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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020794
Report Date: 06/25/2021
Date Signed: 06/25/2021 04:10:02 PM

Document Has Been Signed on 06/25/2021 04:10 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:BYER FAMILY CHILD CAREFACILITY NUMBER:
198020794
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 2DATE:
06/25/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Licensee Tamera ByerTIME COMPLETED:
04:00 PM
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An announced (scheduled), in-person Pre-licensing relocation inspection was conducted on 06/25/21, by Licensing Program Analyst (LPA) Emiko Bell. Licensee was previously licensed under license 198020300. Upon arrival, LPA was met outside and greeted by Licensee Tamera Byer and assistant Maria Morales.

Census: In addition to licensee and assistant, licensee's mother and three children, ages 13, 9, and 5 were present.

Applicant's proposed days and hours of operation are 24/7. At this time, applicant is proposing to care for children ages 6 weeks-17 years old. This is a two-story, single family residence with four bedrooms and three bathrooms. All areas identified on the facility sketches were inspected in the following order: (indoors): foyer, living room, dining room, kitchen, bathroom 1, bedrooms 1-3, bathroom 2, multi-purpose room, (outdoors): courtyard, garage 1, garage 2, backyard, and then (indoors): second floor.

The areas which have been designated off-limits are: both garages, both dog runs, bathroom 1, bedroom 2, and the second floor. Both garages are locked by padlocks; one dog run is locked by a padlock There is a baby gate located at the bottom of the stairs leading to the second floor. There is a doorknob handle cover on bathroom 1.
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Betty Bell
LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2021
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BYER FAMILY CHILD CARE
FACILITY NUMBER: 198020794
VISIT DATE: 06/25/2021
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Physical Plant: The residence was inspected for safety, comfort, cleanliness, telephone service (there is a landline and licensee has a cell phone); heating and ventilation (there is central heating and air-conditioning) and there are ceiling fans in each bedroom); inaccessibility to poisons (they are locked in garage 2), detergents (they are kept under the kitchen sink), cleaning compounds (under the kitchen sink), medicine (which is kept in a cabinet in bathroom 2) and other hazardous items that can pose a danger to children. Knives are kept in a locked case and in a latched drawer in the kitchen.

Toys and napping equipment: There are age-appropriate toys and napping equipment (six mats and two cribs) on the premises.



Parent Board: The Parent Board is hung on a wall in the entryway in the courtyard, through which the parents will be entering and exiting.

Pets: Licensee has three dogs, one of which is kept upstairs and two of which are kept in the dog run.

Fire safety: There are six smoke detectors on the premises, four of which are operable. All were tested during today's inspection. There is one in each downstairs bedroom, one in the hallway by bathroom 1, one in the multi-purpose room and one at the top of the stairwell on second floor. The detector in the hallway by bathroom 1 is a combination smoke detector and carbon monoxide detector. In addition, there is a separate carbon monoxide detector in the kitchen, which was tested and is operable. There are three fire extinguishers: one upstairs, one mounted in the kitchen and one mounted by the entryway/exit by the multi-purpose room; all three were serviced 06/22/21 and all three are size 2-A10-B:C.
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Betty Bell
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2021
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BYER FAMILY CHILD CARE
FACILITY NUMBER: 198020794
VISIT DATE: 06/25/2021
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Transportation: Applicant stated that she will provide transportation. She currently has two booster seats.

Firearms: Applicant stated that there are currently no weapons or firearms on the premises.

Incidental Medical Services: This facility provides Incidental Medical Services – IMS. 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

There are three First Aid Kits: one in the multi-purpose room, one in bedroom 3, and one in bathroom 1.



The following was discussed: Individuals who are 18 years of age or older living in the home must be fingerprint cleared prior to licensure. Individuals within one month of their 18th birthday must be fingerprinted immediately. The existing, immediate $100 per individual Civil Penalty has been increased to an immediate.$100 per day Civil Penalty, for a maximum of 5 days for the 1st violation and a maximum of 30 days for subsequent violations. If an individual has a clearance with the Department, a criminal record clearance may be transferred. LIC 9182 Criminal Background Clearance Transfer Request may be used.

No smoking; no infant walkers, Johnny jumpers, exersaucers and any other items that fall into that category; earthquake & fire disaster drills and safety; posting requirements; children's records requirements; mandated child abuse and injury/death reporting; criminal records, child
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Betty Bell
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2021
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BYER FAMILY CHILD CARE
FACILITY NUMBER: 198020794
VISIT DATE: 06/25/2021
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abuse clearance, and criminal records transfer requirements

The following sample forms packets were mailed to applicant:



Children's Records: LIC 311D Forms/Records To Keep In Your Family Child Care Home; LIC 700 Identification and Emergency Information; LIC 702 Child's Pre-Admission Health History; LIC 995A Notification of Parents Rights; LIC 995E Caregiver Background Check Process; LIC 9212 Family Child Care Consumer Awareness Information; PM 286 California School Immunization Record; LIC 627 Consent for Emergency Medical Treatment; LIC 613A Personal Rights; LIC 282 Affidavit Regarding Liability Insurance; and LIC 9150 Parent Notification, Additional Children in Care.

Facility Records: LIC 311D Information To Be Posted In Your Family Child Care Home; LIC 9149 Property Owner/Landlord Consent; PUB 394 Notification of Parents Rights; PUB 269 California Child Passenger Safety Law; LIC 9040 Facility Roster; LIC 610A Emergency Disaster Plan; LIC 9148 Earthquake Preparedness Checklist; a sample fire, earthquake, and smoke detector drill record; LIC 624B Unusual Incident/Injury Report; PUB 271 Never Shake A Baby; "Reduce the Risk of Sudden Infant Death Syndrome" pamphlet; "Safe Sleep Policy for Infants in Child Care Programs" and "A Safer Generation of Cribs" and "Your Guide to New Crib Standards" by US CPSC as well as the Lead Facts Flyer.

Staff Records: LIC 311D Facility Forms/Records; LIC 508 Criminal Record Statement, LIC 501 Personnel Record, LIC 503 Health Screening/TB, LIC 9052 Employee Rights, LIC 9108 Statement Acknowledging Requirement to Report Child Abuse, LIC 9163 Request for LIVESCAN, LIC 9188 Criminal Record Exemption.
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Betty Bell
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2021
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: BYER FAMILY CHILD CARE
FACILITY NUMBER: 198020794
VISIT DATE: 06/25/2021
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Paperwork: Licensee provided a Mortgage Statement as verification of control of property. Licensee completed an EMSA-approved Preventative Health and Safety course (which includs the 2016 nutrition requirement and the 2020 lead requirement) on 07/24/20. Licensee's Pediatric First Aid/CPR were issued by the American Heart Association and expire 07/22. Licensee completed the Mandated Reporter Training on 09/10/20 (Child Care Providers). Licensee provided verification of TB clearance and MMR and TDAP immunizations and a declination of the influenza vaccination.

Applicant has been reminded of the following:
*Fire and earthquake drills to be conducted every six months (for small FCCH) and monthly (for large FCCH.)
*Outdoor supervision is required at all times. If the outdoor area is not adequately fenced, the provider must be with the children at all times when outdoors. Licensee's initials ( ).

Residence appears to meet Title 22 Regulations and appears ready for licensure.

An exit interview has been conducted with Licensee Tamera Byer. A copy of this report has been signed by and provided to Tamera Byer.
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Betty Bell
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2021
LIC809 (FAS) - (06/04)
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