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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021309
Report Date: 09/21/2023
Date Signed: 09/21/2023 01:03:54 PM

Document Has Been Signed on 09/21/2023 01:03 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:LEDEZMA FAMILY CHILD CAREFACILITY NUMBER:
198021309
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
09/21/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Applicant, Martha LedezmaTIME COMPLETED:
01:20 PM
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An announced Pre-Licensing Inspection was conducted by Licensing Program Analyst (LPA) Lilli Babcock. LPA met with Applicant, Martha Ledezma. A Covid risk assessment was conducted. The purpose of today's visit is to inspect and evaluate facility for initial licensure, Applicant is applying for a Small Family Child Care Home License. Present during this inspection was Applicant only.

Per Applicant, family members residing in the home are 2 adults and five children, including 3 foster children. Per applicant, operation hours will be Monday to Friday, 7:00 AM to 6:00 PM. Applicant states that they will care for children birth - 10 years of age.

During this inspection the following was observed:

All areas identified on the facility sketch were inspected, including but not limited to, all off-limit areas. This is a one-story home that consists of 4 bedrooms, 2 bathrooms, kitchen, living room, dining room, front yard, backyard which is fenced, and garage.

Per applicant, the children will use 1 bathroom, living room, and fenced backyard. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service, ventilation and heating. Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible in areas designated for children. The applicant states that there are no poisons on the premises, and none were observed on this day. Applicant was advised that all poisons should be locked with a key or combination lock.
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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE: DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/21/2023
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: LEDEZMA FAMILY CHILD CARE
FACILITY NUMBER: 198021309
VISIT DATE: 09/21/2023
NARRATIVE
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Based on the Facility Sketch submitted, areas off-limits to children and parents are: The front yard, four bedrooms, one bathroom, dining room, kitchen, and garage. All areas inaccessible for children were observed to have a childproof doorknob, lock, and/or a security gate making them inaccessible for children in care. The applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary.

LPA observed a fire extinguisher located in the kitchen, however the size was a
1A 10BC fire extinguisher and not the required 2A 10BC. LPA observed a fireplace in the living room, which was observed to be locked with a childproof lock making it inaccessible to children in care. Smoke and carbon monoxide detectors were tested during the inspection and observed to be operable on this day.

There are toys available for children. LPA observed sleeping arrangements in forms of a playpen, and cots.

The applicant states that they will provide food for children in care and are planning to apply for the food program.

The applicant has completed the required Health and Safety Training, Nutrition and Lead Training, and Pediatric First Aid and CPR via the American Red Cross. There are first aid supplies available.

Per applicant, there are no guns or weapons in the facility, and none were observed on this day. Per applicant there are no bodies of water on the premises. LPA did not observe any bodies of water on this day.

The children will use the back yard for outdoor play, which was observed to be fenced, and contained age-appropriate toys available for children.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023
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: LEDEZMA FAMILY CHILD CARE
FACILITY NUMBER: 198021309
VISIT DATE: 09/21/2023
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At 11:45 AM The following was discussed with the applicant:

· In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR training, Immunizations (Pertussis, Measles, Influenza), current mandated reporter training, and a valid criminal record clearance associated to the facility license.
· Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License may be terminated.
· The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.
· Reporting Requirements: Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.
· Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.
· Fire and safety drills must be performed every six months and the date and time documented for review by the Department.
· Smoking is prohibited in a family child care home.
· Children and Staff records must be maintained and updated as needed and must be available for review by the Department.
· Infant walkers, Johnny Jumpers, saucer chairs, and any other item that fall into those categories are not permitted in the facility.
· All adults living and working in the home shall be made of aware of the Department’s right to inspection of the home, which includes, but is not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.
· The facility license number must be on all advertisements, publications or announcements with the intent to attract clients.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023
LIC809 (FAS) - (06/04)
Page: 3 of 7
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: LEDEZMA FAMILY CHILD CARE
FACILITY NUMBER: 198021309
VISIT DATE: 09/21/2023
NARRATIVE
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  • Isolation for Ill children: When a child is ill, he/she shall be separated from other children (reference 102417(e) Operation of a Family Child Care Home).
· Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information.

· Immunization Requirement: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The licensee and all adults working with children have proof of immunizations.

· Mandated Reporter Training: H&S 1596.8662: Beginning January 1, 2018, all licensed providers, applicants, directors and employees to complete training as specified on mandated reporter duties. Training is available at: www.mandatedreporterca.com

LPA advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.



Per applicant, she has a dual foster care license at this address. Applicant’s email address was obtained during this inspection. The applicant was advised that email may be public information.

The applicant’s signature on this report acknowledges that they have signed the Application for a Family Child Care Home License (LIC 279) under the penalty of perjury and that the statements on the application and any attachments are correct.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023
LIC809 (FAS) - (06/04)
Page: 4 of 7
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: LEDEZMA FAMILY CHILD CARE
FACILITY NUMBER: 198021309
VISIT DATE: 09/21/2023
NARRATIVE
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Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 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.

The applicant provided proof of control of property.

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) or (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.

LPA reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Home, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

LPA discussed the safe sleep regulations with applicant 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 of the importance of checking for

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023
LIC809 (FAS) - (06/04)
Page: 5 of 7
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: LEDEZMA FAMILY CHILD CARE
FACILITY NUMBER: 198021309
VISIT DATE: 09/21/2023
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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.

On this date, 09/21/23, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, 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.

Applicant is seeking to provide care for 8 children ages birth -10 years old. Based upon today’s inspection, the following correction needs to be completed by 9/22/23.

- Applicant will purchase a 2A 10 BC Fire Extinguisher and email LPA a picture of the box and receipt with date visible.

The application will be submitted for final review to the department once the corrections have been received. Once licensed, the applicant is required to adhere to the terms and limitations stated on the license.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023
LIC809 (FAS) - (06/04)
Page: 6 of 7
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: LEDEZMA FAMILY CHILD CARE
FACILITY NUMBER: 198021309
VISIT DATE: 09/21/2023
NARRATIVE
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A notice of site visit was given to applicant and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the applicant, Martha Ledezma.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/ subscribe and select the Child Care option to receive email communication.


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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023
LIC809 (FAS) - (06/04)
Page: 7 of 7