192002652-8-12-2022-54-CC-JESA-CH8NBN-20220812101925

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 192002652
Report Date: 08/12/2022
Date Signed: 08/12/2022 10:19:44 AM

Document Has Been Signed on 08/12/2022 10:19 AM - 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:	TORRES FAMILY CHILD CARE		FACILITY NUMBER:	192002652
ADMINISTRATOR:	ROSA TORRES		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 404-5219
CITY:	NORWALK	STATE: CA	ZIP CODE:	90650
CAPACITY:	14	CENSUS: 3	DATE:	08/12/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Licensee Rosa Torres		TIME COMPLETED:	10:30 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	Due to technical issues, although annual inspection was completed on 8/2/22 from 12:54PM to 3:25PM, LPAs Jeanette Estrada and Austin Estrada were unable to issue the report, report was lost, and a written report was issued to Licensee. ________________________________________________________________________________ On 8/12/22 LPA Jeanette Estrada returned to issue report and deficiencies for the inspection below which was completed on 8/2/22. On 8/2/22 Licensing Program Analysts (LPAs) Jeanette Estrada and Austin Estrada conducted an unannounced required 1 year inspection at the above facility. LPAs met with the Licensee Rosa Torres and informed her of the purpose for the visit. LPAs provided Licensee with a copy of the Facility Entrance Checklist. Licensee guided LPAs on a tour of the facility. There were 8 children present during the inspection. All residents were noted and verified. Also present was one assistant. Facility provides care to children ages 0 to 12. Facility is open Monday to Friday 5AM to 6PM. This is a one story, 2 bedroom, 2 bathroom home, with a living room, dining room/kitchen, detached garage, enclosed patio and fenced front yard. Areas on limits to children are: living room, bathroom in patio, kitchen in passing to the back yard patio and front yard. Areas off limits to children are: all bedrooms, bathroom inside the home, a section of the backyard that is separated by a gate and garage. All areas that are accessible to children were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection: LPA reviewed required posted documentation for Facility License with Licensee. LPAs observed the required documents to be posted: Facility license, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. The following facility records were observed during the inspection: LIC 610- Facility Disaster Plan and Disaster drill log. Last documented drill date: July 2022. There was a current roster LIC 9040 available in the facility. There is an operable carbon monoxide detector and a smoke detector in the facility.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2022

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: TORRES FAMILY CHILD CARE	FACILITY NUMBER: 192002652
	VISIT DATE: 08/12/2022

NARRATIVE

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LPAs observed a 2A10BC Fire Extinguisher in the facility that was last serviced on August 30, 2021.
The home maintains telephone service (Land line and cell phone). Food is provided by Licensee. Licensee was reminded if children bring food from home it must be labeled with the child’s name and properly stored or refrigerated. The home is observed to be clean and orderly. There are toys and other age appropriate materials available for children. LPA also observed 1 dog observed in an off limit area in the back yard.
Sharp objects, detergents and cleaning compounds are inaccessible to children in care. Sharp objects are kept in an upper cabinet in the kitchen inaccessible to children in care. Cleaning products are kept in the cabinet under the kitchen sink. Per Licensee no children enrolled require medication. Personal medication is kept in an upper cabinet in the kitchen. The children only access the kitchen as they walk through to the enclosed patio. Per Licensee, children are escorted through the kitchen. There is a fan available in the living room. Per Licensee,the wall heater is used when needed. The wall heater is in the hallway and it is covered. LPA did not observe any fireplaces in the home. Per Licensee, if weather permits children spend the majority of the day in the enclosed patio and sleep in the living room. LPA observed age appropriate toys and materials in the day care area. Children use the restroom in the enclosed patio.
The outdoor area is separated into two sections. There is a gate separating the off limits part of the back yard. Children also use the fenced front yard for play.
Per Licensee, there are no poisons in the home. Licensee understands that all poisons must be locked, not only inaccessible to children. Isolation area for sick children waiting to be picked up is in the patio with supervision. Per Licensee, there are no firearms or weapons stored in the home. LPA did not observe pools or spas, or other bodies of water.
Infant Care: Currently licensee has 1 infant enrolled. LPAs observed Child 1 asleep in a car seat in the kitchen. Per Licensee, child has just arrived 5 minutes earlier. LPA advised Licensee to place child in appropriate napping equipment. LPAs observed a play yard in the enclosed patio. Licensee's assistant took play yard to the living room. Licensee was advised that napping equipment should not block entrances or exits. Infant mattresses should be firm with tightly fitted sheets. LPA discussed that each infant enrolled must have their own crib/ napping mat and bedding. LPA informed licensee of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months and 15-minute sleep check documentation for infants 0-24 months. Overnight Care: There is no overnight care provided at the moment. LPA discussed the following: Licensee is aware that they must remain wake while children are awake. If children sleep in separate area from licensee, the door must remain open. If licensee cannot hear children when they wake up, video or audio device can be used.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2022

