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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198401030
Report Date: 04/25/2024
Date Signed: 04/25/2024 11:55:02 AM

Document Has Been Signed on 04/25/2024 11:55 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:PEREZ FAMILY CHILD CAREFACILITY NUMBER:
198401030
ADMINISTRATOR/
DIRECTOR:		PEREZ, TERESAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 872-4112
CITY:CARSONSTATE: CAZIP CODE:
90745
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
04/25/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Teresa Perez, LicenseeTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On 04/25/2024 at 9:00 AM, Licensing Program Analysts (LPAs)Katrina Chicote and Claudia Kam conducted an Announced – Prelicensing Inspection to the above facility. Upon arrival, LPAs met with Licensee, Teresa Perez, who granted entry to facility and guided the LPA on a tour of the facility both indoors and outdoors, including off limits areas. Adults in the home were discussed and all have criminal record clearance. The Applicant is requesting a large family child care home license max capacity of 14 (landlord consent not needed). Licensee states she will be caring for children 0 to 12+ years of age. Per Licensee, operation hours will be 24 hours, 7 days a week. LPAs discussed license limitations of not providing care for children longer than 23 hours and overnight care requirements per Title 22 Regulations at time of inspection. Required postings were observed and discussed.

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 three bedrooms, two bathrooms, Kitchen, Dining Room, Living Room, Daycare Room, and attached garage. Per Licensee and Facility Sketch, the children will have access to Kitchen (located to the left upon entry), Dining Room (located through Kitchen), Living Room (next to Dining Room), Bathroom 1 (located down hallway to the right), and Daycare Room (located to the rear of the home). Per Licensee and Facility Sketch submitted, off limit areas of the home will be all bedrooms and Bathroom 2 (which is located inside bedroom), and attached garage. Per Licensee, Bedroom 1 (located down hallway to the left, near Bathroom 1) will only be used as isolation area for sick children. At 9:10 AM, LPAs observed Bedroom 1 to have bed available. Licensee states off limits bedrooms and garage will be locked during operating hours, and LPAs observed bedroom doors to have locks available at time of inspection.

All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. LPAs observed central air and heat. At 9:14 AM, LPAs observed a fireplace in Living Room that is barricaded making it off limits at time of inspection. Per Licensee, fireplace is electric and does require a specific key to operate, LPAs observation
Report Continues - Page 1 of 6
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2024
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 6
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: PEREZ FAMILY CHILD CARE
FACILITY NUMBER: 198401030
VISIT DATE: 04/25/2024
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confirm Licensee statement. There is a working telephone maintained in the home. At 9:08 AM, LPA observed Kitchen to be free of clutter and hazards at time of inspection. Per Licensee, she will be providing food to children in care and use Dining Room and Daycare Room for eating. At 9:10 AM, LPA observed Dining Room to have round dining room table and four chairs available. At 9:13 AM, LPA observed Living Room to have large sectional couch, TV hanging on wall, and round coffee table. At 9:16 AM, LPA observed Daycare Room to have age appropriate furniture free of hazards, including shelving for toys and cubbies for children's belongings. LPAs observed a variety of age appropriate toys free of loose and sharp parts such as infant tracking toys and puzzles. Per Licensee, Daycare Room will also be used for napping and overnight care. LPAs observed playpens stored and per Licensee she will be using blue cots for children sleeping equipment. At 9:20 AM, LPAs observed Bathroom 1 to have adequate supplies, operable equipment, and general safety and sanitation. LPAs observed operable child safety locks on under cabinet sink at time of inspection. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. At 9:24 AM, LPAs observed hazardous cleaning solutions in off limits detached garage stored on high shelf and medicines stored in high shelf in storage closet in hallway. Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the age, size, and abilities of children in care. LPAs advised that poisons used to kill any kind of bugs/vermin should be locked with a key or combination lock to be inaccessible for a variety of children's size, age, and abilities.

Per Licensee, the children will have access to backyard for outdoor play which is accessible through french doors in Daycare Room. At 9:37 AM, LPAs observed back yard has concrete flooring and adequate perimeter fencing through-out. LPAs observed a variety of age appropriate toys such as: plastic crawl tube and ride along toys, that were free of loose and sharp parts available for the children. LPAs observed all trees, shrubs, and plants are maintained at time of inspection. At 9:40 AM, LPAs observed a pool in backyard with a white fence that is at least 5' feet high and opening between railings not exceeding 4" apart though fencing did not surround perimeter of pool at time of inspection. LPAs observed two windows from Daycare Room allowing access to the pool and fencing of pool to not go completely around the perimeter. LPAs discussed requirements for bodies of water with Licensee and need to have perimeter fencing for pool or pool cover meeting requirements.

At 9:45 AM, LPAs observed two dogs (French Bulldog and Bulldog) in side yard. Per Licensee, dogs will be kept separate from children at all times and they will be kept in dog run on side yard. LPAs observed dog run Report Continues - Page 2 of 6
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2024
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PEREZ FAMILY CHILD CARE
FACILITY NUMBER: 198401030
VISIT DATE: 04/25/2024
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to be fenced off making it off limits to children at time of inspection. Per Licensee, there are no weapons, firearms in the home and none were observed.

At 9:50 AM, LPAs observed the valve on the required 2A-10BC fire extinguisher indicates fully charged with service tag dated 08/31/2023. LPAs tested dual smoke and carbon monoxide detectors and observed to be in operable condition at time of inspection. LPAs observed First Aid kit stored in Kitchen and was inventoried for necessary supplies. The Licensee has current Pediatric First Aid and CPR valid until 04/2026 and required AB1207 Mandated Reporter training completed on 04/10/2024. Proof of immunization against influenza, pertussis, and measles were readily available during today’s inspection.

The following was discussed with the Licensee:
· 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.
· 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 or 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.
Report Continues - Page 3 of 6
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2024
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PEREZ FAMILY CHILD CARE
FACILITY NUMBER: 198401030
VISIT DATE: 04/25/2024
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· 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

In order to provide night care (overnight care, less than 24 hours): The provider must remain awake whenever children are awake. The door to the room where the provider is sleeping must remain open when the provider is sleeping. If the sleeping arrangements are not situated in such a way that the provider can be assured of hearing a child waken, a monitor system must be used, and must be maintained in good working order at all times. Appropriate cribs or beds, complete with adequate and clean bedding and nightclothes, must be available.



Incidental Medical Services (IMS):
This facility plans to 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 Licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.
Report Continues - Page 4 of 6
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2024
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PEREZ FAMILY CHILD CARE
FACILITY NUMBER: 198401030
VISIT DATE: 04/25/2024
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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 Applicant 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 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. Forms referenced on LIC 311D were provided to Applicant during this inspection.

OTHER INFORMATION AND FORMS PROVIDED:
· Capacity Handout for a Small Family Child Care Home and Large Family Child Care Home was provided.
· Handout for Lead poisoning

Licensee 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.

The Licensee provided proof of control of property.

On this date, 02/28/2024, 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: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2024
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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: PEREZ FAMILY CHILD CARE
FACILITY NUMBER: 198401030
VISIT DATE: 04/25/2024
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Licensee 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.

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 platforms. 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 Licensee, there are no dual licenses at this address. The Licensee was advised that email may be public information.

Based on the LPAs observation, the following correction needs to be corrected prior to obtaining a large family child care license. Corrections are due by 05/09/2024.
  • Licensee states she will install a mesh gate that will surround perimeter of pool that will be self-closing and self-latching or she will install pool cover that meets Title 22 Regulation requirements.

Report Ends - Page 6 of 6
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2024
LIC809 (FAS) - (06/04)
Page: 6 of 6