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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197402369
Report Date: 12/11/2019
Date Signed: 12/11/2019 01:36:34 PM

COMPREHENSIVE INSPECTION
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:DALPATHADO FAMILY CHILD CAREFACILITY NUMBER:
197402369
ADMINISTRATOR:DALPATHADO, ANGELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 709-1084
CITY:CANOGA PARKSTATE: CAZIP CODE:
91306
CAPACITY:12CENSUS: 7DATE:
12/11/2019
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Angel DalpathadoTIME COMPLETED:
02:00 PM
NARRATIVE
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On 12/11/2019 at approximately 10:00 AM, Licensing Program Analyst, Stella Gutierrez met with Licensee, Angel Dalpathado and explained the purpose of todays visit of an 3 Year Required inspection to ensure that facility is in compliance with Title 22 regulations and Health and Health Safety codes. Upon arrival, LPA observed 7 children (1 INFANT and 6 Pre-Schoolers) being supervised by licensee and sister Linthotage Fernando. Facility is license for a capacity of 12 Children. Facility is operating within capacity limitations. All adults observed during today’s visit are fingerprinted and associated to the facility. Licensee guided LPA on a tour of the facility inside and out. Hours of operation are from 6:00 AM to 6:00 PM, Monday through Friday.

Areas identified in the sketch and observed by LPA, Gutierrez during today’s visit:
Interior:
This is a Two-Story dwelling, three-bedroom, three bathroom home with kitchen/dining, living room, Family Room, laundry room and an attached garage. There is no pool, spa or other bodies of water on the premises. There are no weapons kept at the facility. Family members residing in the home include licensee, spouse and child. The facility was inspected inside and outside for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds and hazardous items (sharp knives in kitchen only in top tier shelf) that can pose a danger to children. The home has a fireplace that has a screen mounted to the wall to make inaccessible to the children in care. On limits areas include Kitchen, Family room, living room and Bathroom #1 located down stairs next to family room. The Bathroom is with locks and was not free from hazards. LPA, Gutierrez observed cleaners under the sink (Children’s bathroom) in a latched cabinet. Cleaners removed during today. Off-limits area includes the following: upstairs and all bedrooms in the upper level, Dining room, laundry room and attached garage. LPA, Gutierrez observed a crock pot of boiling water on kitchen counter where the children have access. Also observed in the kitchen were cleaners underneath the sink area (Items were removed during today's visit) and no latch on cabinet to make accessible. The laundry area is located next to the entrance of the garage which is locked. Main care is provided in the Family room (entrance through the kitchen).

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SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: DALPATHADO FAMILY CHILD CARE
FACILITY NUMBER: 197402369
VISIT DATE: 12/11/2019
NARRATIVE
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Children use the bathroom that is located next to the family room. Children use the living room and family room area for nap time; age appropriate napping equipment and materials available and inspected. According to the sketch in facility file the Licensee has installed a child safety gate so that children do not access the stairs that lead to the remainder of the home. Today LPA observed the gate was removed and Licensee was unable to attach gate to make the stairway inaccessible to the children in care. LPA observed a working smoke detector, operable carbon monoxide detector and 2A10-BC fire extinguisher located in a box underneath kitchen sink. The Fire Extinguisher was not accessible in case of an emergency and has no service tag. Licensee stated that she has not had it serviced since purchased in 2016.
LPA, Gutierrez observed age appropriate toys, learning materials, games and activities for children in care. All furniture was found in good repair, clean, and without hazards.

Exterior:
LPA, Gutierrez inspected the outdoor play area / back yard and that is on limits to the children in care. Back yard is fenced in. There are two exits (Sliding doors) to the outdoor area, One exit is through the Dining are and the other exit is through the family room where the main care is provided for the children. Right side of home is inaccessible to the children and locked gate was observed during today’s visit to ensure that children do not have access, LPA observed several bikes and toys that were in good condition for the children’s use. They back yard was free from any potential or immediate hazards to the children in care. Children do not use the front yard. Licensee stated that front yard is off limits other than arriving to the facility and leaving the facility. Home is located on a busy street and could be of harm when children are not 100% supervised when arriving and leaving the facility. Speed limit on main street is 40 mph. Licensee advised to remind parents to properly supervise their children at all times and front door is kept locked when children are in care.
Administration:

LPA observed licensee’s Pediatric First Aid and Adult, Child and Infant CPR to be current (expires on 07/2020). LPA observed a disaster drill log of drills performed once every six months at the facility. Records reviewed today were 7 children’s files, employee files for Licensee and Assistant and children’s roster.

LPA discussed capacity limitations, new car seat law, personal rights, Notification of Parent's Rights revised 12/06, inspection authority & agency's consultative role. Smoking is prohibited on the premises when children are present. The LPA also discussed earthquake safety and necessity of drills every 6 months. The applicant

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SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: DALPATHADO FAMILY CHILD CARE
FACILITY NUMBER: 197402369
VISIT DATE: 12/11/2019
NARRATIVE
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was also informed that all adults living in or having access to day care children in the home are required to have fingerprint clearances with Department of Justice, FBI and Child Abuse Index prior to having contact with children. If the aforementioned is not adhered to, a Civil Penalty of $100 /day per uncleared adult will be assessed.

The facility is not currently providing IMS. Incidental Medical Services (IMS) policy was discussed with the Licensee. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. LPA obtained a copy of the facility's IMS Plan. 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.html

The licensee was informed of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541.


