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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400654
Report Date: 03/13/2024
Date Signed: 03/13/2024 03:53:25 PM

Document Has Been Signed on 03/13/2024 03:53 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:AMAYA FAMILY CHILD CAREFACILITY NUMBER:
198400654
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 7CENSUS: 4DATE:
03/13/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Assistant - Ingrid Mejia De AmayaTIME COMPLETED:
03:20 PM
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Licensing Program Analyst (LPA) Randy Derraco and Claudia Kam conducted an unannounced case management inspection to the above mentioned address on 03/13/24 at 1:30 PM. LPAs met with assistant, S1, who guided LPAs on a tour of the home. LPA observed one adult and 4 children present during inspection. Per assistant, one child presently live in the home. Child was verified via LIC 279B. Individuals residing in the home have been noted and discussed. The licensee is requesting a capacity increase to his family childcare home license. Per licensee, operation hours will be seven days a week, from 4:00 AM to 3:00 AM. Applicant states that they will care for children 0 to 13 years old. Licensee was observed arriving to the home at 3:05 PM

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, living room, kitchen, garage, and front yard. The off limit areas include 2 bedrooms, 1 bathroom, kitchen and garage. The garage space has been converted into a living space that consists of a kitchen, living room, bathroom and bedroom. The applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary.

Main care areas include the living room, bedroom, and front yard. The living was observed to have age appropriate toys, child sized table, child sized chairs, a couch, a wall mounted baby changing station, children's rug, 2 wooden Foundations cribs, and a Ingenuity high chair feeding table. The bedroom was observed to have a couch, napping cots and a Graco play pen. Baby gates were observed to be mounted to the wall at the entrance to the kitchen and the base of the stairs. 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 bathroom was observed to be clean with an operable sink, faucet and toilet. The front yard play area was observed to have perimeter fencing, a pop up tent for shade, outdoor play equipment and additional age appropriate toys. A parent board was observed at the entrance of the home and has all required postings. Per licensee there are no pets, there are no firearms or weapons stored
in the home and there are no bodies of water. LPAs did not observe any of the above items.
(page 1 of 3)
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE: DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2024
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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: AMAYA FAMILY CHILD CARE
FACILITY NUMBER: 198400654
VISIT DATE: 03/13/2024
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Areas that will be used by children were inspected for safety, comfort, cleanliness. LPA observed operable telephone service, air conditioning, heating, and ventilation. Detergents, cleaning compounds and hazardous items that can pose a danger to children are made inaccessible in the off limits kitchen. LPAs observed a lock on the cabinet beneath the kitchen sink. Disinfectant spray was observed to be kept on top of the refrigerator. The licensee was advised that any poisons must be locked, not just inaccessible. LPA observed that the Applicant has a 2A10 BC fire extinguisher in the home, with a service 12/15/23. Smoke and carbon monoxide detector were tested and are operable.

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.

The licensee has completed the required Health and Safety Training, Nutrition, and Lead Training, Mandated Reporter Training and Pediatric First Aid and CPR. Licensee has proof of required immunization records. 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 applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.cdss.ca.gov
(page 2 of 3)
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: AMAYA FAMILY CHILD CARE
FACILITY NUMBER: 198400654
VISIT DATE: 03/13/2024
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Licensee is requesting a large family child care. Fire clearance was approved on 02/27/24.

A large 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.

Prior to license approval, licensee must make the following corrections by 04/11/24:
-Criminal background clearance must be granted for all adults living or working in the home
-LIC 279 must be updated with corrected hours of operation and names of adults living in the home
-Mandated reporter AB1207 compliant training must be completed by S1.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Jose David Amaya.

(page 3 of 3)
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2024
LIC809 (FAS) - (06/04)
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