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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400560
Report Date: 03/16/2022
Date Signed: 03/16/2022 01:24:09 PM

Document Has Been Signed on 03/16/2022 01:24 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:ZUNIGA FAMILY CHILD CAREFACILITY NUMBER:
198400560
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
03/16/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Applicant Maxima Zuniga TIME COMPLETED:
12:20 PM
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On 3/15/22 at 8:55 AM Licensing Program Analyst (LPA) Jeanette Estrada conducted an announced pre-licensing inspection at 1021 S. Bonnie Beach Pl Los Angeles CA 90023. The purpose of this inspection is to inspect and evaluate the facility for a relocation. The applicant is currently licensed under the Monterey Park Regional Office at 1801 1/2 W. OLYMPIC BLVD MONTEBELLO, CA 90640 LICENSE NUMBER: 198020339. LPA Estrada met with Applicant, Maxima Zuniga. Applicant is requesting a small license. Operating hours will be Monday to Sunday 12AM to 11:59PM and care will be provided for children ages 0 to 12 years. All residents living in the home were discussed and verified.

This is a 3 bedroom/1 bathroom home with a front play area, living room, kitchen and a back yard area. There are two additional homes that sit on the same premises. The homes all share a driveway and back yard area. The additional homes have separate addresses.

Off Limit areas: Back yard, 2 bedrooms and kitchen. The back yard is accessible through one of the off limits bedrooms. This bedroom will be kept locked during operating hours. This bedroom is accessed through the kitchen which is also off limits. The applicant has installed a safety gate blocking access from the living room to the kitchen. The other off limits bedroom is accessed through the living room. This bedroom will also remain locked during operating hours. The Applicant has installed a safety door knob to prevent further access. This bedroom is also accessed through the on limits bathroom. The applicant has installed a safety door knob on this door.

On Limits: Front yard area, 1 bedroom, 1 bathroom and living room. The day care areas (living room, bedroom, bathroom and front yard) that will be used by children were observed for safety, comfort, cleanliness, telephone service (cell phone), ventilation and heating. LPA observed an A/C unit installed in the living room wall (out of reach of children). There is wall heater in the living room. LPA observed a metal cover installed over the heater. Per Applicant, the wall heater is not connected and will be removed. Per Applicant a portable heater will be purchased. LPA advised applicant to keep heater out of reach of children.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/16/2022
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: ZUNIGA FAMILY CHILD CARE
FACILITY NUMBER: 198400560
VISIT DATE: 03/16/2022
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Detergents, cleaning compounds, sharp objects and hazardous items that can pose a danger to children are inaccessible to children in care. Knives, sharp objects and medicines are kept in a latched upper cabinet in the kitchen, cleaning compounds are kept in a latched cabinet under the kitchen sink. Laundry detergent is kept in the off limits outdoor area. The restroom children will use is in the on limits bedroom. It is accessed through the on limits bedroom and the off limits bedroom. Per Applicant, the children will only access the bathroom through the on limits bedroom and will be escorted depending on age of the children. Personal Hygiene items in the bathroom are inaccessible to children. Per the applicant, there are no poisons other than cleaning compounds in the home. LPA advised that if any poisons are kept in the home at a later date to keep them in a locked cabinet or container.

LPA observed a smoke detector and carbon monoxide detector in living room. LPA observed Applicant push the test buttons which indicated they are operable. LPA observed a 2A10BC fire extinguisher which indicates full and the Applicant provided a receipt indicating it was purchased on 2/23/22 The fire extinguisher is installed on the living room wall next to the kitchen. The home has electrical outlet covers throughout the day care area and maintains a first aid kit. LPA did observe age appropriate materials and toys available for children. LPA observed napping cots and a play yard. Per the Applicant the main area for children will be in the living room. Children will nap in the living room. Applicant stated there are no firearms or weapons on the premises. Per the applicant there are no bodies of water on the premises. LPA did not observe any bodies of water on the premises.

Per the Applicant, if a child becomes ill, they will be taken to the on limits bedroom. The children will also eat in the living room. LPA observed a child sized table and chairs in the living room. Per Applicant, food will be provided for children in care and children will be supervised while eating in the kitchen. LPA advised Applicant that high chairs are to only be used for eating during mealtimes. Applicant was advised that if food is brought from the children’s homes, the container shall be labeled with the child’s name and properly stored or refrigerate

The on limits outdoor area that will be used is the front yard area. The front yard of the home is fenced but it includes access to the driveway. To block access to the driveway, the Applicant has installed a safety gate along the side of the yard. Per Applicant, children will be supervised while playing outside.

Applicant has completed the required Health and Safety Training, Nutrition Training, Lead training and Pediatric First Aid and CPR which expires 2/5/24. Applicant also completed the required Mandated Reporter Training which expires 9/9/23.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2022
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: ZUNIGA FAMILY CHILD CARE
FACILITY NUMBER: 198400560
VISIT DATE: 03/16/2022
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The following was discussed with the 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. The fire extinguisher type 2A-10BC or bigger 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. Unusual Incident report email: MPSWIncidentreports@DSS.CA.GOV

· Fire and safety drills must be performed every six months and 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.
· No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines 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.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2022
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: ZUNIGA FAMILY CHILD CARE
FACILITY NUMBER: 198400560
VISIT DATE: 03/16/2022
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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 Applicant has submitted proof of immunization vaccines. 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 .

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, 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 applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Applicant 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.


This facility plans to provide Incidental Medical Services – IMS. For IMS information , see PIN 22-02-CCP. 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
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2022
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: ZUNIGA FAMILY CHILD CARE
FACILITY NUMBER: 198400560
VISIT DATE: 03/16/2022
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LPA reviewed with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

Entrance Checklist was provided to the applicant.

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 platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Corrections to be submitted by:

Proof that wall heater has been removed

Proof of purchase of portable heater

Copy of IMS plan

A small family child care license will be granted when corrections are submitted and the department does a final application review.

Exit interview conducted and report was reviewed with the Applicant.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2022
LIC809 (FAS) - (06/04)
Page: 5 of 5