191601066-8-29-2019-30-CC-DMIA-BFHMBS-20190829092827

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191601066
Report Date: 08/29/2019
Date Signed: 08/29/2019 09:28:47 AM

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:	DUENAS & MAURTUA DE DUENAS FCC		FACILITY NUMBER:	191601066
ADMINISTRATOR:	DUENAS, & MAURTUA DE DUENA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 839-1866
CITY:	CULVER CITY	STATE: CA	ZIP CODE:	90230
CAPACITY:	12	CENSUS: 5	DATE:	08/29/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	07:10 AM
MET WITH:	Francisco Duenas and Rosa Maurta de Deunas		TIME COMPLETED:	09:30 AM

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	On 8/29/2019, at 7:10 am Denise Miranda and Lisa Rios, Licensing Program Analyst (LPA’s) conducted an unannounced annual/random visit inspection to ensure the health & safety standards as required by regulations governing family child care homes are being met. Upon arrival, LPA's met with licensee Francisco Duenas and co-licensee Rosa Maurta Duenas. LPA's observed licensee and co-licensee caring for 1 child (infant). The licensee’s home is a 1 story 3 bedroom, 2 bathrooms, 1 living room, 1 dining room, 1 kitchen, and no garage. There is no pool, spa or other bodies of water on the premises and guest house: one room and 1 bathroom. Family members residing in the home include 3 adults (licensee, co-licensee and licensee’s son (associated to the facility) and no children. Main care is provided in the back of the house as playroom (licensee provided copy of the permit) and 2 bedrooms as napping area located at inside of the home and dining room. Off limit areas include inside of the house 1 master bedroom, 1 master bathroom,1 living room, 1 kitchen. LPA observed tables, chairs and napping equipment. Parents and children will use the left gate to the house. The off-limits area includes: master bedroom and master bathroom and living room At 8:15am LPA’s observed the licensee’s assistant arrived. At 8:20am LPA’s observed a complete first aid, full charged Fire extinguisher size 3-A:40-B:C Fire Extinguisher in the guest house, working smoke and carbon monoxide detector, age appropriate toys. Telephone service, air conditioner, lighting and ventilation were evaluated and in good condition. LPA reviewed the licensee’s Pediatric First Aid AEDInfant/CPR 6/2020 . LPA reviewed the fire drill log. Licensee conducted on 7/19/2019. LPA observed that licensee conduct fire drill once a month.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Denise Miranda	TELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2019

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: DUENAS & MAURTUA DE DUENAS FCC	FACILITY NUMBER: 191601066
	VISIT DATE: 08/29/2019

NARRATIVE

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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.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are required to be posted.

Licensee informed fire drill to be completed every 6 month and to keep a log and to ensure records for staff and children as well as a roster are kept for 3 years.

Licensee was also reminded that only children eating may be in high chairs and that car seats are utilized only for transportation.

LPA reminded the co-licensee every two year to take the Mandated Reporter training: www.mandatedreporterca.com. LPA’s observed the certification of completion of Mandated Reporter General Training: Licensee completed on 2/24/2018 and co-Licensee on 3/11/2019.

Licensee 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 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

During this inspection, LPA's also provided the following documents about: 1) A Safe Infant Environment Sleeping, 2) Never ever shake a Baby English and Spanish (California Department of Social Services), 3) California School Immunization Record form CDPH286, 4) LIC311D Forms/Records to Keep in your Family Child Care Home 5) Prohibited items in Family Child Care Homes H&S 1596.846(b) &) Health 6) Pillow and babies don ‘t mix, 7) Keep me safe 8) Health beverages in child care (California Childcare Health Program), 9 California Law will keep your child safe in the car (California Department Public Health)
During this visit Licensees provided a copy of the permit of the guest house located at the back of the house and the updated sketch (floor plan and yard).
The facility was found to be in substantial compliance per Title 22 Regulations. A copy of report, a Notice of Site Visit and were issued and explained to the Licensee and co-licensee.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Denise Miranda	TELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2019

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: DUENAS & MAURTUA DE DUENAS FCC	FACILITY NUMBER: 191601066
	VISIT DATE: 08/29/2019

NARRATIVE

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Licensee was informed, Absence of Supervision: including, but not limited to, a child left unattended, a child left alone with a person under 18 years of age, and lack of supervision resulting in a child wandering away. (HSC 1597.58(c)(2)). Regulation(s): 102417(k)(1) Children shall not be left in parked vehicles. Civil penalty applies when a child is left unattended in a parked vehicle.
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 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.
New Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment. All appeals must be sent to:
300 N. Continental Blvd., Suite 290-A
El Segundo, CA 90245
Also, LPA discussed with the licensee the following:
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. 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. The fire extinguisher type 2-A:10-B:C must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should check, 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. Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. (use LIC624B for written report). Fire and safety drills must be performed every six months and documented for review by the Department. Children and Staff records must be maintained and updated as needed and must be available for review by the Department. No smoking, 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.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Denise Miranda	TELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2019

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: DUENAS & MAURTUA DE DUENAS FCC	FACILITY NUMBER: 191601066
	VISIT DATE: 08/29/2019

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At 8: 28am LPA’s observed three more infants and one child arrived at the facility.
At 8:29am LPA reviewed children’s file. Children’s file was completed.
The licensee states that does not have weapons/firearms in the home and none observed by the LPA's.
LPA's observed age appropriate toys. Per licensee no pets. LPA's observed no pets.
Licensee states at this time is not providing IMS - Incidental Medical Services (IMS): LPA disclosed the following information. – 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

Incidental Medical Services Include: Blood-Glucose Monitoring for Diabetic Children, Administering Inhaled Medication, Administering EpiPen Jr. and EpiPen or other Epinephrine Auto-Injectors, Glucagon Administration, Gastrostomy Tube Care (G-tube care), Insulin Injections Administration, Anti-Seizure Administration, and Emptying an Ileostomy Bag.

The following was discussed with the licensee:
Licensee was reminded that all infants must be placed on their backs when sleeping 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. LPA provide brochures will information regarding SIDS and never shake a baby to prevent the shaken baby syndrome.
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 and a valid criminal record clearance associated to the facility license and immunization.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Denise Miranda	TELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2019

LIC809 (FAS) - (06/04)

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