198400458-10-8-2021-54-CC-ECHZ-C7LQUT-20211008122914

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400458
Report Date: 10/08/2021
Date Signed: 10/08/2021 12:29:29 PM

Document Has Been Signed on 10/08/2021 12:29 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:	CHAIDES FAMILY CHILD CARE		FACILITY NUMBER:	198400458
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	10/08/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Vanessa Chaides		TIME COMPLETED:	12:40 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	At 9:40 AM on 10/08/2021, Licensing Program Analyst (LPA) Elka Chavez conducted a pre-licensing inspection. LPA met with applicant, Vanessa Chaides, who guided analyst on a tour of the facility. Adults residing in the home were discussed and noted. The applicant is requesting a small family child care home license. Per applicant, operating hours will be Monday through Friday from 5:30am to 6:30pm. Applicant states that she will care for children from birth to 10 years of age. All areas identified on the facility sketch were inspected. This is a single-story home which consists of two bedrooms, one bathroom, kitchen, dining room, living room, front yard (fenced), back yard (fenced) and detached garage. The home was inspected for safety, comfort, cleanliness, telephone service (landline), heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. LPA observed a wall heater with a barrier. LPA did not observe the barrier to be anchored to the wall. LPA observed medicines are kept in the off-limit laundry room making them inaccessible to children in care. LPA observed outdoor play area (backyard) to be safe. Backyard is adequately fenced. LPA did not observe any bodies of water. Per Applicant there are no pets in the premises. The applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary. Rooms that are off-limits need to be made inaccessible during operating hours Areas off limits include: Two bedrooms, detached garage (fenced) and laundry room. Areas used by children include: Living room, dining room, bathroom, front yard (fenced) and backyard (fenced). The Applicant states that supervision will be provided outdoors during play time. The applicant states that she will provide food for children in care. If food is not provided and food is brought from the children’s homes; containers shall be labeled with child’s name and properly stored or refrigerated.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2021

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 4

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: CHAIDES FAMILY CHILD CARE	FACILITY NUMBER: 198400458
	VISIT DATE: 10/08/2021

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

There are age appropriate toys and napping equipment on the premises. LPA observed knives are kept on top of the fridge in a knife storage case with a padlock. The required fire extinguisher (3A40BC) was purchased on 5/19/21. LPA observed the extinguisher in the kitchen. Smoke detectors and carbon monoxide detectors located in the living are in operable condition. Per Applicant there are no weapons, firearms in the facility. First Aid and emergency kits are available in the kitchen. The Applicant has current Pediatric First Aid and CPR. Applicant has proof of immunization against influenza, pertussis, and measles. Applicant has taken the Mandated Reporter Training.

COVID-19 Technical Assistance was provided during today’s inspection. LPA observed Covid-19 postings located in the facility and bathroom used by the children in care. LPA Chavez discussed protocols in place regarding COVID-19. Licensee stated protocol in place is not having parents fully enter the facility and sign-in/out will take place at the front entrance. Applicant understands that if a parent must enter the day care she will ask them to wash their hands, enter and exit the room one person at a time to allow for social and physical distancing and consider asking them to wear facial coverings. Take children’s temperature each morning with a no-touch thermometer. Applicant will evaluate children for any symptoms such as fever, running nose, cough or child's behavior and will inform authorized representative child cannot stay if any symptoms related to COVID-19; or if symptoms appear during the day, Applicant will isolate the child and call authorized representative for immediate pick-up. Children will wash their hands during arrival, entering from outdoor play, meal times and from using the restroom. Infants and children under 2 years of age should not wear a mask. Children ages 2 to 8 can safely wear a mask with adult supervision. For napping Applicant will place cots, cribs, and mats 6 feet apart, with heads in opposite directions.

The following was discussed with the applicant:

Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.

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, TB clearance, immunizations, and a valid criminal record clearance associated to the facility license.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2021

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: CHAIDES FAMILY CHILD CARE	FACILITY NUMBER: 198400458
	VISIT DATE: 10/08/2021

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

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.

The fire extinguisher type 2A10BC must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.

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. Mandated reporter requirements was reviewed and explained.

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, 24/7.

Children and Staff records must be maintained and updated as needed and must be available for review by the Department.

No baby bouncers, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility.

All adults living and working in the home shall be made of aware of the Departments right to inspection authority.
During this visit, the LPA reviewed Forms/Records to Keep in Your Family Child Care Home (LIC 311D) with the applicant. LPA advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.cdss.ca.gov

Safe Sleep: 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 a

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2021

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: CHAIDES FAMILY CHILD CARE	FACILITY NUMBER: 198400458
	VISIT DATE: 10/08/2021

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

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.
Forms to be posted: LIC6101A, Emergency Disaster Plan, PUB394 Notification of Parents Rights Poster, Facility License.
Facility Records: LIC 624B Unusual Incident/Injury Report, LIC 9040 Child Care Facility Roster, LIC 9052 Employee Rights, LIC 9108 Statement Acknowledging Requirement to Report Child Abuse.
Staff Forms/Records - any assistant present must have the following on file: Proof of TB clearance (within one year), Notice of Employee Rights (LIC 9052), Criminal Record Statement (LIC 508), Statement Acknowledging Requirements to Report Suspected Child Abuse (LIC 9180).
Children’s records requirements: LIC 700 Identification and Emergency Information, LIC 627 Consent For Emergency Medical Treatment, LIC 282 Affidavit Regarding Liability Insurance, LIC 9150 Parent Notification Additional Children In Care, Immunization record, PUB 72- Family Child Care Consumer Guide, LIC 995A Notification of Parent’s Rights.
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

Based on the LPA’s observation, the following corrections need to be corrected prior to obtaining a small family child care license. Corrections are due by 10/11/2021.

· The wall heater needs to be anchored to the wall

After further review by the department, applicant will be notified if/when License is granted.
Once licensed, the applicant is required to comply with the terms and limitations stated on the license.

Exit interview conducted and report was reviewed with the applicant, Vanessa Chaides.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2021

LIC809 (FAS) - (06/04)

Page: 4 of 4