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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400776
Report Date: 04/24/2023
Date Signed: 04/24/2023 11:15:10 AM

Document Has Been Signed on 04/24/2023 11:15 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:AUSTIN FAMILY CHILD CAREFACILITY NUMBER:
198400776
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
04/24/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Applicant Nicole Austin TIME COMPLETED:
11:20 AM
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On 4/24/23 Licensing Program Analyst (LPA) Jeanette Estrada conducted an announced pre-licensing inspection. The purpose of this inspection is to inspect and evaluate the facility for a new small license. LPA met with Applicant Nicole Austin who provided a tour of the facility. Operating hours will be Monday to Sunday 12AM to 11:50PM and care will be provided for children ages 6 weeks to 12 years old. All residents living in the home were discussed and verified and have obtained a criminal record clearance.

The day care facility is a 4 bedroom, 2 bathroom home with a living room/dining area, kitchen, enclosed backyard and attached garage (no access from inside the home).

Off Limit areas: Three bedrooms, kitchen and garage. On Limit areas: Living room, both hallway bathrooms, one bedroom and backyard. The day care areas that will be used by children were observed for safety, comfort, cleanliness, telephone service (land line and cell phone), ventilation and heating. The facility has central air/heating. No wall heaters were observed. LPA observed the heater for the central air/heating is located in a closet in the home. There is a latch attached to the door to prevent access. There is an electric fireplace in the home. Per Applicant, the fireplace will remain unplugged during day care hours.

Per Applicant, children will have access to one bedroom that will be used for day care activities and infant napping and the living room will be used for day care activities, meals and napping. LPA observed age appropriate materials and toys available for children. LPA observed napping cots are available. Per Applicant, there are three play yards available. Per Applicant, food may be provided for children in care. 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 refrigerated. LPA advised applicant that high chairs are to only be used for eating during mealtimes. Per Applicant, the kitchen is off limits. Per Applicant, safety gates will remain at the two entrances to the kitchen. Detergents, cleaning compounds, sharp objects and hazardous items that can pose a danger to children are inaccessible to children in care. Knives and sharp objects are kept in a latched cabinet in the kitchen.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 04/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/24/2023
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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: AUSTIN FAMILY CHILD CARE
FACILITY NUMBER: 198400776
VISIT DATE: 04/24/2023
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Personal medicines are kept in an off limits bedroom. Per Applicant, they plan to administer medication. Children's medicine will be kept in a latched kitchen cabinet. Cleaning compounds are kept in latched cabinet under the kitchen sink. Laundry detergent is kept in the locked laundry room next to the kitchen. Poisons are maintained in the locked garage. LPA advised that if any other poisons are kept in the home at a later date to keep them in a locked cabinet or container. LPA observed an operable smoke detector in the day care room and an operable carbon monoxide detector in the hallway. LPA observed a 1A10BC fire extinguisher in the kitchen. Per Applicant, a 2A10BC fire extinguisher will be purchased. LPA observed electrical outlets covered throughout the home. Children will have access to both bathrooms in the home. LPA observed latched cabinets where personal items are stored. LPA did not observe any medicines in the bathrooms.

Children will have access to all of the backyard. Children will access the backyard through the living room. Per applicant, children will be supervised while playing outside. In the backyard LPA observed a swing set. Per Applicant, the swing set is for ages 3 to 8 and will only be used for that age group.

Per the Applicant there are no bodies of water on the premises such as pools/ hot tubs or spas. LPA did not observe any bodies of water. Applicant stated there are no weapons or firearms in the home. There is one pet dog in the home. Per Applicant, if a child becomes ill, they may use a section of the living room, separated from other children while they wait to be picked up.

Applicant has completed the required Health and Safety Training, Nutrition Training, Lead training and Pediatric First Aid and CPR which expires 3/2024. Applicant has also completed the required Mandated Reporter Training which expires 10/19/24. Applicant has proof of the required immunizations for measles, pertussis and flu. Applicant has submitted proof of TB clearance.

LPA discussed the safe sleep regulations with Applicant. Applicant stated they plan to enroll infants. Infants will nap in the day care room. Per Applicant, the door will remain open while infants nap. LPA advised Applicant that there shall be no loose objects in the play yards. LPA advised Applicant that high chairs shall be used for their intended use and children shall not be left in car seats. LPA 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

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

DATE: 04/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2023
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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: AUSTIN FAMILY CHILD CARE
FACILITY NUMBER: 198400776
VISIT DATE: 04/24/2023
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Per 3
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.
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)/ (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 Licensee 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 licensing 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.
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.

The following items are required to be corrected before the application is submitted for Department review:
-Proof that a 2A10BC fire extinguisher has been purchased for the home.

A small family child care license will be granted upon Department approval. Once licensed, the Licensee is required to comply with the terms and limitations stated on the license. Exit interview conducted and report was reviewed with Applicant Nicole Austin.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2023
LIC809 (FAS) - (06/04)
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