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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414184
Report Date: 12/19/2022
Date Signed: 12/19/2022 11:39:19 AM


Document Has Been Signed on 12/19/2022 11:39 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 NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:VALENCIA FAMILY CHILD CAREFACILITY NUMBER:
197414184
ADMINISTRATOR:VALENCIA, R.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 264-9557
CITY:CANOGA PARKSTATE: CAZIP CODE:
91303
CAPACITY:14CENSUS: 5DATE:
12/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:18 AM
MET WITH:VALENCIA, RESURRECCION- LicenseeTIME COMPLETED:
12:05 PM
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On 12/19/2022 Licensing Program Analyst (LPA), Suzette Ornelas conducted an unannounced Annual Required Inspection and was met by Licensee, VALENCIA, RESURRECCION. Also present was Licensees Daughter (Assistant). Days and hours of operation are Monday through Friday 6am-6pm.

LPA toured the home inside and outside and a census was taken. LPA observed 5 children (1 infant). Current facility sketch reviewed and all areas identified on the facility sketch were inspected. Licensee's home is a single story dwelling with 3 bedrooms and 2 bathrooms. All three bedrooms and 1 bathroom are off-limits to children in care. Child care is provided mainly in the child care room. Children in care have access to the bathroom located in the hallway (restroom to the right). Children eat in the child care room. Licensee has made the kitchen and living room area inaccessible by placing a gate in the doorway between the kitchen and child care room. All other rooms are off-limits and made inaccessible by use of locked doors, gates and supervision. Children have access to the back yard for activities. The Fire Extinguishers (2A-10-BC) is mounted on the wall in the kitchen. There is a working smoke/carbon monoxide detector located in the living room and in the child care room. The required carbon monoxide detectors and smoke detectors are in operable condition.

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 First Aid kit was observed and complete. Per LIS the facility annual fees are current. The facility roster was observed, and current. There are age appropriate toys and napping equipment on the premises. Licensee has posted as required the License, and all other required postings in a visible location.


There are no firearms or ammunition on the premises. There is no swimming pool or other bodies of water on the premises. Fireplace located in the living room has a glass screen and is inaccessible to children in care. There are no stairs in this home.
SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Suzette OrnelasTELEPHONE: 424-301-3008
LICENSING EVALUATOR SIGNATURE:
DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/19/2022
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: VALENCIA FAMILY CHILD CARE
FACILITY NUMBER: 197414184
VISIT DATE: 12/19/2022
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There is currently 1 infant in care. LPA discussed Safe Sleep Regulations with licensee and provided a copy of the Infant Safe Sleep Regulation, a sample of an infant safe sleep log, a copy of the LIC 9227, and Frequently Asked Questions regarding Infant Safe Sleep packet. Licensee will begin to document infant sleep beginning today 12/19/2022. Licensee ensures that children in care are supervised at all times 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. LPA discussed the importance of ensuring that equipment is regularly inspected, dusted off as needed and removed if broken.

Capacity as specified on the license is being maintained. LPA reviewed 5 children's records and observed records were incomplete. LPA provided Licensee with copies of the CDPH 286 and information on ensuring form in filled out by licensee and kept in children’s file moving forward. An emergency fire/disaster drill has been completed and documented within the last 6 months. Licensee and Assistants pediatric CPR/First Aid is current. Licensee and Assistants Mandated Reporter Training is current. LPA provided information regarding the Mandated Reported Training regulation and the requirement to complete every two years. LPA reviewed staff files and observed staff files were complete. 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 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.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.
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. suzette.ornelas@dss.ca.gov
SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Suzette OrnelasTELEPHONE: 424-301-3008
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2022
LIC809 (FAS) - (06/04)
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