192006242-10-8-2019-33-CC-LGOZ-BGRUEP-20191008153128

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 192006242
Report Date: 10/08/2019
Date Signed: 10/08/2019 03:31:36 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	RODRIGUEZ FAMILY CHILD CARE		FACILITY NUMBER:	192006242
ADMINISTRATOR:	RODRIGUEZ, AMANDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 255-0061
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90065
CAPACITY:	14	CENSUS: 13	DATE:	10/08/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Amanda Rodriguez		TIME COMPLETED:	03:48 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) Lissete Gonzalez conducted an unannounced annual random site inspection to ensure the health & safety standards as required by regulations governing family child care homes. Upon arrival, LPA met with Licensee, Amanda Rodriguez, who provided LPA on a tour of the facility indoors and outdoors. There were 13 children present, 4 being infants. Also present were Licensee’s Assistants, Wendy Guevara and Maria Escobedo. Licensee states there are 13 children enrolled. The children’s roster was reviewed and is current. Licensee’s operating hours are from 7:00 a.m. to 6:00 p.m. from Monday through Friday. This is a one story home which consists of 2 bedrooms, 1 bathroom, kitchen, dining room, living room, garage and backyard (fenced). Licensee uses the garage as an activity space for the children. Licensee was advised that the garage can only be used for activities. There are no areas off limits to children in care. LPA toured all areas used by children during this visit. LPA inspected the living room used by the children. There are adequate age appropriate toys, books, and games. There is an open face heater that is barricaded and inaccessible to children. No hazards or violations were observed. There is proper ventilation through the home provided by a ceiling fan and an air conditioning unit. LPA inspected the kitchen and adjacent dining room used by the children. Knives and sharp objects are stored in a magnetic latched kitchen cabinet and are inaccessible to children. Cleaning compounds and detergents are stored in a magnetic latched kitchen cabinet located underneath the sink. The bathroom was inspected for safety and cleanliness. LPA observed the bathroom vanity cabinet is maintained closed using rubber bands; hygiene products are stored in the vanity’s lower cabinet. LPA inspected the bedrooms. No hazards of violations were observed. There are electrical outlet covers throughout and a First Aid Kit is available. REPORT CONTINUES ON NEXT PAGE: 1 OF 3

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Lissete Gonzalez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2019

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 4

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: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 192006242
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/08/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/22/2019 Section Cited	1 2 3 4 5 6 7	Operation of a Family Child Care Home The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stred where they
	8 9 10 11 12 13 14	are inaccessible to children. This requirement was not met as evidenced by: LPA observed the bathroom vanity cabinet is maintained closed using rubber bands; hygiene products are stored in the vanity’s lower cabinet. This poses a potential risk to the health and safety of children in care.	8 9 10 11 12 13 14
Type B 10/22/2019 Section Cited	1 2 3 4 5 6 7	Immunizations Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000. This requirement was not met as evidenced by: Child #7 and Child #12 did not have proof of immunizations. This poses a
	8 9 10 11 12 13 14	potential risk to the health and safety of children in care.	8 9 10 11 12 13 14

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: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Lissete Gonzalez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2019

LIC809 (FAS) - (06/04)

Page: 4 of 4

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: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 192006242
	VISIT DATE: 10/08/2019

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
26
27
28
29
30
31
32

The outdoor backyard was inspected by LPA. The outdoor yard is fenced and there is shade available to the children. There are age appropriate toys available to children in care. The garage used as an activity space was inspected. No hazards or violations were observed.

Licensee has the Parent’s Rights poster and other appropriate forms posted on a board in the living room. Licensee, Amanda Rodriguez’s First Aid/Infant CPR certificates are valid through 06/08/2021. Licensee completed the AB1207 Mandated Reporter training on 8/14/2018. Licensee's disaster drill log notes last drill conducted on 09/13/19. Licensee has a working telephone.

LPA observed the 2A10BC fire extinguisher located in the kitchen is fully charged and was last serviced on 1/28/2019. There is an operational smoke detector and an operational carbon monoxide detector in the home. There are no firearms or poisons present on the premises as stated by Licensee. Currently there are no pets.

Staff files were reviewed and found to be complete. Children’s files were reviewed for proper documentation. Child #7 and Child #12 did not have an immunization record on file.

The following were discussed: 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. 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.

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
REPORT CONTINUES ON NEXT PAGE: 2 OF 3

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Lissete Gonzalez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2019

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 192006242
	VISIT DATE: 10/08/2019

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
26
27
28
29
30
31
32

A qualified Assistant must be present and actively involved in caring for children whenever nine (9) or more children are present at the facility in a large family child care home.

LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing
website at: www.ccld.ca.gov

Based on this information, the following deficiencies listed on the attached LIC 809d 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.

Exit interview was conducted with Licensee, Amanda Rodriguez. The Licensee was provided a copy of the appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

A copy of the LIC 9213 was given to licensee—Notice of Site Visit. 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 $100.00.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Lissete Gonzalez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2019

LIC809 (FAS) - (06/04)

Page: 3 of 4