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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400606
Report Date: 08/03/2022
Date Signed: 08/18/2022 10:09:36 AM

Document Has Been Signed on 08/18/2022 10:09 AM - 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:AMAYA FAMILY CHILD CAREFACILITY NUMBER:
198400606
ADMINISTRATOR:AMAYA, J/AMAYA, SFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 285-2740
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/03/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Licensees - Jose and Sandra AmayaTIME COMPLETED:
03:40 PM
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Licensing Program Analyst (LPA) Randy Derraco conducted an announced pre-licensing inspection to the above mentioned address on 08/03/22 at 2:00PM. LPA met with licensees, Jose and Sandra Amaya, who guided LPA on a tour of the home. LPA observed no additional adults and zero children present during inspection. Individuals residing in the home have been noted and discussed. The licensee is requesting a location change for their family childcare home license. Per licensee, operation hours will be Sunday to Saturday, 23 hours a day. Licensee states that they will care for children ages 40 days to 13 years old.

All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a two story home that consists of 3 bedrooms, 2 bathrooms, 2 living rooms, kitchen, laundry area, front yard (fenced) and backyard. The location of the home is on the same lot as 380 E. Janice Street.

Main care areas include 2 bedrooms, 1 bathroom, downstairs living room, and outdoor play area . Parents will enter the facility through a gate next to the attached garage that leads to the front door. LPA observed the living room to have a child sized table and child sized chairs, and a baby highchair feeding table. Bedroom 1 was observed to have a baby crib, a wooden baby changing station, age appropriate toys, and a wooden storage cabinet. LPA observed sleeping mats stored in the closet of bedroom 1. Bedroom 2 was observed to have additional age appropriate toys, art materials, child sized table and chairs, and a couch.



Off limit areas include the master bedroom, master bathroom, upstairs living room, laundry area, attached garage, back yard, and kitchen. The master bedroom, master bathroom, 2nd living room, and laundry area are located in the off limit upstairs space. A wood gate was observed at the bottom of the stairs making the entire 2nd floor inaccessible to children in care. The licensee understands that licensing staff may have access to off-limit areas during inspection visit if necessary.

Outdoor play area is located outside the front door. A white picket fence was observed to separate the space (page 1 of 3)
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE: DATE: 08/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/03/2022
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 3
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: AMAYA FAMILY CHILD CARE
FACILITY NUMBER: 198400606
VISIT DATE: 08/03/2022
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used between the two addresses (380 and 380A East Janice St). Per licensee, a pop up tent will be temporarily used to provide shade. LPA also observed a canopy made up of a passion fruit plants being used to provide shade to children in care. Outdoor play equipment, a tether ball pole cemented into a spare tire, a sink, and a toy bin were also observed outside. .

Areas that will be used by children were inspected for safety, comfort, cleanliness. LPA observed operable telephone service, ventilation and heating (central). Detergents, cleaning compounds and hazardous items that can pose a danger to children are made inaccessible in the off limits laundry area and off limits kitchen area. The licensee was advised that any poisons must be locked, not just inaccessible. 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 cots in the main care area and bedroom 1.


LPA discussed the safe sleep regulations with licensee 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 licensee 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.

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



LPA observed that the licensee has a 2A-10BC fire extinguisher in the home with a service tag dated 07/11/22. Smoke and carbon monoxide detector were tested and are operable.

The licensee 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 licensees have completed the required Health and Safety Training, Nutrition, and Lead Training, Mandated Reporter Training and Pediatric First Aid and CPR. Licensees have proof of required
(page 2 of 3)
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: AMAYA FAMILY CHILD CARE
FACILITY NUMBER: 198400606
VISIT DATE: 08/03/2022
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immunization. There are first aid supplies available.

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 licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.cdss.ca.gov.

Licensees are requesting a location change for their family child care license. Fire clearance was approved on 06/29/22.

A location change to a family childcare license may be granted upon Licensing Program Manager (LPM) approval. Once licensed, the licensee is required to comply with the terms and limitations stated on the license.



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

Exit interview conducted and report was reviewed with the licensees Jose and Sandra Amaya.

(page 3 of 3)

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

DATE: 08/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2022
LIC809 (FAS) - (06/04)
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