Email Address: childcareadvocatesprogram@dss.ca.gov

Safe Sleep Links:
AAP: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx


NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative

Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials

SIDS & SHAKEN BABY SYNDROME INFORMATION (discussed) flyer provided.


LPA provided safe sleep flyer and discussed safe sleep practice. Infants must be placed on their backs and must be physically checked every 15 minutes to gauge temperature and ensure they are breathing. Applicant, ANGEL DALPATHADO understand safe sleep practice for infants and to ensure supervision at all times infant’s are in care at DALPATHADO FAMILY CHILD CARE facility.

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SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019
LIC809 (FAS) - (06/04)
Page: 3 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: DALPATHADO FAMILY CHILD CARE
FACILITY NUMBER: 197402369
VISIT DATE: 12/11/2019
NARRATIVE
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FORMS TO BE POSTED AND OBSERVED BY LPA during today’s visit
· LIC203 Facility License
· LIC 610A Emergency Disaster Plan
· LIC 9148 Earthquake Preparedness Checklist
· PUB394 Notification of Parents Rights Poster

The following were also discussed with licensee:



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, Gutierrez did not observe any immunization records for Licensee or assistant today.

New Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment. A copy provider rights and Appeal process provided to Licensee. All appeals must be sent to:

California Department of Social Services | Community Care Licensing Division
300 Continental Blvd., Suite 290-A
El Segundo, CA 90245

New Immunization Requirement: Law enacted by SB 277, beginning January 1, 2016, personal beliefs exemptions will no longer be an option for the vaccines that are currently required for entry into child care or school in California. Personal beliefs exemptions already on file will remain valid until the child reaches the next immunization checkpoint.

Assembly Bill 1207: California Child Care Workers; Mandated Training Requirement. Beginning January 1, 2018, all licensed providers, applicants, directors and employees must complete Mandated Reported Training prior to March 30, 2018 and renew training every two years at: www.mandatedreporterca.com. Volunteers are

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SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: DALPATHADO FAMILY CHILD CARE
FACILITY NUMBER: 197402369
VISIT DATE: 12/11/2019
NARRATIVE
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encouraged but not required to take the training. Providers are to complete the 4 hour General Training and 3 hour Child Care Provider Training. Licensing did not provide a copy of the mandated training certificate for herself or any other staff that provide care in the facility.

Nutrition Requirement: Beginning January 1, 2016, AB 290 will require for each new license issued, at least one director or teacher at each child care center or family child care home to have 15 hours of Preventative Health and Safety practices certification and at least one hour of training in the importance of childhood nutrition. This applies to anyone submitting a new application, relocating their facility, selling their facility or transferring their license. Please note this training cannot be completed online or by home study programs. The training must be taken from an Emergency Medical Services Authority (EMSA) approved training program OR an accredited college or university. LPA, Gutierrez did not observe certification during today’s visit for Licensee.

Assembly Bill 633: Upon receipt by the licensee, licensees are to provide to parents/guardians the following: Copies of any licensing reports that document a Type A citation- this includes facility visits and substantiated complaint investigations; copy of licensing documents pertaining to a conference conducted by a local licensing agency management representative and the licensee of this family child care home in which issues of noncompliance are discussed or copies of a summary of an accusation indicating the Department's intent to revoke the facility's license. Copies of any of the above licensing documents the licensee has received in the prior 12 months shall be provided to parents/guardians of newly enrolled child at the facility.





The Facility was found to be not in compliance per Title 22 Regulations and Health and Safety Codes. There will be Type B deficiencies cited during today’s visit. LPA, Gutierrez discussed the deficiencies and plan of correction requirements that are due 12/18/2019 and 12/27/2019.

An exit interview was conducted and a copy of this report along with the notice of site visit were provided to Licensee, Angel Dalpathado.

SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: DALPATHADO FAMILY CHILD CARE
FACILITY NUMBER: 197402369
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/11/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/27/2019
Section Cited

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H&S 1597.622
Employee and Volunteer Immunization
(a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer ...
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During today's inspection the requirement was not met. Licensee stated that both adult in home today has this requirement but she did not keep the records.
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Type B
12/27/2019
Section Cited

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102416
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.
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Based on today's observation this requirement was not met.
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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: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:
DATE: 12/11/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/11/2019
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: DALPATHADO FAMILY CHILD CARE
FACILITY NUMBER: 197402369
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/11/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/27/2019
Section Cited

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California Child Care Workers; Mandated Training Requirement. Beginning January 1, 2018, all licensed providers, applicants, directors and employees must complete Mandated Reported Training prior to March 30, 2018 and renew training every two years at: www.mandatedreporterca.com
Type B
12/18/2019
Section Cited

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(g) The home shall be free from defects or conditions which might endanger...
(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 Marshal.
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Based on today's observation this requirement was not met. Fire Extinguisher has not been serviced for more than two years.
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Type B
12/18/2019
Section Cited

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(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to:(4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if ...
-Based on today's observation this reuirement was not met.
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: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:
DATE: 12/11/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/11/2019
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: DALPATHADO FAMILY CHILD CARE
FACILITY NUMBER: 197402369
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/11/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/18/2019
Section Cited

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102417
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 be limited to(3) Where children less than five years old are in care, stairs shall be fenced or barricaded.

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Based on today's observation this need was not met.
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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: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:
DATE: 12/11/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/11/2019
LIC809 (FAS) - (06/04)
Page: 8 of 8