licensee stated that they do provide transportation for children.

The Licensee stated they do not have any children with allergies.

The Licensee stated that does have first aid kit.

There are no large bodies of water on the premises.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process

Criminal Record Clearance - Family Child Care Homes Licensee- Jose Amaya was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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

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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024
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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: AMAYA FAMILY CHILD CARE
FACILITY NUMBER: 198015772
VISIT DATE: 12/05/2024
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penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Safe Sleep

LPA discussed the safe sleep regulations with Licensee- Jose Amaya 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 Licensee- Jose Amaya 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.

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: https://www.ada.gov/resources/child-carecenters/.

MyChildCarePlan.org – Centers and Family Child Care Homes Licensee- Jose Amaya was informed of the

MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Megan’s Law - Family Child Care Homes During the exit interview, the Licensee- Jose Amaya, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days.

Appeal rights explained and given to Licensee - Licensee- Jose Amaya.

No deficiencies cited during todays visit.

Exit interview conducted and report was reviewed with the Licensee - Licensee- Jose Amaya.

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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024
LIC809 (FAS) - (06/04)
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