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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198401136
Report Date: 11/07/2024
Date Signed: 11/07/2024 12:17:24 PM

Document Has Been Signed on 11/07/2024 12:17 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:AMAYA FAMILY CHILD CAREFACILITY NUMBER:
198401136
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
11/07/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH:David Amaya Mejia, ApplicantTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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Inspection was conducted in English with Andrea Escobar and translated in Spanish for applicant. Licensing Program Analyst (LPA) Dayna Chambers conducted a pre-licensing inspection on November 7, 2024. LPA arrived at the facility at 9:10am and met with David Amaya Mejia, Applicant, who guided analyst on a tour of the facility. Also present was applicant’s mother/landlord, and adult resident. During the inspection individuals residing in the home were discussed and noted. The applicant is requesting a small family childcare home license. Per applicant, operation hours will be 5:00am to 4:00am- Monday through Sunday. Applicant states that they (he/she) will care for children 0 to 13 years of age. Entrance Checklist was provided to the applicant. 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 3 bedrooms, 1 full restroom in hallway, and half restroom located in the kitchen area, living room, dining area/kitchen, front yard, back yard (fenced). The backyard is split into two areas which are fenced. The children’s play yard is on the right side of the home (facing the home). There is a detached garage converted into an apartment in the backyard. The garage apartment is fenced and separate from the children’s play area. The garage apartment has its own entry/exit located on the left side of home (facing home). Relatives living in the garage apartment have been printed and cleared and associated to the facility. Per applicant, the children will use both restrooms, one in the hallway and the half bathroom in the kitchen. The living room will be used for children’s activities. Bedroom #1 located in the living room area, will be used for napping. The children will have meals in the dining room area located in kitchen. The kitchen is gated and off-limits to children. Bedroom #2 and Bedroom #3 are off-limits to children. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service via cell phone. Ventilation and heating are available via central heat and air conditioning. Detergents, cleaning compounds, medicines, sharp objects, and hazardous items that can pose a danger to children are inaccessible in areas designated for children. The applicant was advised that any poisons must be locked with a key or combination lock. Based on the Facility Sketch submitted, areas off limits to children and parents are Bedroom #2 located in hallway and applicant's bedroom #3 at end of
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE: DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/07/2024
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: AMAYA FAMILY CHILD CARE
FACILITY NUMBER: 198401136
VISIT DATE: 11/07/2024
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hallway. All bedroom doors have door locks. Applicant states that doors will stay locked during the hours of operation. The applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary. The children will use the back yard for outdoor play. The play area is located on the right side of the home (facing the home). LPA observed the play yard is fenced. Per applicant, there are no firearms, weapons, or bodies of water on the premises. Per applicant, there are no pets on the premises. The value on the 2A10BC fire extinguisher indicates fully charged, as indicated on receipt submitted or service tag observed. Smoke and carbon monoxide detectors were tested and are operable. The service tag is dated 11/06/2024. There are toys available for children. The applicant states that they will provide food for children in care. If food is not provided and food is brought from the children’s homes; container shall be labeled with child’s name and properly stored or refrigerated. The applicant has completed the required Health and Safety Training, Nutrition Training, and Pediatric First Aid and CPR which expires 09/07/26. There are first aid supplies available and located in the kitchen cabinet. Applicant was reminded of all the terms and conditions noted on the LIC 279 – Application of a Family Childcare Home that applicant signed and agreed to. Applicant states that they will care for infants. Bedroom #1 will be used for infant napping. LPA advised the door shall remain open where they can be directly supervised at all times. LPA provided the applicant with a copy of LIC9227, Infant Safe Sleep FAQs, Sleep Chart, Title 22 Infant Safe Sleep. Per applicant, there are no dual licenses at this address. Applicant’s email address was obtained during this inspection. The applicant was advised that email may be public information. 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 Childcare 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 applicant provided proof of control of property. Because the applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149). Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, an updated Plan of Operation that includes 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at:
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
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: AMAYA FAMILY CHILD CARE
FACILITY NUMBER: 198401136
VISIT DATE: 11/07/2024
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http://www.ada.gov/childqanda.htm
LPA reviewed with applicant the LIC 311D, Forms/Records to Keep in Your Family Childcare Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.
LPA discussed the safe sleep regulations with applicant 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.
On this date, November 7, 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.
Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.
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 David Amaya Mejia.
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-care-licensing/subscribe and select the Child Care option to receive email communication.
LPA observed the home to be in compliance.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024
LIC809 (FAS) - (06/04)
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