197492911-11-6-2024-58-CC-RLAA-DARSD6-20241106124637

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197492911
Report Date: 11/06/2024
Date Signed: 11/06/2024 12:46:46 PM

Document Has Been Signed on 11/06/2024 12:46 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	NEVAREZ FAMILY CHILD CARE		FACILITY NUMBER:	197492911
ADMINISTRATOR/ DIRECTOR:	NEVAREZ, ELIZABETH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 808-9365
CITY:	NORTH HILLS	STATE: CA	ZIP CODE:	91343
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 8	DATE:	11/06/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:20 AM
MET WITH:	Licensee, Elizabeth Nevarez		TIME VISIT/ INSPECTION COMPLETED:	01:00 PM

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) Roberto Luque Avila conducted an unannounced annual inspection to the above facility on 11/6/2024. LPA arrived at the facility at 9:20AM, identified self and met with Elizabeth Nevarez, Licensee who guided analyst on a tour of the facility. LPA provided Licensee with a copy of the LIC 126 Entrance Checklist to help facilitate the inspection. LPA observed 8 children 1 staff upon arrival. Per Licensee, operation hours are Monday through Friday 6:30AM to 6PM. There are 12 children that are currently enrolled. The licensee is observed to be operating within the license capacity limitations. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted. This is a one story home which consists of 4 bedrooms, 2 bathrooms, kitchen, dining room, living room, family room, garage, front yard and backyard. The children use the bathroom #1 in the hallway. The restroom that children use was observed to be safe and sanitary. LPA observed that there is a fireplace in the family room and it is screened. Per Licensee, areas off limits are bedroom #1, bedroom #2, bedroom #3, bedroom #4, bathroom #2 and garage, these areas are made inaccessible by locked doors. The licensee does not provide meals to children in care and LPA observed lunch boxes with the childrens name on them. 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 cellphone that is used and the cellphone stays at the facility during operation hours. The facility has central air ventilation. Safe toys, play equipment and materials were observed. Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. Page 1 of 4

Rita Ramos	TELEPHONE: (424) -301-3042
Roberto Luque Avila	TELEPHONE: (424) 301-3059
	DATE: 11/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024

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 5

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: NEVAREZ FAMILY CHILD CARE	FACILITY NUMBER: 197492911
	VISIT DATE: 11/06/2024

NARRATIVE

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Poisons are locked in the garage which is inaccessible by a locked door.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 8/19/24, as indicated on service tag. A smoke and carbon monoxide detectors are located in the living room and were tested and are operable.

All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. Last drill has not been documented at this time, the last fire and disaster drill was conducted on March 2024. Technical Violation given at this time.

Licensee states that they are currently caring for one infant. Appropriate sleeping arrangements and cribs were observed. One crib for each infant in care was observed. Cribs or play yard did not hinder the entrance or exit from the sleeping space, mattresses shall be firm and covered with a fitted sheet that overlaps the underside so it cannot be dislodged. Cribs and play yards were observed to be free of loose articles and objects. No objects were observed to be hanging above or attached to the side of the crib. LPA did not observe any infants swaddled while in care. LPA advised the Licensee that infants shall be placed on their backs for sleeping and shall be supervised. Infants shall be checked every 15 minutes and the time of each 15-minute check shall be documented with child’s name, date, and labored breathing. At this time the Licensee does not have documentation of 15 min sleep checks for infant in care. The LIC 9227 Individual Infant Sleeping Plan shall be completed for each infant up to 12 months of age.

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.

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 [or facility representative] 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.-----Page 2 of 4

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) -301-3042
LICENSING EVALUATOR NAME: Roberto Luque Avila	TELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: NEVAREZ FAMILY CHILD CARE	FACILITY NUMBER: 197492911
	VISIT DATE: 11/06/2024

NARRATIVE

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LPA did not observe any children left in parked vehicles. Car seats shall only be used for transportation. LPA did not observe any children sleeping in car seats.

Licensee states that there are no firearms stored in the home.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 12/9/25. There are first aid supplies available.

LPA observed that the Licensee and employee do not have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file.

The licensee does have proof of immunization against influenza, pertussis, measles and TB clearance. .

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

There is a dog on the premises. Vaccinations dated 8/23/24 were observed and complete.

LPA did observe a pool in the backyard during the inspection and is in compliance with Title 22 regulations.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

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: Rita Ramos	TELEPHONE: (424) -301-3042
LICENSING EVALUATOR NAME: Roberto Luque Avila	TELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: NEVAREZ FAMILY CHILD CARE	FACILITY NUMBER: 197492911
	VISIT DATE: 11/06/2024

NARRATIVE

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LPA advised that if a child shows signs of illness he/she/they shall be separated from other children. Per licensee ill children are separated from other children, placed in the hallway and parents pick up their child.

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.

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/process

LPA advised the Applicant to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. 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.

The following deficiencies listed on the attached 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.

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

During the exit interview, the licensee, confirmed that there are no Registered Sex Offenders living in the facility.

Exit interview conducted, appeal rights and report were provided with the licensee Elizabeth Nevarez. -----Page 4 of 4

SUPERVISOR'S NAME: Rita Ramos	TELEPHONE: (424) -301-3042
LICENSING EVALUATOR NAME: Roberto Luque Avila	TELEPHONE: (424) 301-3059
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 11/06/2024 12:46 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: NEVAREZ FAMILY CHILD CARE	FACILITY NUMBER: 197492911
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/06/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record review, the licensee did not comply with the section cited above. Licensee and employee have not completed their mandated reporter training which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/22/2024
	Plan of Correction
1 2 3 4	Licensee will provide a certicifate of completion for the Mandated Reporter requirement by the POC due date.

Section Cited

Infant Safe Sleep

Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record review, the licensee did not comply with the section cited above. Licensee does not have record of 15 minute sleep log for infant in care which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/22/2024
	Plan of Correction
1 2 3 4	Licensee will provide a 15 min check log for infant in care by the POC due date.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Rita Ramos	TELEPHONE: (424) -301-3042
Roberto Luque Avila	TELEPHONE: (424) 301-3059
	DATE: 11/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024

LIC809 (FAS) - (06/04)

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