Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198013959
Report Date: 06/16/2015 12:00:00 AM
Date Signed 06/16/2015 11:01:54 AM

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:MACIEL FAMILY CHILD CAREFACILITY NUMBER:
198013959
ADMINISTRATOR:MACIEL, CLAUDIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 906-1235
CITY:WHITTIERSTATE: CAZIP CODE:
90604
CAPACITY:14CENSUS: 3DATE:
06/16/2015
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Claudia MacielTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Maria Romo conducted an unannounced random visit in Spanish. LPA met with licensee, Claudia Maciel who guided analyst on a tour of the facility. Family members living in the facility are 3 adults (licensee, Claudia, her spouse, George, son, Kimball) and one 16 year old child.

This is a one story home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, living room, garage and backyard (fenced). The children use the bathroom in the hallway, living room, dining room and kitchen area, as noted in the facility sketch initially submitted. Per licensee, areas off limits to children and parents include: 3 bedrooms, licensee's bathroom and detached garage. The LPA toured all areas used by children during this visit.

Upon receipt the Licensee shall post the Notice of Site Visit and the Licensing Report. This report and the Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

NO CITATIONS - At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

SUPERVISOR'S NAME: Joan HayesTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Maria RomoTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2015
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MACIEL FAMILY CHILD CARE
FACILITY NUMBER: 198013959
VISIT DATE: 06/16/2015
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Exit interview was conducted with Licensee. Appeal rights explained & provided.

See the following 809-C for observations during tour of facility.

MNMNONAIn accordance to FCCH Kit # 2 the following was observed:
xPer licensee, there are no weapons, firearms.
xPer licensee there are no bodies of water on the premises.
xStorage areas for poisons were inaccessible to children and locked.
xDetergents, cleaning compounds, medicines, and other items which could pose a danger to children were observed inaccessible to children.
xOpen space heater was screened to prevent access by children.
xFire extinguishers and smoke detectors meet State Fire Marshal standards.
xHome observed be kept clean and orderly, with heating and ventilation for safety and comfort.
xWhere children are less than five years old are in care, stairs shall be fenced or barricaded.
xHome observed to have working telephone service. Land line and cell phone.
xNo Children were observed left in parked vehicles.
xOutdoor play area is fenced or Licensee understands 100% supervision is required during outdoor play. ________ Licensee’s initials.
xCapacity and ratio was observed to be in compliance.
xCurrent roster was observed.
xCurrent Disaster drill was available and last drill was conducted 3/25/15.
xAll individuals present, working, or residing in the home have a criminal record clearance and are associated to the facility.
xLicensee complied with Inspection Authority.
xThe licensee has current Pediatric First Aid and CPR, which will expire 9/21/15.

**END OF REPORT**

SUPERVISOR'S NAME: Joan HayesTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Maria RomoTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2015
LIC809 (FAS) - (06/04)
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