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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495219
Report Date: 05/10/2023
Date Signed: 05/12/2023 03:33:34 PM

Document Has Been Signed on 05/12/2023 03:33 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CIACCI FAMILY CHILDCAREFACILITY NUMBER:
197495219
ADMINISTRATOR:CHIARA CIACCIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 733-9588
CITY:SANTA MONICASTATE: CAZIP CODE:
90403
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
05/10/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Chiara CiacciTIME COMPLETED:
03:00 PM
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On 05/10/2023 Licensing Program Analyst (LPA) Judy Laureano conducted an announced inspection with applicant Chiara Ciacci the purpose of a pre licensing inspection of 932 Princeton Street, Santa Monica, CA 90403. The purpose of this inspection is to ensure the standards for a Family Child Care Home are being met in accordance to California Tittle 22 Regulations and California Health and Safety Codes. Present during today’s inspection was licensee significant other.

Applicant is a applying for a Large Family Child Care License with a Max capacity of 12. Per the application, at this time, the ages the applicant wishes to provide services for are children 2 years old to 5 years old, Monday- Friday from 9:00 am to 5:00 p.m. Licensee was informed that any changes to ages, hours and days of operation shall be submitted to the department for approval prior to initiation of changes. Applicant is rent/lease the home and copy of rental agreement was submitted to the ESCRO. Landlord notification was submitted and file. Currently living in the home is applicant with significant other; J. Meloro. Applicant does have two dogs and updated vaccination records have been submitted to the department. Applicant confirmed dogs will not be with the day care children.

The home is a single-family two story home with 4 bedrooms, 3 ½ bathroom, a living room, dining room, kitchen area and laundry room. The home was observed with a detached garage with a back yard.

Applicant confirmed the following areas will be used for day care: 1st floor bedroom 1/ block room and bedroom 2/classroom, bathroom 1 outside bedroom 2/classroom space and bathroom 2.

Parents will access the home through the side gate. The outside fence as you enter the home has been designated as the Parent Board area. Care and supervision has been designated in bedroom 1/block room and bedroom 2/classroom. LPA observed age-appropriate toys and materials.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2023
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CIACCI FAMILY CHILDCARE
FACILITY NUMBER: 197495219
VISIT DATE: 05/10/2023
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LPA observed children’s size table and chairs and children’s cubbies. Smoke detector and carbon monoxide was tested by applicant and all electrical outlets were observed to be covered in both room. Applicant confirmed children will eat and nap in bedroom 2/classroom. Applicant confirmed the outside picnic area will be used for meals when weather permits.

Bathroom 1 located outside the classroom/bedroom 2 will be used for day care. The bathroom was inspected; sink, toilet, shower, and under the sink cabinet. LPA observed paper towels in the area and advised applicant to add the hand washing sign in the space.

LPA observed a ½ bathroom outside the bedroom 2/classroom that will be used for staff/adults. LPA observed a door knob cover making the area inaccessible to the children in care. Across the ½ bathroom, LPA observed a staircase that leads to the 2nd floor. Stair case was observed to have a safety gate at the bottom of the staircase making the area inaccessible to the children in care.

LPA observed the 2nd floor- all designated as OFF LIMITS to the children in care. One bedroom with a patio and bathroom were inspected. LPA reminded applicant that all areas designated as OFF LIMITS need doors closed during the hours of operations.

The hallway was inspected and observed water heater closet with a safety latch and a safety gate between the hallway and dining room. Next to the water heater closet, LPA observed a guest bedroom in the first floor that has been designated OFF LIMITS to the children in care. LPA observed a door knob cover on the door.

Outside bedroom 2/classroom you are led to a hallway that leads to bathroom 2. Applicant confirmed bathroom 2 will only be used if a child needs diapering. LPA observed the area; changing table, sink, toilet and tub. All cabinets were inspected.

Outside bathroom 2 you are led to bedroom 1/block room. LPA observed age appropriate toys and materials.

