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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191226552
Report Date: 02/04/2020
Date Signed: 02/04/2020 12:52:17 PM

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:GARCIA, MARY LOUISE FAMILY DAY CAREFACILITY NUMBER:
191226552
ADMINISTRATOR:MARY LOUISE GARCIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 846-3168
CITY:BURBANKSTATE: CAZIP CODE:
91506
CAPACITY:12CENSUS: 4DATE:
02/04/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Mary Louise Garcia TIME COMPLETED:
01:30 PM
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On 02/04/2020 at approximately 10:50 AM, Licensing Program Analyst, Stella Gutierrez met with Licensee, Mary Louise Garcia and explained the purpose of todays visit of an annual random inspection to ensure that facility is in compliance with Title 22 regulations and Health and Health Safety code standards. Upon arrival, LPA observed 3 children ( 2 INFANTS and 2 TODDLERS) being supervised by licensee and assistant, Sonia Flores. Facility is license for a capacity of 12 children. Facility is operating within ratio and capacity limitations. All adults observed during today’s visit have obtained a criminal record clearance and associated to the facility. Licensee guided LPA on a tour of the facility inside and out. Hours of operation are from 7:30 AM to 6:00 PM, Monday through Friday.

Areas identified in the sketch and observed by LPA, Gutierrez during today’s visit:
Interior:
This is a single-story dwelling, 3- bedroom, 2-bathroom home with kitchen/dining, living room, and an detached garage. Garage has a passage through to get to back house which is a large room used for the main care area for the children. There is a pool on the premises. There is a pool with a spa behind a 6 foot wrought iron fence. A double gate on the east side opens outward and is currently locked. Another gate just outside the day care room (facing wet) also swings outward and is also locked. Bottom of the fence is no more than 2 inches from the cement. There no more than 3 inches between the vertical bars. The screen door (a double door) leading out to front of the fence of the pool is latched and is out of reach of children (4 ft. 10"). There are no weapons kept on the premises. Family members residing in the home include Licensee, spouse and two children over the age of 18. The facility was inspected inside and outside for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning when compounds, and hazardous items that can pose a danger to children.

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SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020
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: GARCIA, MARY LOUISE FAMILY DAY CARE
FACILITY NUMBER: 191226552
VISIT DATE: 02/04/2020
NARRATIVE
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On limits areas include: Dining are which is considered a nap area, Bathroom #1 is located next down hall last door on left and main care area back house one room. LPA observed age appropriate toys, learning materials, games and activities for children in care. All furniture was found in good repair, clean, and without hazards. Dining room area is used for napping area, age appropriate napping equipment (MATS) and cribs materials available and inspected for the children. Bathroom #1 is for the children to utilize for potty training purposes. LPA observed the bathroom to be in operable condition and free from hazards.


LPA observed a working wired smoke detector / operable carbon monoxide detector dual located in main care area and 2A10-BC fire extinguisher in garage (serviced last June 2019) and a fully equipped first aid kit including a digital thermometer located in garage area upon entering main care area.

Off-limits areas include the following: Kitchen, living room, Bedrooms # 1 and 2 , bathroom #2, Cleaners/chemicals observed under kitchen sink without latch and sharp objects in drawer with latches. There were no items in home that can pose an immediate or potential danger to the children in care.

Exterior:

On limits areas include: Back patio- LPA observed play cars, slides and other play equipment that pose no danger to the children.

Off limits areas include: The detached garage is used a passage only, front yard and side yard where pool is located. LPA, observed that children do not have access to these areas and licensee was reminded to keep the pool gate at all times and to never permit access to any children in care at the facility.

Administration:

FORMS TO BE POSTED AND OBSERVED BY LPA during today’s visit in hall area


· LIC203 Facility License
· LIC 610A Emergency Disaster Plan
· LIC 9148 Earthquake Preparedness Checklist
· PUB394 Notification of Parents Rights Poster

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SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020
LIC809 (FAS) - (06/04)
Page: 2 of 7
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: GARCIA, MARY LOUISE FAMILY DAY CARE
FACILITY NUMBER: 191226552
VISIT DATE: 02/04/2020
NARRATIVE
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Children’s roster observed and up to date during today’s visit. .

Licensee file and 4 children’s files were reviewed today.

-Pediatric First Aid and Adult, Child and Infant CPR to be current (expires on 01/2021) for all staff

-Preventative Health and Safety was observed and completed 11/1999

-No immunization records for Licensee or assistant was observed today.

Mandated reporter Training certification was not observed for licensee or assistant today.

LPA discussed capacity limitations, new car seat law, personal rights, Notification of Parent's Rights revised 12/06, inspection authority & agency's consultative role. Smoking is prohibited on the premises when children are present. The LPA also discussed earthquake safety and necessity of drills every 6 months. The applicant was also informed that all adults living in or having access to day care children in the home are required to have fingerprint clearances with Department of Justice, FBI and Child Abuse Index prior to having contact with children. If the aforementioned is not adhered to, a Civil Penalty of $100 /day per uncleared adult will be assessed.

