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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197418259
Report Date: 12/12/2023
Date Signed: 12/12/2023 10:47:26 AM


Document Has Been Signed on 12/12/2023 10:47 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:VALENCIA FAMILY CHILD CAREFACILITY NUMBER:
197418259
ADMINISTRATOR:VALENCIA, ADAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 874-9260
CITY:SAN PEDROSTATE: CAZIP CODE:
90731
CAPACITY:14CENSUS: 0DATE:
12/12/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Licensee, Ada ValenciaTIME COMPLETED:
11:00 AM
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On 12/12/2023 at 9:00am, Licensing Program Analyst (LPA), Sarah Garcia conducted an unannounced Required Inspection at the above-mentioned facility. LPA was greeted by licensee, Ada Valencia. During the initial inspection, LPA observed 0 children in care. Licensee currently does not have children enrolled in care as of 2019. Present during today's inspection was licensee's husband. When the facility is open it operates Monday through Friday from 6:00 a.m. to 6:00 p.m. Currently licensee is available to care for children 0 years old to 12 years old. Facility is Large Family Child Care Home with a max capacity of 14.

LPA toured the home inside and outside. The home is a single family home with 3 bedroom and 2 bathroom, living room dining room, kitchen area, laundry area, outdoor area, attached garage (play area), and pool area. Licensee confirmed the following areas are designated for day care only: Attached garage (play area), bathroom #1, and outdoor area. LPA inspected the living room and observed the space to be clean and orderly. LPA inspected the attached garage (play area) and observed age-appropriate toys, materials, and books. The bathroom that children use is located inside the hallway near the living room. LPA inspected the bathroom and did not observe any medications, toxins or cleaning compounds as accessible. LPA inspected the kitchen and dining room and observed the knives and sharp objects on the counter. Licensee stated that when children are in care the knives and sharp objects are placed on the top cabinet. LPA did not observe any medications or cleaning compounds in the kitchen. LPA inspected the laundry area next to the living room and observed the cleaning compounds on the top shelf making it inaccessible.

The following areas are OFF LIMITS to the children in care: Bedroom #1, Bedroom #2, bedroom #3, bathroom #2, dining room, living room, laundry room, pool area, kitchen area.

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SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Sarah GarciaTELEPHONE: (424) 301-3066
LICENSING EVALUATOR SIGNATURE:
DATE: 12/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/12/2023
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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Document Has Been Signed on 12/12/2023 10:47 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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: VALENCIA FAMILY CHILD CARE
FACILITY NUMBER: 197418259

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(5)(A)
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: (5) All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence. (A)Fences shall be at least five feet high and shall be constructed so that the fence does not obscure the pool from view. The bottom and sides of the fence shall comply with Division 1, Appendix Chapter 4 of the 1994 Uniform Building Code. In addition to meeting all of the aforementioned requirements for fences, gates shall swing away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate. Pool covers shall be strong enough to completely support the weight of an adult and shall be placed on the pool and locked while the pool is not in use.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above by having a pool that is not self-closing which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 12/13/2023
Plan of Correction
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Licensee will repair the self-closing device on the pool fence. Licensee will send a picture and video of the self-closing device to LPA phone (916) 605-9569 by 5pm on 12/13/2023.

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: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Sarah GarciaTELEPHONE: (424) 301-3066
LICENSING EVALUATOR SIGNATURE:
DATE: 12/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/12/2023
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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: VALENCIA FAMILY CHILD CARE
FACILITY NUMBER: 197418259
VISIT DATE: 12/12/2023
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LPA inspected the outdoor area and observed safe toys and play equipment. Outdoor area is clean and free from debris. The outdoor area is properly fenced and supervised at all times.

On the south side of the home there is a pool on the premises. The pool has a five foot mesh fence that swings away from the pool and has a latching device six inches from the top of the fence. The fence is not self-closing. LPA will develop a plan of correction (POC) with licensee. LPA took photographs and videos of the pool.

Per licensee, there is (1) dog in the home. Dog remain locked on the outside of the home.



All electrical outlets were observed to be covered. LPA reminded licensee to ensure all areas that have been designated as OFF LIMITS need to have doors closed, locked, and made inaccessible when children are present.

LPA observed licensee test the carbon monoxide detector in the home. LPA observed licensee test the smoke detector in the home. One working fire extinguisher 2A10BC was observed. LPA observed first aid kit with Band-Aids and gauze. LPA advised licensee to purchase a thermometer. There are no firearms or ammunition on the premises.

Licensee currently does not administer medication. Adequate ventilation for safety and comfort were observed in the space. The home has working telephone service and LPA confirmed the phone number (310) 874-9260.

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.

Capacity as specified on the license is being maintained during today’s inspection.

LPA did not review children's files as the licensee does not have children enrolled as of 2019. LPA discussed all necessary forms needed in each children’s file and provided licensee with the LIC 311D- Records to be maintain in the facility and provided licensee with a current copy to use as a reference when auditing files.

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SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Sarah GarciaTELEPHONE: (424) 301-3066
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023
LIC809 (FAS) - (06/04)
Page: 5 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: VALENCIA FAMILY CHILD CARE
FACILITY NUMBER: 197418259
VISIT DATE: 12/12/2023
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LPA reviewed licensee's Pediatric CPR and first aid and observed a certification with an expiration date of 09/2025. LPA reviewed Licensee’s Mandated Reporter training and observed certificate with a expiration date of 03/2021. LPA developed a POC with licensee and provided the Website: www.mandatedreporterca.com.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.



LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage 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) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

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

During the exit interview, the LICENSEE Ada Valencia, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Sarah GarciaTELEPHONE: (424) 301-3066
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023
LIC809 (FAS) - (06/04)
Page: 6 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: VALENCIA FAMILY CHILD CARE
FACILITY NUMBER: 197418259
VISIT DATE: 12/12/2023
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Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809D) Licensee was provided with a copy of appeal rights.

LPA Sarah Garcia informed licensee Ada Valencia that this report dated 12/12/2023 document(s) (1) Type A citation(s) which shall be posted for 30 consecutive days as there are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Garcia informed the licensee to provide a copy of this licensing report dated 12/12/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report along with appeal rights was reviewed with the licensee, Ada Valencia .

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website atwww.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

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SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Sarah GarciaTELEPHONE: (424) 301-3066
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023
LIC809 (FAS) - (06/04)
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