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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400802
Report Date: 05/17/2023
Date Signed: 05/17/2023 03:18:43 PM

Document Has Been Signed on 05/17/2023 03:18 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:FLORES FAMILY CHILD CAREFACILITY NUMBER:
198400802
ADMINISTRATOR:FLORES, JAMIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 850-6770
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
05/17/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Applicant Jamie Flores TIME COMPLETED:
03:25 PM
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On 5/17/23 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 large license. LPA met with applicant Jamie Flores who provided a tour of the facility. LPA provided the pre-licensing entrance checklist to applicant. Operating hours will be Monday to Friday 7 AM to 5PM and care will be provided for children ages 0 to 13 years old. All residents living in the home were discussed and verified and have obtained a criminal record clearance. An approved fire clearance for a capacity of 14 was received on 5/16/23.

The day care facility is a two bedroom, one bathroom home with a front yard, living room (day care area), kitchen, backyard, laundry room and attached garage (access from inside the home).

Off Limit areas to children in care: One bedroom (safety knob installed), laundry room and garage (kept locked).

On Limit areas to children in care: Living room (main day care area), one bedroom used for infant napping, hallway bathroom, kitchen (in passing to backyard) and backyard.

The day care areas that will be used by children were observed for safety, comfort, cleanliness, telephone service (cell phone), ventilation and heating. Per applicant, open windows and fans will be used for ventilation. LPA advised applicant that cord that keeps curtains open shall be made inaccessible to children. Per applicant, portable heaters will be used when needed. There is a wall heater in the day care room. Per Applicant, it is not operable and it will be made inaccessible or proof that it is not operable will be provided. Per Applicant, children will have access to one bedroom that will be used as the infant napping room and the living room which will be the main day care room. Per Applicant, the living room will be used to nap and eat. LPA observed age appropriate materials and toys available for children in the day care room. Napping cots are available for children that don't use a crib or play yard. A play yard is available in the infant napping room. Per Applicant, food will be provided for children in care and children will be supervised while eating. 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 observed a safety gate blocking the entrance to the kitchen.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2023
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: FLORES FAMILY CHILD CARE
FACILITY NUMBER: 198400802
VISIT DATE: 05/17/2023
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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 are kept in a shelf above the kitchen sink and other sharp objects are kept in a kitchen cabinet with a magnetic lock installed. Laundry detergent and cleaning products are kept in the off limits laundry room next to the kitchen. There is a safety knob installed on the laundry room door. There are also additional cleaning supplies stored in a latched cabinet under the sink. Per applicant, currently there are no personal medications kept in the home. Per Applicant, medicine for children will be administered if required. Medicine will be kept in a locked cabinet in the kitchen. Children will use the bathroom in the hallway. LPA observed the cabinets where personal items are stored had latches installed to prevent access. LPA did not observe any cleaning supplies or medicine in the bathroom. Per Applicant, there are no poisons kept 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 an operable smoke detector and an operable carbon monoxide detector in the day care room. There is a 2A10BC fire extinguisher in the kitchen with proof of purchase dated 4/17/23. LPA observed electrical outlets covered throughout the home. Children will have access to all of the backyard. Per applicant, children will walk through the kitchen to access the backyard. Per applicant, children will be supervised while playing outside. In the backyard there are several items that will be removed per the applicant. LPA observed a pile of sand and wooden boards on a plastic tarp, worn wooden table, a loose sprinkler pipe and a fire pit. Per applicant, the fire pit is not gas or electric powered and it will be kept latched. Per Applicant, the items in the yard will be removed or made inaccessible to children. 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, dog will be maintained in the off limits laundry room or garage. Per Applicant, the isolation area will be in the infant napping room, separated from other children while supervised.
Applicant completed the required Health and Safety Training, Nutrition Training, Lead training on 3/19/23. Applicant completed an pediatric first aid/cpr course by the American Heart Association on 8/19/2022. Applicant also completed the required Mandated Reporter Training for child care providers on 8/9/2022. Applicant has proof of required immunization against measles, pertussis and the flu. Applicant has submitted proof of TB clearance. TB clearance is required for the additional adult living in the home. Applicant was advised of requirements needed for a qualified assistant.
LPA discussed the safe sleep regulations with Applicant. Applicant stated they plan to enroll infants in the facility. LPA advised Applicant that there shall be no loose objects in the cribs/play yards. LPA advised Applicant that high chairs shall be used for their intended use and children shall not be left in car seats.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023
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: FLORES FAMILY CHILD CARE
FACILITY NUMBER: 198400802
VISIT DATE: 05/17/2023
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LPA advised sleeping equipment shall not block entrances or exits and the door shall remain open in the napping room when an infant is sleeping. LPA advised applicant of the 15 minute sleeping log and the LIC 9227 individual infant sleeping plan. 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 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. Per applicant, they do plan to administer medication. 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 Applicant 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.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: FLORES FAMILY CHILD CARE
FACILITY NUMBER: 198400802
VISIT DATE: 05/17/2023
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The following items are required to be corrected/submitted before the application is submitted for Department review:
-Proof that items in the backyard have been removed or made inaccessible to children in care.
- loose sprinkler pipe
- sand and wooden boards on tarp
- latch on fire pit
- worn wooden table
- wall heater in day care room
- curtain cord
- Proof that adult #2 living in the facility has obtained a TB clearance
Proof that these items have been corrected will be provided via pictures and video by 5/26/23 .

A large 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 Jamie Flores.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4