191609404-8-16-2021-54-CC-SSAZ-C5XPHP-20210816112016

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191609404
Report Date: 08/16/2021
Date Signed: 08/16/2021 11:20:23 AM

COMPREHENSIVE INSPECTION

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:	RUIZ-CHAVARIN FAMILY CHILD CARE		FACILITY NUMBER:	191609404
ADMINISTRATOR:	CONCEPCION RUIZ CH.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(424) 406-2106
CITY:	CARSON	STATE: CA	ZIP CODE:	90746
CAPACITY:	12	CENSUS: 2	DATE:	08/16/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:42 AM
MET WITH:	Concepcion Ruiz-Chavarin, Licensee		TIME COMPLETED:	11:40 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	THIS INSPECTION WAS CONDUCTED IN SPANISH Licensing Program Analyst (LPA) Susann Sanchez conducted an unannounced Required inspection to the above facility. Licensing staff met with Concepcion Ruiz-Chavarin, Licensee who guided analyst on a tour of the facility. Also present during this inspection was a parent touring the facility and filing out paperwork to enrol child. Tour began at 9:35am. During this inspection there were 2 children present. A children’s roster is available and is current and shows that 7 children are enrolled. Per Licensee, hours of operation are 6am to 5pm, Monday to Friday. This is a one-story home which consists of 3 bedrooms, 2 bathroom, kitchen, dining area, living room, daycare rooom, garage, side yard, front yard and backyard (fenced). The children use the bathroom in the hallway, living room, day care room, kitchen, dining room, and backyard. Per licensee, areas off limits to children and parents include: all the bedrooms, one room, garage, side yard, and front yard. The licensee provides food for children in care. The licensee states that 2 adult currently live in the home. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. Per licensee, there are no weapons, firearms or bodies of water on the premises. All areas identified on the facility sketch that children use, were inspected for safety, comfort, telephone service (cell phone & land line) , ventilation and heating (central). The following was observed and reviewed during this inspection. PHYSICAL PLANT Detergents, cleaning compounds, medications, and other items which could pose a danger are inaccessible to children. Licensee's state that all poisons and clean compounds are kept in a locked under the sink. PAGE - 01 of 03

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Susann Sanchez	TELEPHONE: (323) 981-3366
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2021

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: RUIZ-CHAVARIN FAMILY CHILD CARE	FACILITY NUMBER: 191609404
	VISIT DATE: 08/16/2021

NARRATIVE

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The valve on the required 2A 10BC fire extinguisher indicates fully charged as indicated on receipt . Per State Fire Marshall standards, fire extinguishers shall be serviced annually. Smoke and Carbon detector was tested and is operable. All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill documented was conducted on 08/16/21.

There is heating and ventilation for safety and comfort. There are toys available for children. The licensee states that there is a land line and a cell phone that is used and stays at the facility during operating hours.

The outdoor play area was observed to be fenced. At this time, children are using the back yard for outdoor play time. The licensee states that supervision is provided at all times.

The licensee states that she has completed training on preventive health practices including Pediatric First Aid and CPR, however Licensee was unable to provide proof of a current CPR and First Aid card.

The following items were also discussed with licensee during this inspection.
PETS: There are no pets on the premises.
POSTING REQUIREMENTS: Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are observed to be posted in the entrance of the home.
PROHIBITED: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that falls into these categories are not permitted in a family child care facility. No sleeping children in CARSEATS. SMOKING IS PROHIBITED IN A LICENSED FAMILY CHILD CARE HOME.

LPA discussed Department of Public Health, Early Care and Education Guidance COVID-19 recommendations. PIN 20-24 was given and explained.

Infant Care: Licensee states that she is currently not caring for infants. LPA advised the licensee to sleep infants where they can be directly supervised at all times and advised the licensee against sleeping infants in a separate room. The licensee stated the following as a supervision plan for infants in the future will be: Licensee states that infants sleep in the living room. LPA will sleep infants where they can be directly supervised at all times and advised the licensee against sleeping. LPA provided the licensee with a copy of the Child Care Pro. LPA consulted and explained Child Abuse Reporting, Updated Patent’s Rights Poster with Complaint Hotline information, Never Shake a Baby, Sudden Infant Death Syndrome (SIDS), and Safe Sleeping practices. Provider’s Guide to Safe Sleep, by American Academy of Pediatrics and Helping you to reduce the risk of SIDS.

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SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Susann Sanchez	TELEPHONE: (323) 981-3366
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2021

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: RUIZ-CHAVARIN FAMILY CHILD CARE	FACILITY NUMBER: 191609404
	VISIT DATE: 08/16/2021

NARRATIVE

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Incidental Medical Services (IMS):
The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS at this time. 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.

LPA advised the licensee how to access forms, regulations and quarterly updates on line at: www.ccld.ca.govAB1207 Mandated Child Abuse Reporter training must be renewed every two years.

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). Licensees shall reveal each facility license number in all advertisements, publications, or announcements made with the intent to attract clients.

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with licensee. Appeal Rights were given and explained.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Susann Sanchez	TELEPHONE: (323) 981-3366
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2021

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: RUIZ-CHAVARIN FAMILY CHILD CARE	FACILITY NUMBER: 191609404
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/16/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/16/2021 Section Cited	1 2 3 4 5 6 7	The Licensee personnel as specified shall complete training on preventive health practices including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. The requirement is not met as evidenced by Licensee does not have CPR/1st Aid training. This is a potential risk to the health and safety of children in care.
Type B 08/16/2021 Section Cited	1 2 3 4 5 6 7	The licensee shall maintain, in each child's record, a copy of the emergency information card required in Section 102417(g)(7). The requirement is not met as evidenced during file review, children file review, emergency information was filled out in the roster and was missing information. This is a potential risk to the health and safety of children in care.
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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: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Susann Sanchez	TELEPHONE: (323) 981-3366
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2021

LIC809 (FAS) - (06/04)

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