197493193-8-4-2021-54-CC-DGIS-C5KT5A-20210804142514

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197493193
Report Date: 08/04/2021
Date Signed: 08/04/2021 02:25:22 PM

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:	BUSTOS CORTEZ FAMILY CHILD CARE		FACILITY NUMBER:	197493193
ADMINISTRATOR:	BUSTOS CORTEZ, ALIN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 449-2335
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90018
CAPACITY:	14	CENSUS: 4	DATE:	08/04/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Alin Bustos-Cortez, Licensee		TIME COMPLETED:	02:45 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) Denise Gibbs conducted an unannounced annual required inspection at the above facility on 8/4/21 at 1:00PM. LPA met with Alin Bustos-Cortez, Licensee who guided analyst on a tour of the facility. There were four children child present when LPA arrived. Two day care children and licensee's two children under ten years old. This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen, living room, front yard and backyard (fenced). This property is a duplex, licensee lives in the front house. Back address is 1342 Exposition Blvd. Main care is provided in the living room and one bedroom (playroom). The children use the bathroom adjacent to the hallway next to the playroom. Per Licensee, areas off limits to children and parents include: 2 bedrooms (locked), kitchen (gated), and back yard. Hours of operation are Mon-Fri 23.5 hours. Individuals residing in the home have been discussed and noted. All adults present in the home have obtained a criminal record clearance or exemption. 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 operable telephone service at the facility. There is ventilation via fans and air conditioning unit and heat via portable heaters. The following was observed and reviewed during this inspection: LPA observed that cleaning products are stored in the off limits kitchen and in a locked cabinet under the bathroom sink. The licensee states that there are no poisons stored in the home. Isolation area for sick children waiting to be picked up is located on the covered porch in the front yard. ------------------Page 1

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2021

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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BUSTOS CORTEZ FAMILY CHILD CARE	FACILITY NUMBER: 197493193
	VISIT DATE: 08/04/2021

NARRATIVE

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The valve on the required 2A 10BC fire extinguisher indicates fully charged and was last purchased on 6/27/21 as noted on the purchase receipt. Smoke and carbon monoxide detectors were tested 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 playroom. The bathroom that children use was observed to be clean and free of hazards.

Infant Care: Currently licensee cares for one infant that is her child. Licensee does not care for any day care infants. LPA informed applicant of the new Safe sleep regulation, including LIC 9227 Infant Sleep Plan for infants under 12 months and provided PIN 20-24-CCP.

Currently, children are using the front yard for outdoor play. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that could be hazardous to children in care. There are no pools or spas, or other bodies of water.

Children’s records were reviewed for emergency information and are complete.

The licensee does have proof of Pediatric CPR and first aid, expiration date 2/2023, immunization against influenza, pertussis, and measles, and Mandated Reporter AB 1207 compliant Child Care Training Certificate on file, exp-4/2023.

LPA conducted COVID-19 Technical Assistance visit with licensee. LPA observed that licensee is still implementing COVID-19 precautions and procedures.

Incidental Medical Services (IMS):
The licensee states that she will not 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 ------Page 2

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2021

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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BUSTOS CORTEZ FAMILY CHILD CARE	FACILITY NUMBER: 197493193
	VISIT DATE: 08/04/2021

NARRATIVE

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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: http://www.ada.gov/childqanda.htm.

Health and Safety Code 1596.7996 Effective January 1, 2019, Child Care Centers and Family Child Care Homes are required to provide parents and guardians of children enrolled, enrolling or reenrolling in care with written information on the risks and effects of lead exposure, blood lead testing requirements and recommendations and options for locations of affordable blood lead tests. 2019 Lead flyer Provided.

Based on the LPA observations and records review no deficiencies will be cited today 8/4/21.

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 Alin Bustos-Cortez, Licensee, including, but not limited to Appeal Procedures and Appeal Rights.

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2021

LIC809 (FAS) - (06/04)

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