192001812-8-23-2022-54-CC-KCHE-CHKUKU-20220823153942

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 192001812
Report Date: 08/23/2022
Date Signed: 08/23/2022 03:40:19 PM

Document Has Been Signed on 08/23/2022 03:40 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:	BAUTISTA FAMILY CHILD CARE		FACILITY NUMBER:	192001812
ADMINISTRATOR:	BAUTISTA, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 604-4425
CITY:	LYNWOOD	STATE: CA	ZIP CODE:	90262
CAPACITY:	14	CENSUS:	DATE:	08/23/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:05 PM
MET WITH:	Maria Bautista, Licensee		TIME COMPLETED:	04:00 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	Licensing Program Analyst (LPA)Katrina Chicote conducted an Unannounced Required – 1 Year inspection to the above facility on 08/23/2022 at 12:10 PM. Upon arrival, LPA disclosed the purpose of the inspection and met with Licensee, Maria Bautista, who guided the LPA on a tour of the facility. Adults in the home were discussed and all have criminal record clearance. There was five day care children present during today’s inspection. Licensee states that there are currently nine children enrolled. The children's roster was reviewed and is current. Per Licensee, the facility’s hours of operation are 6:00 AM to 6:00 PM Monday thru Friday. Emergency Disaster Plan, License, and Parents’ Rights were posted at the time of inspection. Disaster drill log was also available during today’s inspection, last disaster drill conducted on 08/23/2022. This is a single-story home which consists of three bedrooms and two bathrooms, kitchen, living room, and playroom. There is a fireplace in the home that is barricaded by a gate and LPA observed to be locked. Areas used by the children include the Living Room (located upon entry of the home), Bathroom 1 (located through right doorway next to Living Room), Kitchen/Dining Room, and Playroom ( in the rear of the home, located through Bedroom 1). Per Licensee, areas off limits to children and parents include all three bedrooms and Bathroom 2 located inside a bedroom. LPA observed that there is a baby gate separating areas used by children and off-limits area and child safety door knobs on off limits rooms. Per Licensee, Bedroom 1 is only accessible as a walkway to access Playroom. LPA discussed making sure children are supervised as they walk through Bedroom 1 to access Playroom. All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. LPA observed ceiling fans all through out the home. There is a working telephone maintained in the home. LPA observed electrical cover outlets all through the home. At 12:10 PM, LPA observed Living Room to have couches, TV hanging, bins filled with large legos and baby dolls available for children free of loose and sharp parts available for children Report continues- Page 1 of 4

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

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 5

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: BAUTISTA FAMILY CHILD CARE	FACILITY NUMBER: 192001812
	VISIT DATE: 08/23/2022

NARRATIVE

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in care. LPA observed a pack-n-play in corner of Living Room used for infant sleep. At 12:13 PM, LPA observed Bathroom 1 to have operable toilet and sink, general sanitation observed, adequate handwashing and toileting supplies, under cabinet sink to have operable child safety lock, and to be free of hazards (medicine cabinet was obseved). At 12:15 PM, LPA observed Dining Room/Kitchen to have rectangualr dining table and chairs, two high chairs for infant eating, and art supplies on shelves. Per Licensee, they provide food for children in care and use Dining Room for eating. LPA observed child eating on Dining Room upon arrival. At 12:16 PM, LPA observed Playroom to be empty at time of inspection. Per Licensee, this room is currently not in use as it is being painted and floor fixed. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. LPA observed cleaning solutions to be stored in under Kitchen cabinet sink with operable child safety lock and knives to be stored up high on top of refrigerator. Licensee states any medicine is stored in off limits bedrooms. The Licensee states that there are no poisons in the home. The Licensee does understand that poison must be locked with a key or combination lock.

Per Licensee, the children will have access to backyard area. LPA observed backyard will be accessible through front door and using walkway to backyard. At 12:20 PM, LPA observed backyard has turf grass and adequate perimeter fencing through-out the yard. LPA observed portion of yard is off limits and made off limits by white picket fence. LPA observed plastic play house and large wooden play structure with slide and swings well maintained available for the children with turf grass below to cushion fall. LPA observed all trees, shrubs, and plants are maintained. LPA observed a large breed dog in backyard that Licensee keeps separate from children in an area of yard with wooden fence. LPA observed fencing to be close together with no spaces in between.

At 12:15 PM, LPA observed the valve on the required 2A 10BC fire extinguisher indicates fully charged with service tag dated 02/09/22. At 12:23 PM, LPA observed smoke and carbon monoxide detectors are in operable condition. LPA observed First Aid kit kept on shelf in Living Room and was inventoried for necessary supplies. The Licensee has current Pediatric First Aid and CPR which expires on 07/10/2023. Proof of immunization against influenza, pertussis, and measles was readily available during today’s inspection. The Licensee has also taken the Mandated Reporter Training on 05/20/2021. At 12:50 PM, LPA observed children's records which were complete.

Report Continues - Page 2 of 4

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: BAUTISTA FAMILY CHILD CARE	FACILITY NUMBER: 192001812
	VISIT DATE: 08/23/2022

NARRATIVE

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Per Licensee, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPA observation did not see any bodies of water around the premises or firearms or weapons at time of inspection.

The following were discussed:
Incidental Medical Services (IMS) 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

Licensee (or facility representative) was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Rooms that are off-limits need to be made inaccessible during operating hours. NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers and any other item that falls into that category are permitted in the facility. Effective January 1, 2010, licensees of family child care homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.

LPA discussed the safe sleep regulations with licensee [or facility representative] 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 an additional resource. LPA also informed licensee [facility representative] 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.
Report Continues - Page 3 of 4

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: BAUTISTA FAMILY CHILD CARE	FACILITY NUMBER: 192001812
	VISIT DATE: 08/23/2022

NARRATIVE

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The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

LPA reviewed and issued the LIC 311D - Forms/Records to Keep in Your Family Child Care Home. Mandatory Forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. The Licensee was advised how to access forms and Regulations online at www.ccld.ca.gov. Licensee was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care.

AB 1207: Beginning on January 1, 2018, this law requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: http://www.mandatedreporterca.com/

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. LPA discussed the influenza waiver during the visit.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today 08/23/2022.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview was conducted and report was reviewed with the Licensee (or facility representative), Maria Bautista.

Report Ends - Page 4 of 4

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

LIC809 (FAS) - (06/04)

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