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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192002212
Report Date: 10/09/2023
Date Signed: 10/09/2023 04:18:05 PM


Document Has Been Signed on 10/09/2023 04:18 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:CARRANZA FAMILY CHILD CAREFACILITY NUMBER:
192002212
ADMINISTRATOR:CARRANZA, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 458-2814
CITY:LOS ANGELESSTATE: CAZIP CODE:
90042
CAPACITY:14CENSUS: 10DATE:
10/09/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Licensee Maria CarranzaTIME COMPLETED:
04:30 PM
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This inspection was conducted in Spanish

Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced 1-year required inspection at the above facility on 10/09/23 at 01:05 p.m. A COVID risk assessment was conducted upon entry- appropriate PPE was used. LPA met with Maria Carranza, Licensee who guided analyst on a tour of the facility. There were 10 children present during this inspection. Per licensee, 15 children are enrolled. Present during the inspection was the Licensee’s assistant.

Operation hours are Monday – Friday 06:00 a.m. – 06:00 p.m.

This is a one-story home which consists of 3 bedrooms, 1 ½ bathrooms, living room, kitchen, garage, front and backyards (fenced). Children use the bathroom in bedroom #3, bedroom #3, kitchen (to eat only), garage (for activities only), and backyard for play. Per licensee, areas off limits to children and parents include: 2 bedrooms, 1 bathroom, kitchen, and front yard (fenced). Per Licensee, family members residing in the home are 4 adults and 1 minors. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing, or volunteering in a licensed home. Individuals living in the home are identified on the attached LIC811.

Per Licensee, there are no pets on the premises.

LPA toured all areas identified on the facility sketch used by children during this visit and were inspected for safety, comfort, and cleanliness. LPA observed appropriate napping equipment (cribs and cots) kept in bedroom #3. LPA observed that the crib and cots do not hinder the entrance or exit to and from the space they are sleeping in. LPA observed that the crib does not have anything hanging on the sides or on top. LPA did not observe any hazardous materials throughout this inspection; exposed outlets were observed to have covers. LPA observed toys and other age-appropriate materials available for children. There’s also a first aid kit readily available.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 981-3386
LICENSING EVALUATOR SIGNATURE:
DATE: 10/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/09/2023
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CARRANZA FAMILY CHILD CARE
FACILITY NUMBER: 192002212
VISIT DATE: 10/09/2023
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LPA observed the following required posted documentation on the entry way of the facility: Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPA reviewed facility records LIC 610- Emergency Disaster Plan and Disaster drill log. Children’s roster was available during this inspection and was observed to be current.

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 09/14/23.

LPA toured the kitchen and observed all knives are kept in a top cabinet inaccessible to children. LPA observed that all kitchen cabinets have child proof locks. LPA did not observe any hazardous materials accessible to children.

Bathroom: LPA observed the bathroom children use to be safe and in sanitary conditions. LPA did not observe any hazardous materials.

Licensee does understand that licensing staff may have access to off-limit areas during inspection visit if necessary.

**Rooms that are off-limits need to be made inaccessible during operating hours**

Per licensee, food is provided to all children in care. The home maintains telephone service via a cell phone and is maintained in the home during hours of operation. There is ventilation and heating via portable fans and heaters.

Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock.

Per licensee, there are no firearms or weapons stored in the home.

At 01:22 p.m. smoke and carbon monoxide detectors were tested and are operable. The valve on the required 2: A10 BC fire extinguisher indicates fully charged and was serviced on 06/21/23, as indicated on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually.

Isolation area for sick children waiting to be picked up is in bedroom #3 with supervision.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 981-3386
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2023
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CARRANZA FAMILY CHILD CARE
FACILITY NUMBER: 192002212
VISIT DATE: 10/09/2023
NARRATIVE
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Currently children are using the back yard for outdoor play. LPA observed the back yard to have adequate shade and age-appropriate play equipment for children in care. LPA did not observe any objects that could be hazardous to children in care. Licensee understands that children should be supervised at all times.

LPA did not observe any pools, spas, hot tubs, fishponds, or similar bodies of water during the inspection.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization's Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, LIC 9227- Infant sleep form (0-12 months, and documentation of 15-minute Infant Sleep Check (0-24 months). C2 is missing LIC 9227. LPA provided consultation.

Licensee and assistant records were reviewed for approved Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. Licensee’s Mandated Reporter Training expires on 06/09/24. Licensee’s Pediatric CPR/FA expires 02/12/24. LPA observed Licensee and assistant are missing proof of MMR vaccine.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018, any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers

The licensee is operating within proper capacity and ratios. LPA observed licensee to be present at the home and providing adequate care and supervision.

Licensee is caring for infants. LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee 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. LPA provided PIN 20-24-CCP SP, and PUB 217 Never Shake a Baby Brochure.

No infant walkers, No baby bouncers, No Johnny jumpers, No exersaucers and any other item that falls into that category.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 981-3386
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2023
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CARRANZA FAMILY CHILD CARE
FACILITY NUMBER: 192002212
VISIT DATE: 10/09/2023
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Licensee Maria Carranza confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

The following deficiencies were cited in accordance with Title 22 of the California Code of Regulations and Health & Safety Codes. Please see 809D for documentation of deficiencies.

Exit interview conducted and report was reviewed with the Licensee Maria Carranza.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 981-3386
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2023
LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 10/09/2023 04:18 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: CARRANZA FAMILY CHILD CARE

FACILITY NUMBER: 192002212

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 10/09/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(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 and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in Licensee and assistant do not have proof of MMR vaccine which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/09/2023
Plan of Correction
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Per Licensee, she will submit proof of MMR vaccine to LPA by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 981-3386
LICENSING EVALUATOR SIGNATURE:
DATE: 10/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/09/2023
LIC809 (FAS) - (06/04)
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