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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400791
Report Date: 06/28/2023
Date Signed: 06/28/2023 12:07:48 PM

Document Has Been Signed on 06/28/2023 12:07 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:PRIETO FAMILY CHILD CAREFACILITY NUMBER:
198400791
ADMINISTRATOR:PRIETO, RUBICELIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 219-7082
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/28/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Rubicelia Prieto, ApplicantTIME COMPLETED:
12:25 PM
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On 06/28/2023 at 9:00 AM Licensing Program Analyst (LPA) Katrina Chicote conducted an Announced – Prelicensing Inspection to the above facility. LPA announced purpose of visit and met with Rubicelia Prieto, Applicant, and was taken on a guided tour of the facility both indoors and outdoors. Also present during inspection was Applicant's Assistant who lives in the home. Adults in the home were discussed and all have criminal record clearance. The Applicant is requesting a large family child care home license. Fire clearance was granted on 06/13/2023 and Applicant has submitted an exception for the one year experience of operating a small family child care home requirement.

All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a single-story home that consists of four bedrooms, two bathrooms, Dining Room/Kitchen, Living Room, and detached garage. Per Applicant, families will enter Main Care Areas of the home through side yard entering backdoor.

Based on the Facility Sketch submitted, areas off limits to children include Bedrooms 1 and 2. Applicant states these doors will be locked during operating hours, and LPA observed doors to be locked at time of inspection which will make these room off limits to children in care. The Applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary.

Per Applicant and Facility Sketch submitted, the children will have access to Living Room (located upon entry of the home), Kitchen/Dining Room (located next to Living Room), Bathroom 1 (located down hallway to the right), Bedroom 3 as Infant Room (located end of hallway to the right), Bedroom 4 as Day Care Room (located next to Infant Room), and Bathroom 2 (located in Day Care Room). Main Care Areas will be the Infant Room and Day Care Room. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service (cell phone), ventilation and heating (central air and heat). At 9:08 AM, LPA observed Living Room to have sectional couch, oval coffee table, and television hanging on wall. LPA Report Continues - Page 1 of 6
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE: DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/28/2023
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 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PRIETO FAMILY CHILD CARE
FACILITY NUMBER: 198400791
VISIT DATE: 06/28/2023
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observed a wood burning fireplace in Living Room that has a gate bolted onto fireplace as barricade. Applicant states Living Room will only be used as isolation area for sick children. At 9:10 AM, LPA observed Kitchen to have rectangular Dining Room table and six chairs. Applicant states Kitchen will only be accessible when Applicant is cooking. Applicant states she may provide food to children in care but may also allow children to bring food from home. LPA discussed requirement of having lunch boxes labeled with children's names and properly stored if food is being brought from home. Applicant states children will use Day Care Room for eating. At 9:13 AM, LPA observed Bathroom 1 to have operable toilet and sink, adequate supplies, general area safety and sanitation with operable child proof locks on under cabinet sinks at time of inspection. At 9:19 AM, LPA observed Infant Room to have soft mat flooring through out room, diaper changing table, cubbies to store infant belongings, and three infant cribs positioned against wall not obstructing entrances and exits at time of inspection. At 9:19 AM, LPA observed Day Care Room to have cubbies available for children's belongings, child appropriate table and chairs, couch, puzzles, and other age appropriate toys free of loose and sharp parts available for children. At 9:21 AM, LPA observed Bathroom 2 to have operable toilet and sink, general area safety and sanitation, and to be free of hazards at time of inspection. The Applicant was advised that any poisons such as detergents, cleaning compounds, and medicines must be made inaccessible or stored somewhere with a key or combination lock. LPA observed these items stored in Kitchen: medicines stored in high shelf, knives stored in drawer with operable child safety lock, and cleaning solutions stored in under cabinet sink with operable child safety lock at time of inspection. The Applicant was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

