197409407-1-13-2020-12-CC-IORA-BKSSK2-20200113125602

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197409407
Report Date: 01/13/2020
Date Signed: 01/13/2020 12:56:13 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME:	ARRIOLA FAMILY CHILD CARE		FACILITY NUMBER:	197409407
ADMINISTRATOR:	ARRIOLA, MARYCRUZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 890-7331
CITY:	PACOIMA	STATE: CA	ZIP CODE:	91331
CAPACITY:	14	CENSUS: 8	DATE:	01/13/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Marycruz Arriola		TIME COMPLETED:	12:55 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	On 1/13/2020 Licensing Program Analyst (LPA) Isabel Ortega conducted an unannounced annual random inspection. The LPA met with licensee Marycruz Arriola who guided the LPA on a tour of the facility. Upon entry to the facility the LPA observed 8 children in care. This is a one story family home with one second story bedroom. There is a living room, den, kitchen, ½ kitchen(in the playroom), dining room, five bedrooms and three restrooms. Main care is provided in a permit approved attached side room which is referred to as the playroom. The children use the bathroom located in the playroom. There is a child safety gate barricading the ½ kitchen. The off-limits areas are the five bedrooms, two restrooms, living room, den, dining room, kitchen (in the main home), LPA observed a door key locked separating the main home from the playroom. The day care home provides breakfast, morning snack, lunch, afternoon snack, and dinner and evening snack. According to Licensee she is currently participating in a Food Nutrition Program. According to Licensee the operating child care hours vary depending on the children's family need Monday thru Sunday. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. The medications are kept in a locked cabinet inaccessible to children (LPA observed a child safety lock). All cleaning supplies are stored in a locked cabinet inaccessible to children (LPA observed a child safety lock). There are age appropriate toys and equipment on the premises. Per the licensee there are no weapons or firearms of any kind in the facility. The LPA did not observe any weapons.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2020

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: ARRIOLA FAMILY CHILD CARE	FACILITY NUMBER: 197409407
	VISIT DATE: 01/13/2020

NARRATIVE

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The First Aid kit was observed and complete. The required fire extinguisher (2A10BC) is in green and purchased from Costco on 2/05/2019(receipt provided). The smoke and carbon monoxide detector(dual) are in operable condition and meets the fire marshal standards. Fire and disaster drills are conducted monthly, last emergency drill was conducted on Jan. 03, 2020 at 9:50 AM. Licensee's Pediatric CPR and First Aid certificate expires on 7/20/2021.

Licensee had all the required posted documents: Facility License (LIC 203, Notice of Parent's Rights Poster (PUB 394), Emergency Disaster Plan (LIC 610A), and Earthquake Preparedness Checklist (LIC 9148)

The licensee and Assistant provided proof of immunization against pertussis (TDAP), measles (MMR), and influenza.

Licensee and Assistant demonstrated proof of Mandated Reported Training certificate dated 3/20/2019.

The LPA observed a current child roster. Child files were found to be complete.

The front yard is gated all around. The outdoor play area was inspected and was observed to be free of hazards, loose and sharp parts. There are two sinks for hand washing and a large shaded area was observed.

The following were discussed: No smoking, infant walkers, Johnny jumpers, exersaucers and any other item that falls into that category are permitted in the facility. The LPA also discussed earthquake safety and necessity of drills, required forms for children’s files, facility files and posting requirements and penalty.

The licensee was informed that all adults living in or having access to 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 up to $500, per non-cleared adult will be assessed immediately. Please advise your analysis of any person who will be visiting regularly or for longer than #1 week.
Safe Sleep new upcoming regulations were discussed with Licensee and referred to the CCL web site for additional information and PINS.

Went over new immunization new regulations and requirements which were effective 7/01/2019. New Regulation regarding varicella(chickenpox) vaccination now due at 15 months month instead 18 months.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2020

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: ARRIOLA FAMILY CHILD CARE	FACILITY NUMBER: 197409407
	VISIT DATE: 01/13/2020

NARRATIVE

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Beginning on January 1, 2018, Assembly Bill 1207 (2015) 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. Applicants must meet requirements as a precondition to licensure. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com.

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

Child Care Advocates:

To sign up for our Quarterly Updates please email the Child Care Advocates at
chilcareadvocatesprogram@dss.ca.gov & (916) 654-1541

The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot-line at 1-800-540-4000.

The facility was in compliance per Title 22 regulations, no deficiencies will be cited today 1/13/2020. An exit Interview was conducted, a copy of this Report, Appeal rights and a Notice of Site visit was provided to the licensee Marycruz Arriola.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2020

LIC809 (FAS) - (06/04)

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