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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400421
Report Date: 07/15/2021
Date Signed: 07/15/2021 01:00:59 PM

Document Has Been Signed on 07/15/2021 01:00 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:AMARO FAMILY CHILD CAREFACILITY NUMBER:
198400421
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
07/15/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Applicant - Mario AmaroTIME COMPLETED:
01:15 PM
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This was a pre-licensing inspection conducted on 07/15/21 at 1429 E. Eleanor Street Long Beach CA by Licensing Program Analyst (LPA) R. Derraco.

Individuals residing in the home have been discussed and noted. The applicant is requesting a small family childcare home license. Per applicant, operation hours will be Monday thru Sunday, 6 AM to 11 PM. Applicant states that they will care for children Infants to school-age.

During the inspection the applicant took LPA on a tour of the home and the following was noted:



All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a one story home that consists of 2 bedrooms, 1 bathroom, living room, dining room, kitchen, front yard and backyard (fenced).

Main care areas include one bedroom and back yard. Parents will enter the facility through a gate on the side of the home.



Off limit areas include living room, second bedroom and kitchen. The applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary.

Outdoor play area is located in the backyard. LPA observed that the yard is fenced and free of hazards. LPA observed shade and age appropriate toys and material outdoors. A washer/dryer stack and detergents are located behind a locked door in the backyard

Areas that will be used by children were inspected for safety, comfort and cleanliness. LPA observed operable telephone service, ventilation and heating (central). Detergents, cleaning compounds and hazardous items Page 1 of 5

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE: DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/15/2021
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 5
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: AMARO FAMILY CHILD CARE
FACILITY NUMBER: 198400421
VISIT DATE: 07/15/2021
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that can pose a danger to children are made inaccessible in a locked cabinet located in the bathroom. The applicant was advised that any poisons must be locked, not just inaccessible. The children's bathroom was observed to be free of hazards.

There are age appropriate toys and material available for children. Parent board is visible in the main care area with required postings. Children will nap on mats in the bedroom designated as the main care area. Applicant does plan on enrolling infants 0-24 months.



Infant Care: LPA informed applicant of the Safe sleep regulation and provided PIN 20-24-CCP for when applicant is ready to enroll infants. The applicant states the following as a supervision plan for infants: infants will sleep in playpens in the main care area and will be supervised at all times. Applicant is aware that one playpen/crib is needed for each infant. LPA provided the applicant with a copy of PIN 19-02-CCP for additional safe sleep guidance.

Per applicant there are no pets, there are no firearms or weapons stored in the home LPA did not observe any bodies of water.



LPA observed that the Applicant has a 2A10BC fire extinguisher in the home with purchase receipt on 06/28/21. Smoke and carbon monoxide detector were tested and are operable. LPA advised applicant that the fire extinguisher must be serviced annually or and often as necessary. Smoke and carbon monoxide detectors should be checked and batteries replaced as needed

The applicant states that they will provide food for children in care. Any food brought from the children’s homes shall be labeled with child’s name and properly stored or refrigerated.

The applicant has completed the required Health and Safety Training, Nutrition, and Lead Training, Mandated Reporter Training and Pediatric First Aid and CPR. Applicant has proof of required immunizations. Assistants have required training and immunizations. There are first aid supplies available.

LPA Provided COVID-19 Technical Assistance by emailing applicant COVID-19 resources and self-assessment prior to visit. LPA discussed self-assessment and answered question regarding COVID-19:

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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: AMARO FAMILY CHILD CARE
FACILITY NUMBER: 198400421
VISIT DATE: 07/15/2021
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Essential Protective Equipment and Supplies- Staff and children (24 months and older) will wear facial coverings throughout the day, excluding meal and nap times (children). Applicant has a contact-less thermometer, disposable gloves, hand sanitizer and disinfectant cleaning supplies in the home on a cart which can be rolled inside and out for drop off and pick up.
Cleaning- Per applicant, high touched areas, bathroom and toys will be disinfected daily or as needed.
Hygiene- Per applicant children will be given hand sanitizer upon entering the home and wash their hands for at least 20 seconds throughout the day. Children will have individual cubbies for their personal belongings. The isolation area for a sick child waiting to be picked up will be in the upstairs infant nap room, the sick child will use one of the bathrooms upstairs if needed.
Arrival Procedures- Per applicant parents will drop off/pick up at the side entrance. Staff will do daily temperature checks and health screening at the front door, as parents will not be allowed to enter the facility. COVID-19 posters and resources are posted in the front entrance accessible to parents. Parents will be made aware of the COVID-19 policies and exclusion procedures in writing. Parents are aware that is they go out of town or participate in a large gathering over the weekend they have to quarantine for 10 days before returning to the facility.

The following was discussed with applicant:

Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Civil Penalties will be assessed if not in compliance.

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 (TDAP, MMR, Influenza), 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.

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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: AMARO FAMILY CHILD CARE
FACILITY NUMBER: 198400421
VISIT DATE: 07/15/2021
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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.

Children and Staff records must be maintained and updated as needed and must be available for review by the Department.

No infant walkers, no Johnny jumpers, no saucer chairs and any other item that falls into that category are not permitted in the facility.

Inspection Authority: All adults living and working in the home shall be made of aware of the Department’s right to inspection 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.

Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information.

Children’s Forms/Records - Children’s files must contain the following documents/information:
Admission agreement, Identification and Emergency Information (LIC 700), Consent for Emergency Medical Treatment (LIC 627), Notification of Parent’s Rights (LIC 995A), Health History, Physicians Report, Personal Rights (LIC 613A), Consent for Emergency Medical Treatment (LIC 627), Immunization Records, TB Test, Individual Infant Sleeping Plan (LIC 9227) if applicable.

Facility Forms/Records - Facility files of licensee and employees must contain the following documents/information:
Immunization Records, TB test, Mandated Reported certificate, current pediatric first aid and CPR training, Notice of Employee Rghts (LIC 9052), Statement Acknowledging Requirement to Report Suspected Child Abuse (LIC 9108), Child Care Facility Roster (LIC 9040)

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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: AMARO FAMILY CHILD CARE
FACILITY NUMBER: 198400421
VISIT DATE: 07/15/2021
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Incidental Medical Services (IMS):
This facility may provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm.

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

A small family childcare license may be granted upon Licensing Program Manager (LPM) Approval. Once licensed, the applicant is required to comply with the terms and limitations stated on the license.

Exit interview was conducted with applicant

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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021
LIC809 (FAS) - (06/04)
Page: 5 of 5