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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197412464
Report Date: 03/05/2024
Date Signed: 03/06/2024 08:42:45 AM


Document Has Been Signed on 03/06/2024 08:42 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:BERMUDEZ FAMILY CHILD CAREFACILITY NUMBER:
197412464
ADMINISTRATOR:BERMUDEZ, TRACYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 886-0417
CITY:HAWTHORNESTATE: CAZIP CODE:
90250
CAPACITY:14CENSUS: 8DATE:
03/05/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Tracy BermudezTIME COMPLETED:
03:30 PM
NARRATIVE
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On 3/5/2024, Licensing Program Analysts (LPA) Ranita Richmond and Judy Laureano conducted an unannounced visit to the above-named Home to conduct the Required 3-year Annual Inspection. LPAs were greeted by Licensee Tracy Bermudez. LPA Richmond observed 1 infant, 1 school age, and 6 preschoolers in care, being supervised and cared for appropriately by licensee and assistant. Hours of operation are Monday through Friday, 7:30am – 4:30pm. Licensee provides before and after school care. Licensee provides transportation services. Licensee provides meals, snacks and water.

At the end of inspection eleven children present outside playing and two children indoors sleeping.

LPAs toured the home inside and outside for a Health and Safety inspection.

LPAs confirmed that the home consists of living room, dining room, kitchen, den, 3 bedrooms, 2 bathrooms, detached converted garage, and fenced backyard.

The ON LIMIT AREAS are as follows: living room (napping room), dining room (eating area), den (main day care area) bathroom #1, detached converted garage (additional recreation area) and fenced back yard.

The OFF-LIMIT AREAS are as follows: kitchen, bedroom #1, bedrooms #2 and #3, and bathroom #2 all of which are inaccessible to children in care by closed and/or locked doors and visual supervision.

Licensee is aware that the children must nap and have meals in the home.

LPA Richmond observed a fully charged 2A:10B:C Fire Extinguisher, a working smoke detector and carbon monoxide detector in the main daycare area (den). LPAs recommended adding additional working smoke detector and carbon monoxide detector in the converted garage area because children are frequently located in the garage area.
SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Ranita RichmondTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:
DATE: 03/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/05/2024
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


Document Has Been Signed on 03/06/2024 08:42 AM - 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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: BERMUDEZ FAMILY CHILD CARE
FACILITY NUMBER: 197412464

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/05/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(4)
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: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in1 of 1. Licensee did not secure multiple cleaning and or chemicals throughout the home which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/12/2024
Plan of Correction
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Licensee moved all chemicals and cleaning supplies to locked cabinets, containers, and or locked off limit rooms while LPAs were present.
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 observation, interview, and record review, the licensee did not comply with the section cited above. Licensee and assistant do not have valid mandated reporter training complete which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/12/2024
Plan of Correction
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Licensee and assistant will complete mandated reporter training and will submit proof to LPA via email.
Mandated reporter training: www.mandatedreporter.ca.com
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: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Ranita RichmondTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:
DATE: 03/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/05/2024
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
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: BERMUDEZ FAMILY CHILD CARE
FACILITY NUMBER: 197412464
VISIT DATE: 03/05/2024
NARRATIVE
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There are no firearms or ammunition on the premises.

LPAs observed chemical sprays (top bin-bathroom), ant and roach spray(kitchen on top of refrigerator and top shelf-garage), Lysol spray(top shelf-garage), Pinesol (top shelf-garage),awesome(top shelf-garage), bug spray(top shelf-garage) and detergent(on top of washing machine-garage). Children were not present in areas where chemicals were stored. Type B citation issued. Licensee made detergents, cleaning compounds, and other hazardous items inaccessible to children in care by using locked containers, cabinets, or storing in locked off limit areas while LPAs were present.

There are no pools, ponds or other bodies of water on the premises.

LPAs observed age-appropriate toys, books and furnishings. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts.

LPAs reviewed 6 children’s files and observed them to be in compliance as they contained current contact information for authorized representatives and/or relatives who can assume responsibility for the child, and authorization for medical treatment, signed Parent’s Rights.

LPA Richmond observed the licensees updated CPR/First Aid taken 10/05/23, assistant CPR taken 05/05/22. LPAs advised licensee of the importance of using EMSA approved vendors.



LPAs reviewed staff files. Current Mandated reporter training is needed. Type B citation issued.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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.

Incidental Medical Services (IMS) are not currently being provided. Licensee is open to taking children that need medication. Prescription medications shall be administered in accordance with the label directions as prescribed by the child’s physician. Medications should be in its original content with all necessary LIC forms completed.

SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Ranita RichmondTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: BERMUDEZ FAMILY CHILD CARE
FACILITY NUMBER: 197412464
VISIT DATE: 03/05/2024
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Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA Richmond reminded Licensee of the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Licensee 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.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&R) throughout California.


During the exit interview, Licensee Tracy confirmed that there are no Registered Sex Offenders living in the home.

Deficiencies were cited today, per Title 22 Regulations and Health and Safety Codes. See LIC 809D.

An exit interview was conducted, a copy of this report was read and provided to Licensee Tracy Bermudez.

Notice of Site Visit was provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Ranita RichmondTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2024
LIC809 (FAS) - (06/04)
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