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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419150
Report Date: 02/08/2024
Date Signed: 02/08/2024 04:23:32 PM


Document Has Been Signed on 02/08/2024 04:23 PM - 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:FUENTES FAMILY CHILD CAREFACILITY NUMBER:
197419150
ADMINISTRATOR:FUENTES, ELSA E.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 953-5109
CITY:WILMINGTONSTATE: CAZIP CODE:
90744
CAPACITY:14CENSUS: 4DATE:
02/08/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Licensee, Elsa FuentesTIME COMPLETED:
04:45 PM
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On 02/08/2024 at 12:45pm, Licensing Program Analyst (LPA), Sarah Garcia conducted an unannounced Required Inspection at the above-mentioned facility. LPA was greeted by licensee, Elsa Fuentes. During the initial inspection, LPA observed 4 children in care. Present during today's inspection was licensee's spouse and child. All adults are fingerprint cleared. Facility 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 3 years old. Facility is Large Family Child Care Home with a max capacity of 14. Licensee does not provide transportation to children.

LPA toured the home inside and outside. The home is one-story home with 2 bedroom and 1 bathroom, living room, kitchen area, recreation room, and converted garage (day care area). Licensee confirmed the following areas are designated for day care only: Converted garage (Day care area). Per licensee, there is currently construction in the outdoor area. LPA instructed licensee that when construction is taking place such as alterations or additions to the home the Department should be notified. During the initial inspection, LPA inspected the living room and observed the space to be unclean with animal fecal matter. LPA observed licensee clean the living room area. LPA observed the living room to be clean. Licensee utilizes cribs and mats for sleeping children. LPA observed age-appropriate toys, materials, children's tables and books. LPA observed (3) tortoises in a tank. LPA inspected the kitchen and observed the knives and sharp objects to be out of reach to the children. LPA observed all poisons, detergents, cleaning compounds, medications and other items which can pose a risk to children in care on the top cabinet above the washer and dryer and made inaccessible.

The following areas are OFF LIMITS to the children in care: 2 Bedrooms, 1 bathroom, kitchen area, and outdoor area during construction.

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SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Sarah GarciaTELEPHONE: (424) 301-3066
LICENSING EVALUATOR SIGNATURE:
DATE: 02/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/08/2024
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
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: FUENTES FAMILY CHILD CARE
FACILITY NUMBER: 197419150
VISIT DATE: 02/08/2024
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LPA inspected the outdoor area and observed a swimming pool on the premise. LPA observed a pool with a slide in the outdoor area. The pool does not have a fence surrounding all sides. The pool does not meet licensing regulations. The pool was installed and completed on December 2023. LPA took photographs. A type A citation will be issued and civil penalty will be assessed. LPA discussed Plan of Correction (POC) with licensee. Per licensee, there is construction taking place on the outdoor area and the fence will be done once the construction is complete. There are two access points to the pool, one sliding door in the day care area and one door in the kitchen. Both doors have sensors. The sliding door in the day care has a sensor and a wooden stick on the bottom of the door making it inaccessible. LPA took videos and photographs. LPA consulted LPM Maureen Neal and LPM advised that by 02/15/2024, the licensee shall have a plan of action on what is to be done about the swimming pool in the backyard.

Per licensee, there are (2) dogs, (3) tortoises, and (6) birds in the home. LPA discussed the importance of making sure that parents know program has pets in the home. Dogs remain locked in off limits kitchen in the home and birds are in their cages inside and outside. There are no firearms or ammunition on the premises.



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 thermometer, gauze, and Band-Aids. Parents provide meals and snacks. LPA discussed the importance of maintaining a system where allergies and food restrictions are noted.

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) 953-5109.

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.

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

DATE: 02/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2024
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: FUENTES FAMILY CHILD CARE
FACILITY NUMBER: 197419150
VISIT DATE: 02/08/2024
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LPA reviewed 4 children’s files and observed files to be complete. LPA observed the earthquake and fire drill log. 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.

LPA reviewed licensee's Pediatric CPR and first aid certification and observed certification with an expiration date of 02/2024. Per licensee, they are enrolled to take the Pediatric CPR course on 02/17/2024. Licensee will send a copy of the receipt of enrollment to LPA via email. LPA reviewed licensee's Mandated reporter certification and observed certification with an expiration date of 11/2025.

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/.



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

DATE: 02/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2024
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: FUENTES FAMILY CHILD CARE
FACILITY NUMBER: 197419150
VISIT DATE: 02/08/2024
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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 Elsa Fuentes, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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 Elsa Fuentes that this report dated 02/08/2024 document(s) (1) Type A citation(s) and (2) Type B citation(s) which shall be posted for 30 consecutive days as there are immediate and potential 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 02/08/2024 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, Elsa Fuentes.

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 at www.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: 02/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2024
LIC809 (FAS) - (06/04)
Page: 4 of 8
Document Has Been Signed on 02/08/2024 04:23 PM - 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: FUENTES FAMILY CHILD CARE
FACILITY NUMBER: 197419150

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/08/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(5)
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.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above installing a swimming pool in the backyard. LPA observed a pool with a slide in the outdoor area. The does not have a fence surrounding all sides. The pool does not meet licensing regulations which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/15/2024
Plan of Correction
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Licensee will create an action plan by 02/15/2024 and inform LPA of the plan to install a mesh or metal fence surrounding the swimming pool and slide. Licensee will contact LPA via email or phone and inform them of the action plan by 5pm on 2/15/2024.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: 02/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/08/2024
LIC809 (FAS) - (06/04)
Page: 5 of 8


Document Has Been Signed on 02/08/2024 04:23 PM - 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: FUENTES FAMILY CHILD CARE
FACILITY NUMBER: 197419150

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/08/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in, licensee does not have measles immunization which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/15/2024
Plan of Correction
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Licensee will obtain measles immunizationa and send a copy to LPA via email at sarah.garcia@dss.ca.gov by 5pm on 02/15/2024.
Type B
Section Cited
CCR
102416.3(a)(3)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (3) Installation of in-ground or above-ground swimming pools, spas, fish ponds, decorative water feature, fountains or other bodies of water.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in, licensee did not inform the Department of the installation of the in-ground swimmng pool in the backyard. LPA observed a swimming pool in the backyard. Licensee stated that the pool was completed in December 2023 which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/15/2024
Plan of Correction
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Licensee will take the Family Child Care Home Orientation at ccld.ca.gov by 5pm on 2/15/2024. Licensee will write in a declaration what they learned and send to LPA email sarah.garcia@dss.ca.gov by 5pm on 02/15/2024.
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: 02/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/08/2024
LIC809 (FAS) - (06/04)
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