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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364846736
Report Date: 08/14/2025
Date Signed: 08/14/2025 12:01:29 PM

Document Has Been Signed on 08/14/2025 12:01 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:AMADO FAMILY CHILD CAREFACILITY NUMBER:
364846736
ADMINISTRATOR/
DIRECTOR:		AMADO, GILELA ELIZABETHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 286-9370
CITY:FONTANASTATE: CAZIP CODE:
92337
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/14/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:41 AM
MET WITH:Gisela AmadoTIME VISIT/
INSPECTION COMPLETED:
12:10 PM
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On date and time listed, Licensing Program Analysts (LPAs) Eric Ramos and Giselle Carbullido arrived at the facility to conduct a pre-licensing inspection. Present in the home during this inspection were Gisela Amado, Juan Olivas (Husband) and Rosalinda Garcia Gonzalez (Grandmother). LPAs toured the facility, inside and out and the following was observed and/or discussed:

Normal days and hours of operation are: Monday - Sunday; 06:00 AM to 10:00 PM
OFF-LIMIT AREAS INCLUDE: Garage, 2nd floor

· Appropriate fire extinguisher, smoke detector and carbon monoxide detector are present and were tested by the applicant during this inspection. Fire extinguisher, smoke detector and carbon monoxide detector are in working order.
· All hazardous items are NOT inaccessible. LPAs observed hazardous items in the two bathrooms, loft area, living room and patio area.
· Storage of poisons/toxins are NOT inaccessible to children and locked. LPAs observed poisons/toxins items in the two bathrooms, loft area, living room and patio area.
· Weapons are not present. Applicant understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 Regulations.
· This is a two story home. Stairs are not barricaded. Applicant stated she is getting custom doors made to block stair access.
NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Eric Ramos
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/14/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: AMADO FAMILY CHILD CARE
FACILITY NUMBER: 364846736
VISIT DATE: 08/14/2025
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· Fireplace is properly screened to prevent access by children.
· The applicant provided proof of control of property and is on file.
· Facility Sketch and Emergency Disaster Plan are not posted.
· Mandated Reporter Training expires on 09/04/2026.
· Pediatric CPR and First Aid Card expires on 08/05/2026.
· Health & Safety Certificate - completed on 08/11/2024.
· There is a pool in the backyard with a self-latching and self-closing door, which swings away from the pool. Fence is at least five feet in height but vertical clearance of two inches was not met per Title 22 regulations. The vertical clearance of the pool gate from the ground to the bottom of where the enclosure starts measures 2.5 inches. Applicant attempted to test the pool alarm, however, pool alarm was not operable during LPAs visit. Life ring and rescue pole were present and meet regulations. Applicant understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 Regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.
· There is a trampoline on the premises and the applicant states that it will be used by children in care. The trampoline and its surrounding cover appear to be in good repair with no tears or exposed springs. The manufacturer of the trampoline is Skywalker Trampoline and the applicant has the manufacturer's instructions and guidelines. The applicant agrees to only use the trampoline in accordance with the manufacturer's guidelines and will provide adequate supervision to all children in care.
· Clean, safe and age-appropriate toys.
· There are no toxic plants observed at this time.
· Resident and/or staff records reviewed on 08/14/2025 indicate that all adults who require caregiver background checks have received all required clearances or exemptions.

· The Applicant was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov.

· The Applicant can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov. Applicant was provided information regarding Guardian.
NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Eric Ramos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2025
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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: AMADO FAMILY CHILD CARE
FACILITY NUMBER: 364846736
VISIT DATE: 08/14/2025
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The following was discussed with the applicant(s):

- Pre-Licensing Visit Packet provided.
- Failure to meet the posting requirements shall result in an immediate $100 civil penalty.
- Documentation of fire & earthquake drills to be conducted at least every six months.
- Responsibilities of being a mandated reporter.
- Responsibility to know the regulations for anyone providing care.
- Inaccessibility of hazards must be constantly reassessed depending on the children in care.
- Current facility’s phone numbers must always be on file with the licensing office.
- Pool Safety requirements per Title 22 Regulations.
- Baby walkers, baby-bouncers, and walker-jumpers are prohibited (H&S 1500.86(a)(4)).
- Types of Visits/Citations.
- Maintain play structure in backyard clean and safe.
- Difference between "Keep out of Reach of Children" and "Call Poison Control Center/Physician/Doctor" labels.
- Licensee must be present at the licensed facility for eighty percent of operating hours per day.

LPAs reviewed with applicant 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.

LPAs discussed the safe sleep regulations with Applicant and discussed the Child Care Licensing Safe Sleep web page at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPAs 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.
NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Eric Ramos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2025
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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: AMADO FAMILY CHILD CARE
FACILITY NUMBER: 364846736
VISIT DATE: 08/14/2025
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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) or (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.

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 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.

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.

Applicant 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.

The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at:
1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200.
NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Eric Ramos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2025
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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: AMADO FAMILY CHILD CARE
FACILITY NUMBER: 364846736
VISIT DATE: 08/14/2025
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Before licensure, the following needs to be corrected/completed:

- Update Facility Sketches and include 2nd floor layout. In the facility sketches please include: Off limit areas of the home, exits, windows, label rooms/bathrooms and sizes of all rooms. (Follow instructions on the LIC999A form).
- Door knobs to be placed on bathroom doors, supply closets and bedroom doors with key locks to prevent access to hazardous items/poisons/toxins and off limit areas.
- Remove paint bottles with "keep out of reach" and "call poison control" labels to an inaccessible area in the home.
- Stairs need to be barricaded.
- Maintain playground in the backyard clean and safe - remove spider webs, wasp nests, tools, debris.
- Pool alarm needs to operable.
- Remove all accessible hazardous items to an inaccessible/off limit area in the home.
- Remove all accessible medication, poisons/toxins to a key locked area in the home.
- Fire clearance approval must be received before licensure as a Large Family Child Care.
- Provide proof of one year of experience as an administrator or director of or as a teacher at, a licensed child care center. If proof does not qualify applicant for a Large Family Child Care, the applicant understands that she will be licensed as a Small Family Child Care.
- All sharp objects, chemicals/cleaners, batteries, alcohol, and knives need to be made inaccessible in the kitchen area.
- Vertical clearance of two inches for pool door must be met. The vertical clearance of the pool gate from the ground to the bottom of the enclosure measures 2.5 inches.

Once all corrections have been verified, the application for a Small or Large Family Child Care Home will be submitted for approval with a maximum capacity of 6, or 8 / 12, or 14 with parent notification/assistant present. Applicant advised that all corrections are due within 30 days, or the application may be withdrawn.
NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Eric Ramos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2025
LIC809 (FAS) - (06/04)
Page: 6 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: AMADO FAMILY CHILD CARE
FACILITY NUMBER: 364846736
VISIT DATE: 08/14/2025
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On this date, 08/14/2025, 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.

Exit interview conducted and report was reviewed with applicant Gisela Amado.
NAME OF LICENSING PROGRAM MANAGER: Ana Noble
NAME OF LICENSING PROGRAM ANALYST: Eric Ramos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2025
LIC809 (FAS) - (06/04)
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