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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192007298
Report Date: 01/28/2020
Date Signed: 01/28/2020 12:24:06 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:CANAL FAMILY CHILD CAREFACILITY NUMBER:
192007298
ADMINISTRATOR:CANAL, IRMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 338-3361
CITY:BALDWIN PARKSTATE: CAZIP CODE:
91706
CAPACITY:14CENSUS: 6DATE:
01/28/2020
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Irma CanalTIME COMPLETED:
12:35 PM
NARRATIVE
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An unannounced case management inspection was made on this day by Licensing Program Analysts (LPAs) Ariel Cazares and Katrina Chicote to the licensed day care. LPA met with Licensee Irma Canal to discuss deficiencies being cited as a result of a complaint investigation not related to the allegations made. At the time of arrival LPAs observed 6 children and licensee with one assistant.
As a result of a complaint investigation concluded on 1/28/2020, LPA determined that the allegation of a child wandering out of the licensed facility was not reported by licensee to the department. Although, LPA was unable to determine if the incident occurred, the alleged incident should have been reported by licensee when made known. Based on licensee's recall the incident allegedly occurred in June or July 2019, although this could not be verified. Licensee was made aware of reporting requirements and provided a copy of the LIC 624- Unusual Incident/Injury Report in Spanish.

The facility will be cited for failing to comply with Reporting Requirements. Please see 809-D for details.

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.

Exit interview was conducted with Licensee Irma Canal. A copy of this report and appeal rights were provided and explained.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Ariel CazaresTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020
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: CANAL FAMILY CHILD CARE
FACILITY NUMBER: 192007298
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/28/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/31/2020
Section Cited

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Any child absence means any instance where a child in care is missing. For example, any child in care who wanders away from the Family Child Care Home, is lost during an outing, or does not return from school, shall be reported even if the child is later found safe.
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This requirement has not been met as evidenced by licensee failing to report an incident made known to her regarding a child allegedly wandering out of her facility. This was revealed during a complaint investigation. This poses a potential risk to the health and safety of 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: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Ariel CazaresTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:
DATE: 01/28/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/28/2020
LIC809 (FAS) - (06/04)
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