304313887-10-19-2022-06-CC-KDEI-CKCQPY-20221019122132

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304313887
Report Date: 10/19/2022
Date Signed: 10/19/2022 12:21:41 PM

Document Has Been Signed on 10/19/2022 12:21 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	CAUDILLO, STACEY		FACILITY NUMBER:	304313887
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 3	DATE:	10/19/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Licensee Ms. Caudillo, Stacey		TIME COMPLETED:	12:30 PM

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A Case Management (Licensee initiated) inspection for a change in capacity was conducted at the facility by Licensing Program Analyst (LPA), Desai, Ketki. LPA observed licensee Ms.Caudillo, Stacey caring for 2 infants and one toddler between the ages of 13 months - 35 months old. Licensee has been a care provider for a Small Family child care home since June 2021 and has been a qualified school teacher with a licensed day care facility for 5 years qualifying her to be a Large Family child care provider.

Licensee was operating within the licensed capacity as specified on license. A review of the Facility Personnel Report Summary on this date indicates all facility residents, staff, or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Currently there are 2 adults including the licensee residing in the facility.

Licensee stated, she is not registered with Resource Foster Care agency nor holds a Resource foster parent license.
Per Licensee, operation hours will be Monday to Friday, 8.00 AM to 5.00 PM, care and supervision shall be provided to children ages 6 months to 12 years of age (Infants to School age).

During today’s inspection, LPA and licensee toured the inside and outside areas identified in the facility sketch as accessible to childcare children.

These is a single-story home with three bedrooms, three bathrooms, living room, family room, kitchen, dining room, attached garage, front yard (not fenced), backyard(fenced), and an Accessory Dwelling Unit built in the backyard and shares the same lot as the primary home.

Detergents, cleaning compounds, medicines, and other items which could pose a danger if readily available to children were stored inaccessible to children. The home does not have a fireplace or a stairway.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CAUDILLO, STACEY	FACILITY NUMBER: 304313887
	VISIT DATE: 10/19/2022

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Off limit areas: Licensee has designated three bedrooms, one bathroom, front yard and garage, as the off-limit areas. The off-limit bedrooms have key door locks, ensuring these off-limit areas are inaccessible to children in care. The applicant acknowledged the children may never enter the off-limit areas . During the inspection LPA observed the off limit areas were locked.

Designated Day care area: Licensee has designated two bathrooms, living room, family room, kitchen, dining room, and Accessary Dwelling Unit (ADU), and backyard, as part of the day-care areas. The children enter through the main door into the living area, walk through the dining area into the family room the designated day care area. Kitchen is open but all the cabinets have magnetic locks making them safe and inaccessible to children, the living room is mainly used during early morning hours and during napping activity. Living room has been set up with napping items and a changing table for infants, dining activities are held in the dining area where a small dining table with high chair is set up for dining activities. The Accessory Dwelling unit is set as a classroom with age appropriate furniture and educational items. This room also has a bathroom with a changing table, sink and a toilet for Day care children. Both the day care areas are spacious and safe for children.

Napping area has been set up with blue cots for older children, linens & blankets are provided by the parent and sent home on a weekly basis. Children nap in these area. Infants nap in the play pens or Crib and Licensee remains in this area during napping time, a 15 minute daily sleeping log is maintained for the Infants. Day care area is safe, it is well lighted with proper ventilation and air flow.

The second designated bathroom is located in the small hallway next to the kitchen. Designated children’s bathroom was observed to be safe and free of hazardous items and bathroom was clean. There is step stool for the young children along with a small toilet seat.

OUTDOOR PLAY AREA: Per Licensee, children use the back yard area, It is completely fenced with grass and concrete flooring, under the shaded patio area, there are age appropriate toys with climbing structures in the grass area along with other pretend play kitchen area, tool play set and play house in the shaded concrete area. Backyard is safe for outdoor activities. There is also a shaded gazebo area for children to play.

Per Licensee there are No Pets, Weapons or Firearms or Bodies of Water on the premises. (2)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CAUDILLO, STACEY	FACILITY NUMBER: 304313887
	VISIT DATE: 10/19/2022

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Licensee does provides AM snack / Lunch and PM snacks to the enrolled children. Licensee is enrolled in the food program. If food is brought from home, this containers are labelled and stored in their individual cubbies.

LPA verified there is a working telephone service (cellular service) along with the Control of Property.

A copy of “A Child Care Providers Guild to Safe Sleep” was provided to Licensee: Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials

LPA reviewed the following safe sleep best practices with Ms Caudillo, Stacey

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*Always place infants on their backs for sleeping
*Use only a tight-fitting sheet on the crib or play yard mattress
*Do not hang any items from the crib or above the crib
*Keep all items, including blankets, out of the crib or play yard
*Pacifiers may be used as long as they do not have items attached to them
*Infants should not be swaddled or have any items covering them while sleeping
*The temperature of the room should be comfortable enough for an adult to wear a T-shirt and not be too hot or too cold

The licensee does have a current roster of children in care and the 3 records were reviewed on today's inspection, LPA reviewed the emergency information card that contains all the information specified by regulation (LIC 700) and found to be in compliance. The licensee holds a valid Pediatric CPR/First Aid certification is valid through September 2024 and have also completed the required Mandated Reporter Child Abuse training on 1/14/2022. Licensee also has conducted Emergency fire and earthquake drills, last drill conducted in September 27th 2022 and log was reviewed.

The licensee understands she must be present in the facility, must ensure children in care are supervised at all times, and children are not to be left in parked vehicles. When the licensee is temporarily absent from the facility, arrangements must be made for a qualified substitute adult to care and supervise children while absent. The substitute adult must have the required criminal record, child abuse index clearances, immunization's, Pediatric CPR/First Aid, and mandated reporter training. (3)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CAUDILLO, STACEY	FACILITY NUMBER: 304313887
	VISIT DATE: 10/19/2022

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A copy of the California Department of Social Services Lead Information Brochure was explained and provided to the licensee.

Fire inspection from LA County Fire Authority Fire inspection services have granted the fire clearance.

LPA discussed the following items with the Licensee Ms. Caudillo, Stacey during the Exit interview:

Criminal Record statement: Facility Representative Ms. Caudillo Stacey was reminded that all adults 18 and over living or working in the home, 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.

Safe Sleep : LPA discussed the safe sleep regulations with Facility Licensee Ms.Caudillo, Stacey & discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the Facility Representative Ms. Caudillo, Stacey 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. 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.

Review of records to be maintained : LPA reviewed with Facility Representative 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. LIC 311D was given to the Licensee at the time of the Exit interview. (4)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CAUDILLO, STACEY	FACILITY NUMBER: 304313887
	VISIT DATE: 10/19/2022

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LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

Subscribe to CCLD important information
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 license-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.

The facility was complying with Title 22 Regulations at the time of inspection

LPA discussed the ratio for the Large Family Child Care home with the Licensee: Large Family Child Care Home, and with an assistant provider, may provide care for more than 12 and up to 14 children when one child is enrolled in and attending kindergarten (including transitional kindergarten) or elementary school, and another child is at least six years old, and no more than three infants are in care.

On today’s inspection each child was observed to have a safe, healthful and comfortable accommodation furnishing and equipment’s.

A license with the change in capacity for 14 children (Large Family Child care home) will be issued after final review, in the event additional requirements are needed, Licensee will be notified.

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

A copy of this report and Appeal rights were presented to the Licensee.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022

LIC809 (FAS) - (06/04)

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