197413379-5-12-2022-30-CC-DWHE-CECPGW-20220512111857

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197413379
Report Date: 05/12/2022
Date Signed: 05/12/2022 11:19:07 AM

Document Has Been Signed on 05/12/2022 11:19 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	ESTRADA FAMILY CHILD CARE		FACILITY NUMBER:	197413379
ADMINISTRATOR:	ESTRADA, ORALIA A.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 897-1769
CITY:	HAWTHORNE	STATE: CA	ZIP CODE:	90250
CAPACITY:	14	CENSUS: 2	DATE:	05/12/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:23 AM
MET WITH:	Oralia Estrada		TIME COMPLETED:	11:30 AM

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On 05/12 /22 Licensing Program Analyst (LPA), Doris Whitmore conducted an unannounced Required 1-year inspection and was met by Licensee, Oralia Estrada. Also present was Staff#1 (S1). Days and Hours of Operation are Monday- Friday 7:30a.m. to 5:30p.m.

LPA toured the home inside and outside and a census was taken. Current facility sketch was reviewed. The home is a two story, five-bedroom, four-bathroom home with a living room, dining room, kitchen and detached garage. Per Licensee, no childcare is conducted in the detached garage. The off-limit areas of the home is the second level of the home. There are three bedrooms and two bathrooms located on the second level of the home. The second floor of the home is off-limits to the children in care and made inaccessible by safety gate at the stairway entry from the dining room area. The children utilize the master bedroom located on the first floor of the home. The master bedroom has been converted into a playroom. LPA observed kitchen play set, blocks, activity carpet, toy chest and play costumes. There is a bathroom located in the master bedroom that is utilized by the children in care. The laundry room is located in the master bedroom adjacent from the master bathroom. The laundry room is made inaccessible to children in care by closed door during operation hours. There is also a bathroom that is located across from the dining room that the children utilize on occasion. The bedroom adjacent to the bathroom is utilized as a napping area. LPA observed a bed and napping cots in the bedroom. LPA also observed safety latch and lock on the kitchen drawer and sink cabinet There is a safety gate at the entrance of the kitchen. Outside play is conducted in the backyard. The outdoor play area is fully fenced in and also is free from defects or dangerous conditions. LPA observed age-appropriate toys and playthings in the outdoor play area.

There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. Firearms and ammunition are stored and locked separately. All poisons are kept in a locked storage area. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible Page 1

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Doris Whitmore	TELEPHONE: 424-301-3029
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2022

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ESTRADA FAMILY CHILD CARE	FACILITY NUMBER: 197413379
	VISIT DATE: 05/12/2022

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There are no fireplaces or open face heaters in the home. There is a working fire extinguisher, smoke/carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no stairs in this home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (310) 897-1769

There are currently no infants in care. LPA discussed Safe Sleep Regulations with licensee. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

Licensee ensures that children in care are always supervised and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed one file missing the Affidavit Regarding Liability Insurance. The Licensee’s Mandated Reporter Training was completed on 02/26/22 Licensee’s pediatric CPR/First Aid expires on 8/22. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

Incidental Medical Services (IMS) are / are not currently being provided. 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 and Licensee discussed 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. Page2

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Doris Whitmore	TELEPHONE: 424-301-3029
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2022

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ESTRADA FAMILY CHILD CARE	FACILITY NUMBER: 197413379
	VISIT DATE: 05/12/2022

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All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Doris Whitmore	TELEPHONE: 424-301-3029
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2022

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ESTRADA FAMILY CHILD CARE	FACILITY NUMBER: 197413379
	VISIT DATE: 05/12/2022

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Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited:(See next page,809D) Licensee was provided a copy of appeal rights.

An exit interview was conducted, and a copy of this report (LIC 809) along with appeal rights were given to Licensee, Oralia Estrada, whose signature confirms today's inspection and report.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

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SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Doris Whitmore	TELEPHONE: 424-301-3029
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2022

LIC809 (FAS) - (06/04)

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