Per Applicant, the children will use the backyard for outdoor play which is accessible through back door in Day Care Room. At 9:20 AM, LPA observed backyard has concrete and adequate perimeter fencing through-out the yard. LPA observed two large dogs kept in rear area of backyard that is completely fenced off. Per Applicant, dogs will be kept separate from children during operating hours. Applicant observed detached garage in backyard that Applicant states is her work room and is off limits to children in care, LPA observed detached garage door to be locked at time of inspection making it off limits. At 9:23 AM, LPA observed a pool in backyard which LPA observed to have at least 5-foot fence around the perimeter of the pool and fence does not obscure the pool from view. LPA observed fence to have a self latching gate that opens away from the pool at time of inspection.
Report Continues - Page 2 of 5
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
LIC809 (FAS) - (06/04)
Page: 2 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PRIETO FAMILY CHILD CARE
FACILITY NUMBER: 198400791
VISIT DATE: 06/28/2023
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· 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 for a minimum of 3 years.
· No infant walkers, No Johnny jumpers, No saucer chairs, No incline sleepers 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.
· Isolation for Ill children: When a child is ill he/she shall be separated from other children (reference 102417(e) Operation of a Family Child Care Home).
· Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information

· 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 licensee and all adults working with children have proof of immunizations.

· 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

LPA discussed the safe sleep regulations with Applicant [or facility representative] 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 [or facility representative] 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.
Report Continues - Page 4 of 6

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
LIC809 (FAS) - (06/04)
Page: 3 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PRIETO FAMILY CHILD CARE
FACILITY NUMBER: 198400791
VISIT DATE: 06/28/2023
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The valve on the required 2A-10BC fire extinguisher indicates fully charged but with no service tag or proof of purchase receipt at time of inspection. Applicant states she obtained fire extinguisher from Crystal Stairs but was not provided a service tag or receipt. At 9:33 AM, LPA tested dual smoke and carbon monoxide detectors and observed to be in operable condition at time of inspection. LPA observed first Aid kit hanging on wall in Day Care Room at time of inspection and was inventoried for necessary supplies. The Applicant has current Pediatric First Aid and CPR valid until 08/2024 and has completed the required Health and Safety Training, Nutrition, and Lead Training. Proof of immunization against influenza, pertussis, and measles were readily available during today’s inspection. The Applicant has taken the Mandated Reporter Training on 10/13/2022.

Per Applicant, there are no weapons, firearms in the home and none were observed at time of inspection.

The following were 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 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.
· Fire and safety drills must be performed every six months and documented for review by the Department.
Report Continues - Page 3 of 6
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
LIC809 (FAS) - (06/04)
Page: 4 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PRIETO FAMILY CHILD CARE
FACILITY NUMBER: 198400791
VISIT DATE: 06/28/2023
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

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, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated

LPA advised the Applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. LPA reviewed and issued the Forms/Records to Keep in Your Family Child Care Home (LIC 311D) and provided the forms referenced.

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

Per Applicant, there are no dual licenses at this address. LPA obtained email address for Applicant.
The Applicant provided proof of control of property.

On this date, 03/27/2023 , the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.
Report Continues - Page 5 of 6
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
LIC809 (FAS) - (06/04)
Page: 5 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PRIETO FAMILY CHILD CARE
FACILITY NUMBER: 198400791
VISIT DATE: 06/28/2023
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Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Based on the LPA’s observation, the following corrections need to be corrected prior to obtaining a small or large family child care license, capacity is dependent on exception approval. Corrections are due by 07/07/2023 provide photo proof of it via email to LPA.
  • Obtaining a service tag or proof of purchase within the year for fire extinguisher.

A Large Family Child Care licensee will be granted upon receipt of proof of corrections for the above pending approval of exception. Once licensed, the Applicant is required to comply with the terms and limitations stated on the license.

A notice of site visit was given to Applicant and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the Applicant, Rubicelia Prieto.

Report Ends - Page 6 of 6
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
LIC809 (FAS) - (06/04)
Page: 6 of 6