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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400804
Report Date: 05/05/2023
Date Signed: 05/05/2023 10:57:22 AM

Document Has Been Signed on 05/05/2023 10:57 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:ALVARADO FAMILY CHILD CAREFACILITY NUMBER:
198400804
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
05/05/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:TIME COMPLETED:
11:05 AM
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Licensing Program Analyst (LPA) Elka Chavez conducted a pre-licensing inspection on 05/05/2023. LPA met with Applicant, Emily Alvarado who guided analyst on a tour of the facility. During this inspection individuals who reside in the home were discussed and noted. The applicant is requesting a small family childcare home license. Per applicant, operating hours will be Monday through Friday from 6:00am to 6:00pm. Applicant states that she will care for children from birth to 13 years of age.

All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a one-story home that consists of three bedrooms and two bathrooms. Areas that the children will use include living room, bathroom next to the bedroom hallway, kitchen and back yard (fenced).

Off limit areas include three bedrooms, master bathroom, laundry room, backyard next to the master bedrooms and detached garage. Rooms are made inaccessible with a lock. The Applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary.

Areas that will be used by children were inspected for safety, comfort, and cleanliness. LPA observed equipment, toys and age-appropriate materials for children in the living room area. Applicant will use their cell phone as the day care phone. LPA observed detergents and cleaning compounds that can pose a danger to children are made inaccessible in a locked cabinet under the kitchen sink.

Medication and knives are stored in a locked kitchen cabinet. LPA did not observe hazardous items in the kitchen. Per Applicant there are no poisons in the home. The Applicant was advised that any poisons must be locked, not only inaccessible. Children will nap on cots or mats in the living room.

Applicant has one dog (Shepard mix). Applicant stated that the dog will be kept in the backyard area next to
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 05/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/05/2023
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: ALVARADO FAMILY CHILD CARE
FACILITY NUMBER: 198400804
VISIT DATE: 05/05/2023
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the master bedroom which is off-limits. LPA observed the area to be accessible to children in care. Applicant stated that she will purchase a gate to make the area in accessible. Per Applicant, there are no firearms or weapons stored in the home. LPA observed that the Applicant has a 3A40BC fire extinguisher in the home, serviced on 4/24/23. Smoke and carbon monoxide detectors were tested and are operable in the bedroom hallway.

The Applicant states that she will not provide food for children in care. LPA reminded Applicant that any food brought from the children’s homes shall be labeled with child’s name and properly stored or refrigerated. Applicant was reminded that they shall be present in the home and ensure children are supervised at all times. If Applicant temporarily leaves the home, they must ensure a substitute adult with required training and documents supervise the children in their absence.

The Applicant has completed the required Health and Safety Training, Pediatric First Aid and CPR and Mandated Reporter Training. Applicant has proof of immunization against measles, pertussis and influenza on file.

Applicant plans to care for infants 0-24 months old. LPA informed Applicant of the new Safe sleep regulations, including the LIC 9227 Infant Sleep Plan for infants under 12 months and 15-minute sleep check documentation for infants 0-24 months.

Outdoor play area is located in the backyard. LPA observed that the backyard is fenced and free of hazards. LPA did not observe any pool, spas or bodies of water on the premises.

Isolation area for sick children waiting to pick up by a parent will be in the dining room or entry way area, away from other children. Capacity and ratio was discussed with Applicant and a handout was provided.

Emily Alvarado 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: Karen Chambers
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE:

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

DATE: 05/05/2023
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: ALVARADO FAMILY CHILD CARE
FACILITY NUMBER: 198400804
VISIT DATE: 05/05/2023
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LPA discussed the safe sleep regulations Emily Alvarado and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-carelicensing/public-information-and-resources/safesleep as an additional resource. LPA also informed [applicant, licensee, 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.

LPA reviewed with Emily Alvarado 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.

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 licensed-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.

Based on the LPA’s observation, the following corrections need to be corrected prior to obtaining a small family child care license. Corrections are due by 05/08/2023.

· Applicant needs to place a gate in the backyard area next to the master bedroom.

A small family child care license will be granted upon receipt of proof of corrections. Once licensed, the applicant is required to comply with the terms and limitations stated on the license.

Exit interview conducted and report was reviewed with the applicant, Emily Alvarado.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE:

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

DATE: 05/05/2023
LIC809 (FAS) - (06/04)
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