197413786-12-12-2019-30-CC-KSCT-BJSQK3-20191212111341

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197413786
Report Date: 12/12/2019
Date Signed: 12/12/2019 11:13:56 AM

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:	JIMENEZ FAMILY CHILD CARE		FACILITY NUMBER:	197413786
ADMINISTRATOR:	FIDENCIA & CHRIS JIMENEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(424) 675-4285
CITY:	HAWTHORNE	STATE: CA	ZIP CODE:	90250
CAPACITY:	14	CENSUS: 11	DATE:	12/12/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:54 AM
MET WITH:	Fidencia Jimenez		TIME COMPLETED:	11:28 AM

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

Licensing Program Analyst (LPA), Keyona Scott, conducted an unannounced Annual Random Inspection to ensure the health and safety of the Child Care Home according to Department Regulations and Health and Safety Codes. LPA arrived at the family child care home on 12/12/2019 at 8:54 AM. LPA met with Licensee's Assistant (Asst 1), Jose Leon, and was guided on a tour of the home. Licensee, Fidencia Jimenez, two assistants and 11 children in care were present during the inspection. Licensee, Christopher Leon, was present in the home and arrived in the child care room at 10:10 AM. All Adults present, residing and working in the home are fingerprint cleared and associated to the facility.

The home is a one story, three bedroom, two bathroom home with a living room, dining room and kitchen. The off-limit areas of the home are all three bedrooms, the living room, dining room and kitchen. The off-limit areas of the hone are made inaccessible by closed half door at the entrance of the childcare room from the kitchen. There is a direct entrance into the childcare room, located at the side of the home. Parents drop-off and pick-up children from childcare entrance door. The primary child care room is located to the rear of the home property. LPA observed two table and chair sets, toys, cubbies, bed, crib, swing sets and high chair in the childcare room. The children utilize the bathroom located directly in the childcare room. LPA obtained an updated facility sketch of the home during the inspection.

The home was inspected 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. Home utilizes heating ventilation air conditioning system as a heating and cooling source. Home has a working telephone. Hazardous materials in the kitchen and bathroom are inaccessible to children. According to the Licensee, there are no weapons or firearms at the home; None were observed by LPA. Per Licensee, there are no pets in the home; none were observed by LPA.

The home is equipped with a fully charged fire extinguisher which is at least a 2A:10BC. The home is also equipped with a working dual smoke detector and carbon monoxide detector. There is also a first aid kit equipped in the home. LPA observed current First Aid and CPR certificate for Licensee, Fidencia Jimenez with an expiration date of 12/01/2020 and Assistant 2 (Asst 2) with an expiration date of 12/15/2020.

Page 1

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Keyona Scott	TELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019

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 3

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: JIMENEZ FAMILY CHILD CARE	FACILITY NUMBER: 197413786
	VISIT DATE: 12/12/2019

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
26
27
28
29
30
31
32

Toys and playthings are safe, orderly and age-appropriate for the children. Licensee agrees that no baby-walkers, bouncers, jumpers, exersaucers and similar items will be used for children in care and are kept inaccessible; None were observed by LPA.

Outside play for the children is conducted at a local park. Per Licensee, obtained written permission from the parents of the children enrolled to transport the children.

LPA observed current Child Care Facility Roster of the children enrolled. There are currently 13 children enrolled at the facility.

LPA observed current Fire Disaster Drill log. Licensee has conducted fire disaster drills at least once every month as required.

The facility operation hours are Monday through Friday, 5:00 AM to 7:00 PM.

Licensee states is not providing IMS (Incidental Medical Services) services at this time.

Update on Incidental Medical Services: 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

The following was thoroughly discussed with Licensee:

All adults living and working in the home must be fingerprinted and cleared prior to entering the facility. The licensee was informed that the presence of adults in the home without Criminal Record Clearance or Exemption will be cited and civil penalty assessed for $100 per day. The licensee may find additional information and forms on the DSS website at www.ccld.ca.gov including information on the Live Scan application (LIC 9163). Appointments can be made for Live Scan at 1-800-315-4507.

Licensee was reminded it is the Licensee’s responsibility to know the regulations as well as anyone who assists in providing care. Licensee was advised on how to access quarterly reports, forms, and regulations for Child Care online at www.ccld.ca.gov. Licensee was also encouraged to read the Child Care quarterly updates every season as the come out to stay informed of any changes or updates to the regulations.

Mandated Reporter: Beginning on January 1, 2018, AB 1207, 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. Volunteers are encouraged but not required to take the training. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/.

Page 2

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Keyona Scott	TELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: JIMENEZ FAMILY CHILD CARE	FACILITY NUMBER: 197413786
	VISIT DATE: 12/12/2019

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
26
27
28
29
30
31
32

Licensee was also reminded that only children eating may be in high chairs and that car seats are utilized only for transportation.

Licensee was reminded that all infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome), and that the Provider is required to wash hands after every diaper change and to never shake a baby to prevent the Shaken Baby Syndrome

The licensee was also recommended the following Safe Sleep Practices: always place infants on their backs for sleeping; use only a tight-fitting sheet on the crib or play yard mattress; do not hang any items from the crib or above the crib; keep all items, including blankets, out of the crib or play yard; pacifiers may be used as long as they do not have items attached to them; infants should not be swaddled or have any items covering them while sleeping; the temperature of the room should be comfortable enough for an adult to wear a t-shirt and not be too hot or too cold. Please note, these guidelines are recommendations for best practices only, until regulations are approved and adopted.

The licensee was advised that, once licensed, the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, (Type A violation), a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed.

Licensee was provided the following forms/brochures:

PIN 19-02-CCP: Safe Sleep Awareness Campaign, SafeBaby2indd- Safe Sleep
NIH Pub. No. 18-HD-5759: What Does A Safe Sleep Environment Look Like?
A Child Care Provider's Guide to Safe Sleep, Safe Sleep in Child Care
PUB 271: Preventing Shaken Baby Syndrome/Abusive Head Trauma
PIN 19-10-CCP U.S. Consumer Product Safety... Fisher-Price Infant Equipment Accessory Recall
PIN 19-12-CCP U.S. Cosumer Product Safety... Infant Sleeper Recall
Effects of Lead Exposure
PIN 19-09-CCLD Division Mailchimp Account Information... Subscribe For Updates

The facility was operating in substantial compliance during this inspection on 12/12/2019. There were no Title 22 Deficiencies cited.

New Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment

An exit interview was conducted, and a copy of this report (LIC 809), Advisory Notes- Technical Violation (LIC 9102TV) along with appeal rights were given to Licensee, Christopher Leon, whose signature confirms today's inspection and report.

Page 3

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Keyona Scott	TELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019

LIC809 (FAS) - (06/04)

Page: 3 of 3