The facility is not currently providing IMS. Incidental Medical Services (IMS) policy was discussed with the Licensee. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. LPA obtained a copy of the facility's IMS Plan. 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.html

The licensee was informed 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 child care 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: childcareadvocatesprogram@dss.ca.gov

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SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020
LIC809 (FAS) - (06/04)
Page: 3 of 7
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: GARCIA, MARY LOUISE FAMILY DAY CARE
FACILITY NUMBER: 191226552
VISIT DATE: 02/04/2020
NARRATIVE
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Safe Sleep Links:
AAP: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx
NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative

Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials

SIDS & SHAKEN BABY SYNDROME INFORMATION (discussed) flyer provided.


Licensee was reminded that all infants must be placed on their backs when sleeping. LPA provided safe sleep flyer and discussed safe sleep practice. Infants must be placed on their backs and must be physically checked every 15 minutes to gauge temperature and ensure they are breathing to prevent S.I.D.S. (Sudden Infant Death Syndrome), and that the Provider is required to wash hands after every diaper change and to never shake a baby to prevent the Shaken Baby Syndrome. Licensee, MARY LOUISE GARCIA stated that she understands safe sleep practice and prevention of Shaken Baby Syndrome for infants and to ensure supervision at all times infants are in care at GARCIA MARY LOUISE CHILD CARE facility.

The following were also discussed with licensee:



Senate Bill 792: This bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles.

New Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment. A copy provider rights and Appeal process provided to Licensee. All appeals must be sent to:

California Department of Social Services | Community Care Licensing Division
300 Continental Blvd., Suite 290-A
El Segundo, CA 90245
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SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020
LIC809 (FAS) - (06/04)
Page: 4 of 7
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: GARCIA, MARY LOUISE FAMILY DAY CARE
FACILITY NUMBER: 191226552
VISIT DATE: 02/04/2020
NARRATIVE
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New Immunization Requirement: Law enacted by SB 277, beginning January 1, 2016, personal beliefs exemptions will no longer be an option for the vaccines that are currently required for entry into child care or school in California. Personal beliefs exemptions already on file will remain valid until the child reaches the next immunization checkpoint.

Assembly Bill 1207: California Child Care Workers; Mandated Training Requirement. Beginning January 1, 2018, all licensed providers, applicants, directors and employees must complete Mandated Reported Training prior to March 30, 2018 and renew training every two years at: www.mandatedreporterca.com. Volunteers are encouraged but not required to take the training. Providers are to complete the 4 hour General Training and 3 hour Child Care Provider Training. Licensee stated that she has not completed the Mandated Reporter Training.

Nutrition Requirement: Beginning January 1, 2016, AB 290 will require for each new license issued, at least one director or teacher at each child care center or family child care home to have at least one hour of training in the importance of childhood nutrition. This applies to anyone submitting a new application, relocating their facility, selling their facility or transferring their license. Please note this training cannot be completed online or by home study programs. The training must be taken from an Emergency Medical Services Authority (EMSA) approved training program OR an accredited college or university.

Assembly Bill 633: Upon receipt by the licensee, licensees are to provide to parents/guardians the following: Copies of any licensing reports that document a Type A citation- this includes facility visits and substantiated complaint investigations; copy of licensing documents pertaining to a conference conducted by a local licensing agency management representative and the licensee of this family child care home in which issues of noncompliance are discussed or copies of a summary of an accusation indicating the Department's intent to revoke the facility's license. Copies of any of the above licensing documents the licensee has received in the prior 12 months shall be provided to parents/guardians of newly enrolled child at the facility.



Internet address for reports, regulations: DSSNET address: http://ccl.dss.cahwnet.gov/ and for children’s and employees forms: http://www.dss.cahwnet.gov/getinfo/pubintro.html#1
SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020
LIC809 (FAS) - (06/04)
Page: 5 of 7
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: GARCIA, MARY LOUISE FAMILY DAY CARE
FACILITY NUMBER: 191226552
VISIT DATE: 02/04/2020
NARRATIVE
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Licensee currently does not receive quarterly updates and will be registered by LPA. An updated email was received during today’s visit.

The Facility was found to be not to be in substantial compliance per Title 22 regulations and Health and Safety Codes standards during today’s visit. There will be TYPE B deficiencies cited today.

An exit interview was conducted and a copy of this report, appeal rights along with the notice of site visit were provided to Licensee, Mary Louise Garcia .

The licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent when a serious deficiency, Type A, is cited (LIC9224).

















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SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: GARCIA, MARY LOUISE FAMILY DAY CARE
FACILITY NUMBER: 191226552
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/04/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/18/2020
Section Cited

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1597.622 (a)(1) Employees or volunteers at family day care home; immunization requirements; records; exemptions. (a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee
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and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.


Based on today's administrative records review this requirement was not met.
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Type B
02/18/2020
Section Cited

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1596.8662
Availability of information regarding detecting and reporting child abuse and neglect; training for mandated reporter who is licensed day care provider, administrator, or employee of a licensed child day care facility; proof of completion.
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Based on today's administrative records review this requirement was not met.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:
DATE: 02/04/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/04/2020
LIC809 (FAS) - (06/04)
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