Outside the hallway, LPA observed the kitchen area, dining room area and living room area. All areas have been designated as OFF LIMITS to the children in care. LPA observed a safety gate outside the dining room area making the areas inaccessible to the

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CIACCI FAMILY CHILDCARE
FACILITY NUMBER: 197495219
VISIT DATE: 05/10/2023
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children in care. Applicant confirmed that children and families will not enter the home through the main entrance.

The kitchen was observed and inspected. The kitchen is located next to the dining room. The kitchen was observed to have a door that gives access to the side of the house and will not be used for day care purposes. Applicant confirmed families are responsible for providing meals and snacks in appropriate containers such as lunch bags with ice packs and/or thermos.

The outdoor area was observed and inspected. LPA observed a garage area that has been converted in extra activity space: Little House and Art studio. LPA observed age appropriate toys and materials. The art studio was observed to have a fire extinguisher and first aid kit. LPA advised applicant to add a smoke detector and carbon monoxide detector in the space.

Outside the extra activity space, LPA observed a cemented area with age appropriate toys. The area is dividing into two sections, the herb garden section and grassy area which includes a mud kitchen and large motor skills materials. LPA observed a metal door that leads to the alley. Door was observed with a safety latch and applicant confirmed that door will remain locked during hours of operations.

The following area are designated as OFF LIMITS:
1. Front Door- Families will use the side wooden gate
2. Dining room, living room, kitchen, laundry room area and guest bedroom located in the first floor.
3. 2nd Floor- Full bathroom and bedroom with a patio- Safety gate will remain on and locked during hours of operations.

The following requirements shall be submitted by May 17, 2023. The licensing determination of this application will be reviewed with Licensing Program Manager for final resolution.

The following corrections need to be completed prior to licensure:
1. Carbon monoxide and smoke detector added to the extra activity space/ garage area.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CIACCI FAMILY CHILDCARE
FACILITY NUMBER: 197495219
VISIT DATE: 05/10/2023
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The following was discussed with the applicant:
Applicant was made aware of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on childcare licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541
Email Address: [email protected]

Immunizations: Commencing September 1, 2016, SB 792, prohibits a person from being employed or volunteering at a childcare facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the inspection.

Mandated Reporter Training: Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com. Licensee was reminded of their responsibility to report suspected child abuse.

LPA discussed the LIC 311D- Forms/Records to Keep In Your Family Child Care Home and provided applicant with a sample packet.

Licensee was made reminded that it is the licensee’s, as well as anyone who assists in providing care responsibility to know the regulations. Licensee was also encouraged to read the Child Care quarterly updates every season as they come out to stay informed of any changes or updates to statutes and regulations. Applicant was advised that regulation prohibits the smoking of tobacco in a private residence licensed as a family childcare home during the hours of operation.

Applicant was made aware that state law prohibits baby walkers, bouncy seats, exer-saucers and any other items that fall into that category. Applicant was also reminded that only children who are eating may be in highchairs and that car seats are utilized only for transportation.
Applicant was also informed that the provider is required to wash hands after every diaper change and to never shake a baby to prevent the Shaken Baby Syndrome.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CIACCI FAMILY CHILDCARE
FACILITY NUMBER: 197495219
VISIT DATE: 05/10/2023
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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.

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

· Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides 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 Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed.


· 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 adult/infant CPR & Pediatric First Aid certification and a valid criminal record clearance associated to the facility license.
· A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CIACCI FAMILY CHILDCARE
FACILITY NUMBER: 197495219
VISIT DATE: 05/10/2023
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· Annual fees must be paid promptly and by the due date or a late fee shall be assessed, and/or the License shall be terminated. (If paying by check please make sure to write facility number on check to ensure that payment is applied to your facility number)

· 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 should be replaced.

· Changes should be reported the to the Department as soon as they occur such as construction and remodeling, telephone number changes and/or if you move from home.

· Reporting requirements: Applicant must report any unusual incident or injuries to the Child Care Regional office by telephone within 24 hours and in writing within 7 days. Applicant was provided with LIC 624 as a reference.

· Fire and safety drills must be performed every six months and documented for review by the Department.

· All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.

· LPA advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov

· 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.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023
LIC809 (FAS) - (06/04)
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