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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192007118
Report Date: 05/06/2022
Date Signed: 05/06/2022 03:07:25 PM


Document Has Been Signed on 05/06/2022 03:07 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:RAMIREZ FAMILY CHILD CAREFACILITY NUMBER:
192007118
ADMINISTRATOR:RAMIREZ, LETICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 585-0232
CITY:LOS ANGELESSTATE: CAZIP CODE:
90001
CAPACITY:14CENSUS: 3DATE:
05/06/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Leticia Ramirez, LicenseeTIME COMPLETED:
03:35 PM
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Licensing Program Analyst (LPA)Katrina Chicote conducted an Unannounced Required – 1 Year inspection to the above facility on 05/06/2022 at 11:45 AM. LPA attempted to conduct COVID-19 screening call but was only able to leave a voicemail. LPA conducted COVID-19 screening call at entrance of facility. Upon arrival, LPA disclosed the purpose of the inspection and initially met with Adult 1(A1), who did not have criminal record clearance and providing care for children at facility. Licensee arrived at 12:02 PM. Adults in the home were discussed. There were three day care children present during today’s inspection. Licensee states there are currently 11 children enrolled. The children's roster was reviewed and is current. Per Licensee, the facility’s hours of operation are 6:30 AM to 6:30 PM, Monday thru Friday. Emergency Disaster Plan, License, and Parents’ Rights were posted at the time of inspection. Disaster drill log was not available during today’s inspection, per Licensee last disaster drill has not been conducted within the last six months.

This is a single-story home which consists of three bedrooms and two bathrooms, living room, and kitchen with laundry area. Areas used by the children include the living room (located to the left upon entry), Bathroom 1 (located thru hallway next to Living Room to the right), and Kitchen (located across from Living Room). Per A1, areas off limits to children and parents include all bedrooms and a Bathroom 2, Licensee confirmed this information. Per Licensee, off limit areas are locked during operating hours, LPA observed doors to be locked. A1 states there are two dogs in the home, Licensee confirms there are two dogs in the home that are kept separate from the children. LPA heard dogs barking inside an off limits Bedroom at time of inspection.
Report Continues - Page 1 of 5
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:
DATE: 05/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/06/2022
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 10


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: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 192007118
VISIT DATE: 05/06/2022
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All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. LPA observed central/air heat vents throughout home. There is a working telephone maintained in the home. At 11:48 AM, LPA observed Living Room to have couch, swing chair, television hanging on wall, child size table and chairs, plastic play kitchen, large legos, dramatic play toys, and other age appropriate toys, free of loose and sharp parts available for children in care at time of inspection. At 11:49 AM, LPA observed Kitchen to have washer and dryer, small tables and chairs and all low cabinets to have operable child safety locks at time of inspection. At 11:52 AM, LPA observed Bathroom 1 to have operable toilet and sink, floor and under cabinet sink to be free of hazards, and adequate hand washing and toileting supplies at time of inspection. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. LPA observed knives to be kept in high cabinet and detergents and cleaning compounds stored in off limits bedroom. The Licensee states that there are no poisons in the home. The Licensee does understand that poison must be locked with a key or combination lock.

Per Licensee, they provide food for children in care but are flexible and allow parents to bring in food from home if they prefer. Per Licensee, there are no weapons, firearms in the home. Licensee states she has updated sick policy and isolation area will be where needed.

Per Licensee, the children will have access to backyard area for outdoor play. Outdoor play area is accessible through backdoor in Kitchen/Laundry. At 11:52 AM, LPA observed backyard has grass and adequate perimeter fencing through-out the yard. LPA observed large trampoline to the right of the backayard to be free of holes with safety netting and zipper maintained. LPA observed small plastic slide and ride along toys free of loose and sharp parts available for the children in the backyard and all trees, shrubs, and plants are maintained. LPA observed a shed in backyard that was locked at time of inspection. LPA did not observed any bodies of water around the premises and Licensee confirms no bodies of water around the premises.
Report Continues - Page 2 of 5
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2022
LIC809 (FAS) - (06/04)
Page: 2 of 10
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: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 192007118
VISIT DATE: 05/06/2022
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At 11:50 AM, LPA observed the valve on the required 2A 10BC fire extinguisher indicates fully charged with service tag indicating not serviced within the year. At 12:00 PM LPA observed smoke and carbon monoxide detectors are in operable condition. Per Licensee, First Aid kit is kept in the Living Room, at 1:56 PM LPA observed First Aid kit and was inventoried for necessary supplies. The Licensee's Pediatric First Aid and CPR is expired. Proof of immunization against influenza, pertussis, and measles were not readily available during today’s inspection. The Licensee has taken the Mandated Reporter Training but is expired.
—CPR Card valid until: 06/2020
—Fire Extinguisher was last serviced on: 09/23/2019
—Mandated Reporter AB1207 Completed: 06/14/2018
—Children records and required licensing forms were discussed as well as mandated child abuse reporting and criminal record clearance requirement.

