192005642-11-5-2019-33-CC-JCHZ-BHMC29-20191105003221

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 192005642
Report Date: 05/06/2019
Date Signed: 11/05/2019 12:32:28 AM

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	LOPEZ FAMILY CHILD CARE		FACILITY NUMBER:	192005642
ADMINISTRATOR:	LOPEZ, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(213) 388-4877
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90004
CAPACITY:	14	CENSUS: 9	DATE:	05/06/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Maria Lopez		TIME COMPLETED:	01:30 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	This is an electronic copy of a hand written report created on 05/06/2019 due to a consistency check. Licensing Program Analyst (LPA) Janeth Chavez conducted an unannounced Random site inspection to ensure the health & safety standards as required by regulations governing family child care homes are met. Upon arrival, LPA met with license, Maria Lopez and toured the facility indoors and outdoors. There are 9 children present and 4 adults. All adults present have obtained a criminal record clearance. Licensee's operating hours are from 6am-6pm (M-F). Licensee stated she carries Liability Insurance for Family Child Care Homes. There are no dual licenses in this home. The home is a two story, 4 bed, 2 bath. The following areas are used for day care: living room (main day care area), enclosed back porch, bathroom next to laundry room, backyard (fenced). Off-limit areas include: All upstairs, kitchen, driveway, front yard, detached garage, & shed in backyard. LPA inspected detached garage and door is locked. The shed is kept locked as well, LPA observed a wood safety gate in the kitchen to prevent access to day care children. The children only use the day care room on the 1st floor and do not have access to the other side of the house or the stairs. There is a door that is kept locked that leads to the other side of the house. Licensee has the parent's rights poster and other appropriate forms posted on the day care room wall. Pediatric CPR/First Aid certificates are valid thru 03/2020. Licensee's disaster drill log notes last drill conducted on 4/10/19. Licensee has a working telephone. Detergents and cleaning supplies were inaccessible and are kept latched in the kitchen cabinet. Fire extinguisher has been serviced in the last year, card on extinguisher notes 4/10/19. There is an operational (combo) smoke & carbon monoxide detector in the home (day care room). The home has electrical outlet covers throughout and maintains a first aid kit. There are adequate age appropriate toys, books, and games. LPA did not observe any pools, spas or other bodies of water. As per licensee there is one dog in the home and is kept in the off-limit areas in the home. Licensee was advised to keep pets isolated from day care children. There are no firearms present on the premises as stated by licensee. Children's roster is readily available and updated. Children's files were reviewed and are complete. Licensee's assistants CPR expires on 12/2020.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) -98-3417
LICENSING EVALUATOR NAME: Janeth Chavez	TELEPHONE: (323) 981-3376
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2019

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LOPEZ FAMILY CHILD CARE	FACILITY NUMBER: 192005642
	VISIT DATE: 05/06/2019

NARRATIVE

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The following was discussed with licensee: Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being in the presence of the children in care. Individuals within one month of their 18th birthday must be fingerprinted immediately.
No smoking, No infant walkers, NO baby bouncers, No Johnny Jumpers, No exersaucers and any other item that falls into that category. LPA discussed disaster drills, posting requirements, children records requirements, mandated child abuse and injury/death reporting. Licensee Initials: _____
LPA reviewed LIC 311D with licensee, reminding her of required forms. LPA reviewed SIDs, Never Shake A Baby, and safe sleeping practices. INFANTS SHOULD SLEEP MOUTH UP, ON THEIR BACKS, FREE OF CLUTTER SURROUNDING THEIR SLEEPING SPACE. Licensee Initials:_____

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)514-0383 (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 was discussed: A qualified assistant must be present and actively involved in caring for children whenever (9) or more children are present at the facility in a large family child care home.

AB1207: California Child Care Providers: Mandated Reporter Training https://mandatedreporterca.com. Licensee is exempt because she is Spanish speaking. Training is not in her language.
SB792: Requires adults or volunteers in a day care to provide proof of vaccinations for Measles, Pertussis and Influenza. Requirement met by licensee and assistant.

LPA advised the license to access forms and regulations online at: www.ccld.ca.gov.

There are no deficiencies cited on today's inspection. The Notice of Site Visit (LIC 9213)-must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100. Exit interview was conducted with licensee. Appeal rights discussed and explained.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) -98-3417
LICENSING EVALUATOR NAME: Janeth Chavez	TELEPHONE: (323) 981-3376
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2019

LIC809 (FAS) - (06/04)

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