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: TORRES FAMILY CHILD CARE	FACILITY NUMBER: 192002652
	VISIT DATE: 08/12/2022

NARRATIVE

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Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights. 2 out of 8 children did not have proof of required immunizations, and child 1 did not have LIC 9227 on file.
Licensee's and Assistant's Pediatric CPR/First Aid was completed on 7/15/2022 . Licensee and assistant did not have proof of required immunizations (measles, pertussis, flu), proof of TB clearance and Mandated Reporter Training certificate.
During inspection the children present was observed to be treated with dignity and respect, observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.
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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm Licensee 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. 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-and-resources/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.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2022

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: TORRES FAMILY CHILD CARE	FACILITY NUMBER: 192002652
	VISIT DATE: 08/12/2022

NARRATIVE

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To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process

The deficiencies listed on the following page were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. One type A citation was issued today for CCR 102425(h) Infant Safe Sleep - regarding Child 1 who was observed to be sleeping in the car seat. Please see attached LIC 809-D for all citations.
Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

The notice of site visit was posted where the parent/guardian of children enter and exit the facility.
A copy of this report shall also be posted where the parent/guardian of children enter and exit the facility.
Both the notice of site visit and licensing report shall remain posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.
A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon their return.
A copy of this report shall also be provided to the parent/guardian of any newly enrolled child for the next 12 months. A signed Acknowledgement of Receipt (LIC9224) shall be in each child’s file, acknowledging receipt.

Exit interview conducted and report was reviewed with the Licensee, Rosa Torres. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/12/2022 10:19 AM - 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: TORRES FAMILY CHILD CARE	FACILITY NUMBER: 192002652
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/12/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102418(g)

102418(g) Immunizations The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. On 8/2/22 2 children's records did not contain proof of immunizations which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/12/2022
	Plan of Correction
1 2 3 4	On 8/12/22 Licensee will provided proof of immunization record for child 1 and child 2 to LPA

Type B

Section Cited

CCR

102425(c)

102425 Infant Safe Sleep (c) An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 month of age the provider has in care and maintained at the facility in the infant’s file. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. On 8/2/22 1 out of 1 infant enrolled did not have LIC 9227 on file which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/12/2022
	Plan of Correction
1 2 3 4	On 8/12/22 Licensee will provided proof of completed LIC 9227 for Child 1 to LPA

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) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/12/2022 10:19 AM - 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: TORRES FAMILY CHILD CARE	FACILITY NUMBER: 192002652
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/12/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(c)

1597.622(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. On 8/2/22 2 out of 2 staff files, Licensee and Assistant 1, did not have proof of required immunizations, measles, pertussis, flu (or written declination of flu vaccine only) and TB which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/12/2022
	Plan of Correction
1 2 3 4	Licensee provided proof of required immunizations for herself and assistant 1-assistant 1 provided a written declination for the flu vaccine.

Type B

Section Cited

HSC

1596.8662(b)(1)

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. On 8/2/22 2 out of 2 staff files, Licensee and assistant 1, did not have mandated reporter training completed which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/19/2022
	Plan of Correction
1 2 3 4	Licensee will obtain mandated reporter training certificate for herself and Assistant 1 and will submit via due date.

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) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2022

LIC809 (FAS) - (06/04)

Page: 7 of 7

Document Has Been Signed on 08/12/2022 10:19 AM - 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: TORRES FAMILY CHILD CARE	FACILITY NUMBER: 192002652
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/12/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102425(h)

102425(h) Car seats shall only be used for transportation purposes and shall not be used for sleeping. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above. On 8/2/22 LPA observed Child 1 asleep in a car seat when LPA arrived which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 08/03/2022
	Plan of Correction
1 2 3 4	Licensee removed child 1 from car seat and placed child in a play yard in the living room during the visit on 8/2/22.. Licensee was advised car seats are not to be used for sleeping.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2022

LIC809 (FAS) - (06/04)

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