The following were discussed:
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

Licensee (or facility representative) 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.

Report Continues - Page 3 of 5
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2022
LIC809 (FAS) - (06/04)
Page: 3 of 10
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: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 192007118
VISIT DATE: 05/06/2022
NARRATIVE
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Rooms that are off-limits need to be made inaccessible during operating hours. NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers and any other item that falls into that category are permitted in the facility. Effective January 1, 2010, licensees of family child care homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.

The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

LPA discussed the safe sleep regulations with licensee [or facility representative] 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 [facility representative] 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 reviewed and issued the LIC 311D - Forms/Records to Keep in Your Family Child Care Home. Mandatory Forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. The Licensee was advised how to access forms and Regulations online at www.ccld.ca.gov. Licensee was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care.

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.

Report Continues - Page 4 of 5
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2022
LIC809 (FAS) - (06/04)
Page: 4 of 10
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: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 192007118
VISIT DATE: 05/06/2022
NARRATIVE
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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. LPA discussed the influenza waiver during the visit.

Based on this information, the following deficiencies 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.

A civil penalty was assessed on this date for $100 for Criminal Record Clearance for A1.

Upon receipt of this report, the Licensee shall post the Notice of Site Visit and any Licensing report documenting a type “A” deficiency. The report and the Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 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 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 of Receipt (LIC 9224 form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the Acknowledgement of Receipt of Licensing Reports (LIC 9224) Form during this visit.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.


Exit interview was conducted and report was reviewed with the Licensee (or facility representative), Leticia Ramirez.


Report Ends - Page 5 of 5
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2022
LIC809 (FAS) - (06/04)
Page: 5 of 10
Document Has Been Signed on 05/06/2022 03:07 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754


FACILITY NAME: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 192007118

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/06/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(1)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation at 11:50 AM, LPA observed fire extinguisher to not be serviced annually. This is an immediate health, safety, and personal rights risk to children in care.
POC Due Date: 05/06/2022
Plan of Correction
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Licensee states she will get fire extinguisher serviced or obtain a new one by POC date and provide photo proof via email/text.
Type A
Section Cited
CCR
102370(d)
Criminal Record Clearance
(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation and interview, A1 was alone providing care to children and did not have criminal record clearance at time of inspection. This is an immediate health, safety, and personal rights risk to children in care.
POC Due Date: 05/06/2022
Plan of Correction
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Licensee arrived at facility at 12:02 PM to take over providing care for children. Clearing deficiency on above 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: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:
DATE: 05/06/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/06/2022
LIC809 (FAS) - (06/04)
Page: 6 of 10


Document Has Been Signed on 05/06/2022 03:07 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754


FACILITY NAME: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 192007118

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/06/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416(c)
Personnel Requirements
(c) 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.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA record review and interview at 12:29 PM, Licensee did not have current pediatric first aid/cpr. Licensee's Assistant did not have current pediatric first aid/cpr. Licensee states she has not renewed. This is an immediate health, safety, and personal rights risk to children in care.
POC Due Date: 05/09/2022
Plan of Correction
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Licensee states she will provide proof of CPR training or appointment made to obtain CPR training by POC date via email/text.
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: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:
DATE: 05/06/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/06/2022
LIC809 (FAS) - (06/04)
Page: 7 of 10


Document Has Been Signed on 05/06/2022 03:07 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754


FACILITY NAME: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 192007118

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/06/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(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
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Based on LPA record review and interview at 12:28 PM, Licensee did not have current mandated reporter training. Licensee states she has not renewed expired training. This is a potential health, safety, and personal rights risk to children.
POC Due Date: 05/09/2022
Plan of Correction
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Licensee states she will do training and will email it to LPA by POC date.
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(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
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 Based on LPA record review and interview at 12:28 PM, Licensee did not have immunization records for MMR, TdaP, and Influenza or written declination for influenza at time of inspection. This poses a potential health, safety, and personal rights risk to children.
POC Due Date: 05/09/2022
Plan of Correction
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Licensee states she will provide proof of immunizations by POC date via email.

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: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:
DATE: 05/06/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/06/2022
LIC809 (FAS) - (06/04)
Page: 8 of 10