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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192004980
Report Date: 08/08/2019
Date Signed: 08/08/2019 04:17:51 PM

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:VALENCIA FAMILY CHILD CAREFACILITY NUMBER:
192004980
ADMINISTRATOR:VALENCIA, VIRGINIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 734-3790
CITY:LOS ANGELESSTATE: CAZIP CODE:
90018
CAPACITY:12CENSUS: 8DATE:
08/08/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Virginia Valenicia, LicenseeTIME COMPLETED:
04:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Denise Gibbs conducted an unannounced annual random inspection to the above facility. LPA met with Virginia Valenica, Licensee who guided analyst on a tour of the facility. Also present during this inspection, was Teresa Medina, Licensee’s Assistant, Daisy Diaz (licensee's mother), Noelia Valencia (licensee's daughter), licensee's son (16 years old and granddaughter 14 years old. Present in the back house was Evelyn Medina and son (14 years old). Licensee states that previous tenants, Audrey Valencia and Vincent Olivera no longer reside in the back house. Per Licensee, there are 10 children that are currently enrolled. A current children’s roster was not available for review. LPA observed 8 children present upon arrival, 3 of the children were infants.

This is a one-story home which consists of 4 bedrooms, 2 bathrooms, kitchen, dining room, living room, front yard and backyard (fenced). Main care is provided in the back bedroom, kitchen/eating area and the back yard. The children use the 1 bathroom outside and 1 inside in hallway between the bedrooms. Per Licensee, areas off limits to children and parents include: 3 bedrooms (locked) front yard and back house (locked). The licensee provides food for children in care. Hours of operation are Mon-Sun 6am-11pm.

The licensee states that 3 adults and 3 children currently live in the home (front and back house combined). one adult is visiting. Per Licensee, she currently has one assistant. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed child care home. Licensee states that there are no firearms or weapons stored in the home.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a land line and a cellphone that is used during operation hours. There is ventilation and heating (fans and wall heater).

The following was observed and reviewed during this inspection: ------------------Page 1
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019
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 8
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: VALENCIA FAMILY CHILD CARE
FACILITY NUMBER: 192004980
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/08/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/08/2019
Section Cited
CCR
102717(g)(4)
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Operation of a Family Child Care Home

Detergents, cleaning compounds, medicines, and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children
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Licensee removed all items during the inspection and made them inaccessible.
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This requirement was not met as evidenced by LPA observing hygienic products in the shower in the inside bathroom and Raid on a shelve near the window outside. This poses an immediate health and safety risk to 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: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019
LIC809 (FAS) - (06/04)
Page: 5 of 8
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: VALENCIA FAMILY CHILD CARE
FACILITY NUMBER: 192004980
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/08/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/06/2019
Section Cited
CCR
102416(c)
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Personnel Requirements
The licensee and other 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.
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Per Licensee, she will send her assistant to renew her CPR next week. Licensee will send proof of enrollment to LPA by POC date.
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This requirement was not met as evidenced by licensee failing to provide current CPR and 1st aid for staff#2. This poses a potential health and safety risk to children in care.
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Type B
09/06/2019
Section Cited
CCR
102417(g)(1)
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Operation of a Family Child Care Home

The home shall contain a fire extinguisher which meet standards established by the State Fire Marshal.
This requirement was not met as evidenced by LPA observing the service
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Per Licensee, she will call the fire department tomorrow and have them come service the fire extinguisher. Licensee will send a picture of the service tag to LPA.
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tag on the fire extinguisher was last services 7/2018. This poses a potential health and safety risk to 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: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019
LIC809 (FAS) - (06/04)
Page: 7 of 8
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: VALENCIA FAMILY CHILD CARE
FACILITY NUMBER: 192004980
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/08/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/06/2019
Section Cited
CCR
102417(g)(8)
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Operation of a Family Child Care Home

Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement was not met by licensee failing to provide a curent
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Per Licensee, she will update the Roster and send a picture to LPA by POC date.
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roster.
This poses a potential health and safety risk to 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: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019
LIC809 (FAS) - (06/04)
Page: 8 of 8
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: VALENCIA FAMILY CHILD CARE
FACILITY NUMBER: 192004980
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/08/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/06/2019
Section Cited
HSC
1596.7995
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Employees or volunteers at day care center; immunization requirements; records; exemptions
Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against
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Per Licensee, she will go to her doctor and send the assisstant to the doctor to update their immunizations. Licensee will send LPA a picture of updated immunization records for staff #1 and #2 by Poc date.
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influenza, pertussis, and measles.
This requirement was not met as evidenced by licensee failing to provide proof of immunizations staff #1 and #2. This poses a potential health and safety risk to children in care.
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Type B
09/06/2019
Section Cited
CCR
1024219(a)(b)
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Child's Records

The licensee shall maintain, in each child's record, the signed and dated notice form required in Section 102419(d). (Notification of Parents’ Rights, LIC 995A)
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Per Licensee, parents are working on them and will bring new forms in by 8/15/19. Licensee will send pictures to LPA by POC date.
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The licensee shall maintain, in each
child's record, a copy of the emergency
information card required in Section 102417(g)(7).
This requirement was not met as evidenced by licensee failing to provide complete files for child #1,2,3,4,5,6,7,8. This poses a potential health and safety risk to 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: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019
LIC809 (FAS) - (06/04)
Page: 6 of 8
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: VALENCIA FAMILY CHILD CARE
FACILITY NUMBER: 192004980
VISIT DATE: 08/08/2019
NARRATIVE
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Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be accessible to children. LPA observed RAID in the backyard on a shelf near the window, and hygienic products and razors in the bathroom inside the house. This poses and immediate health risk to children in care.

The valve on the required 2A 10BC fire extinguisher indicates fully charged but was last serviced on 7/2019, as indicated on service tag. Which exceeds the year allowance. Smoke and carbon monoxide detectors were tested and are operable.

The home is observed to be clean and orderly. There are toys and other age appropriate material available for children. Children nap on cots in the main care area. Infant pack n plays are visible in main care area and are free of hazards.

Currently, children are using the back yard for outdoor play. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that can pose a danger to children on the outdoor yard. There are no pools or spas, or other bodies of water. Licensee has 1 dog that remains in an inaccessible room in the house and birds, chickens and lizards that are inaccessible in the front yard during operating hours.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 3/2020 and the assistant's expired on 5/2019. There are first aid supplies available.

Children’s records were reviewed, including emergency information and were observed to be incomplete.

The licensee does not have proof of immunization's. LPA observed that the Licensee and assistant do not have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file because it is not in their primary language.

LPA issued a Confidential Names List (LIC 811) to the licensee which documents staff and children’s files reviewed during this inspection. All homes shall conduct fire and disaster drills at least once every six ------Page 2.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019
LIC809 (FAS) - (06/04)
Page: 2 of 8
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: VALENCIA FAMILY CHILD CARE
FACILITY NUMBER: 192004980
VISIT DATE: 08/08/2019
NARRATIVE
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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: 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.

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.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit.

Exit interview was conducted with Virginia Valenicia, Licensee, Appeal Rights were provided and discussed. -----------------------Page 4

SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019
LIC809 (FAS) - (06/04)
Page: 4 of 8
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: VALENCIA FAMILY CHILD CARE
FACILITY NUMBER: 192004980
VISIT DATE: 08/08/2019
NARRATIVE
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months and document the date and time of each drill. Last drill documented was conducted on 5/2019.

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

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility.

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

LPA provided the licensee with a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics and Helping you to reduce the risk of SIDS, updated Parent’s Rights Poster with Complaint Hotline information, Capacity Handout (Small & Large) and Never Shake a Baby pamphlet. LPA also consulted and explained Child Abuse Reporting.

Incidental Medical Services (IMS):
The licensee states that she will not 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.

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 to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov



-----Page 3
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019
LIC809 (FAS) - (06/04)
Page: 3 of 8