<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414317
Report Date: 10/17/2019
Date Signed: 10/17/2019 10:26:02 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:FUENTES FAMILY CHILD CAREFACILITY NUMBER:
197414317
ADMINISTRATOR:FUENTES, DORA A.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 203-0896
CITY:LOS ANGELESSTATE: CAZIP CODE:
90018
CAPACITY:14CENSUS: 2DATE:
10/17/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Dora Fuentes, LicenseeTIME COMPLETED:
10:40 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
INSPECTION CONDUCTED IN PARTIAL SPANISH
Licensing Program Analyst (LPA) Denise Gibbs conducted an unannounced annual random inspection to the above facility on 10/17/19 at 8:15 AM. LPA met with Dora Fuentes, Licensee who guided analyst on a tour of the facility. Also present during this inspection, was Franklin Fuentes, Licensee’s son who provided some translation. Per Licensee, there are 7 children that are currently enrolled. A current children’s roster was available for review. There were 2 children present upon arrival.

This is a one-story home which consists of 4 bedrooms, 2 bathrooms, kitchen, dining room, living room, laundry room, front yard and backyard (fenced). Main care is provided in the living room and dining and bedroom at the front of the house. The children use the bathroom located in the front bedroom. LPA observed that there is a fireplace in the living room and is barricaded. Per Licensee, areas off limits to children and parents include: dinning room, kitchen, 3 bedrooms, laundry room and 1 bathroom (baby gate separates all rooms). The licensee provides food for children in care. LPA observed food available in the refrigerator. Hours of operation are Mon-Fri 7am-5pm.

The licensee states that 3 adults currently live in the home. Per Licensee, she currently has one assistant. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed child care home. Licensee states that there are no firearms or weapons stored in the home.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a landline and a cellphone that is used facility during operation hours. There is ventilation and heating (ceiling fans).

The following was observed and reviewed during this inspection: ------------------Page 1
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019
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 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: FUENTES FAMILY CHILD CARE
FACILITY NUMBER: 197414317
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/17/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/18/2019
Section Cited

1
2
3
4
5
6
7
102417(g)(1) Operation of a Family Child Care Home
The home shall contain a fire extinguisher which meet standards established by the State Fire Marshal.

This requirement was not met as evidenced by:
8
9
10
11
12
13
14
Based on observation and interview licensee did not maintain documentation of fire extinguisher within State Fire Marshal regulation, which poses potential Health, Safety or Personal Rights risk to children in care.
8
9
10
11
12
13
14
Type B
11/18/2019
Section Cited

1
2
3
4
5
6
7
102417(g) Operation of a Family Child Care Home
The home shall be free from defects or conditions which might endanger a child.

This requirement was not met as evidenced by:
8
9
10
11
12
13
14
Based on observation and interview licensee did not keep the home free of defects that could endanger a child. LPA observed hazardous items in the outside play space, due to children not having access to this area at the time, this poses potential Health, Safety or Personal Rights risk to children in care.
8
9
10
11
12
13
14
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: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:
DATE: 10/17/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/17/2019
LIC809 (FAS) - (06/04)
Page: 6 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: FUENTES FAMILY CHILD CARE
FACILITY NUMBER: 197414317
VISIT DATE: 10/17/2019
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
All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. LPA did not observe a documented disaster drill log.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility.

Smoking is prohibited in a licensed Family Child Care Home. LPA did not observe anyone smoking in the home.

LPA discussed and provided the licensee with a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics and Helping you to reduce the risk of SIDS, updated Parent’s Rights Poster with Complaint Hotline information, Capacity Handout (Small & Large) and Never Shake a Baby pamphlet.

AB 1207: Beginning on January 1, 2018, this law 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. Website: www.mandatedreporterca.com

Senate Bill 792: this bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles.

Incidental Medical Services (IMS):
The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS at this time. 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)
-----Page 3
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019
LIC809 (FAS) - (06/04)
Page: 3 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: FUENTES FAMILY CHILD CARE
FACILITY NUMBER: 197414317
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/17/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/18/2019
Section Cited

1
2
3
4
5
6
7
1596.7995 Employees...at day care center; immunization requirements;...Commencing September 1, 2016, a person shall not be employed...at a day care center...has not been immunized against influenza, pertussis, and measles.
This requirement was not met as evidenced by:
8
9
10
11
12
13
14
Based on observation and record review licensee did not maintain proof of immunization's for herself at the facility. This poses a potential Health, Safety or Personal Rights risk to children in care.
8
9
10
11
12
13
14
Type B
11/18/2019
Section Cited

1
2
3
4
5
6
7
102417(9)(a) Operation of a Family Child Care Home
Each family child care home shall conduct fire drills and disaster drills at least once every six months.
This requirement was not met as evidenced by:
8
9
10
11
12
13
14
Based on observation and interview, licensee did not conduct an emergency drill within the last 6 months. LPA did not observe documented disaster drill, which poses a potential Health, Safety or Personal Rights risk to children in care.
8
9
10
11
12
13
14
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: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:
DATE: 10/17/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/17/2019
LIC809 (FAS) - (06/04)
Page: 5 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: FUENTES FAMILY CHILD CARE
FACILITY NUMBER: 197414317
VISIT DATE: 10/17/2019
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
Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock. The restroom that children use was observed to be clean and free of hazards.

The valve on the required 2A 10BC fire extinguisher indicates fully charged. LPA did not observe a service tag or purchase receipt indicating purchase or service within the year Smoke and carbon monoxide detectors were tested at and are operable.

The home is observed to be clean and orderly. There are toys and other age appropriate material available for children. Children nap on cots in the main care area. LPA observed 3 Infant playpens are visible in main care (Graco, Chicco) area and are free of hazards.

Currently, children are not playing outdoors. Per licensee when children play outdoors they use the right area of the front yard. LPA observed a broken rake, a power tool, and large tree trunks with sharp edges and splinters in the play area. Licensee states that children have not been outside since the summer and they will not go out until the yard is cleaned (LPA obtained declaration). LPA observed that the outdoor yard has toys and other materials for children to play with. There are no pools or spas, or other bodies of water. Licensee has 1 dog that remains outside during operating hours.

The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 1/31/2020. There are first aid supplies available.

Children’s records were reviewed, including emergency information and were observed to be complete.

The licensee does not have proof of immunization against influenza, pertussis, and measles. LPA observed that the Licensee does not have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file due to it not being in her primary language.

LPA issued a Confidential Names List (LIC 811) to the licensee which documents staff and children’s files reviewed during this inspection. ------Page 2
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019
LIC809 (FAS) - (06/04)
Page: 2 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: FUENTES FAMILY CHILD CARE
FACILITY NUMBER: 197414317
VISIT DATE: 10/17/2019
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
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.

LPA advised the licensee to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov.

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Dora Fuentes, Licensee and Franklin Fuentes (translator), including, but not limited to Appeal Procedures and Appeal Rights. -----------------------Page 4

SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019
LIC809 (FAS) - (06/04)
Page: 4 of 6