197493287-8-21-2019-54-CC-JMOA-BF9QSD-20190821122521

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197493287
Report Date: 08/21/2019
Date Signed: 08/21/2019 12:25:32 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:	URIZAR FAMILY CHILD CARE		FACILITY NUMBER:	197493287
ADMINISTRATOR:	URIZAR, SANDRA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 815-5336
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90062
CAPACITY:	14	CENSUS: 7	DATE:	08/21/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:31 AM
MET WITH:	Sandra Urizar		TIME COMPLETED:	12:40 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) Judy Mora conducted an unannounced Annual/random inspection. LPA met with licensee, Sandra Urizar, who guided analyst on a tour of the facility. The licensee's husband Abilio Urizar, was also present. There were 7 children present. Licensee states that there are currently 08 children enrolled, children's roster was reviewed and was observed to not be current; this is a potential risk to the health and safety of children in care. Disaster drill log was available, last drill documented was 08/10/19. This is a single story dwelling located in a gated community of homes. The home consists of 5 bedrooms, 2 bathrooms, kitchen, living room, and backyard (fenced). The children use one bathroom (in bedroom), one bed room, living room and backyard. Per licensee, areas off limits to children and parents include: 4 bedrooms, licensee's bathroom and kitchen. There is a kiddie gate blocking kitchen entrance. There is also a kiddie gate blocking the hallway on the left side of the living room. The hallway and bedroom are used in order to get to the backyard. The LPA toured all areas used by children during this visit. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for safety and comfort. There is a wall heater in the living room which is inaccessible. There is a ceiling fan in the living room. There is a working telephone service maintained in the home. Family members residing in the home are 4 adults (criminal record clearances on file) and 1 child. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible in all areas of the home. The licensee states that there are no poisons in the home. The licensee does understand that poison must be locked with a key or combination lock. Per licensee, there are no weapons, or firearms on the premises. LPA did observe an above ground pool at the entrance of the gated community which was covered and no ladder for entry. Per Licensee, children are not taken to that area. They are kept in the home and in the gated backyard. There were safe toys, play equipment and materials observed for children. *REPORT CONTINUES ON THE NEXT PAGE

SUPERVISOR'S NAME: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Judy Mora	TELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2019

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: URIZAR FAMILY CHILD CARE	FACILITY NUMBER: 197493287
	VISIT DATE: 08/21/2019

NARRATIVE

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No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility. Effective January 1, 2010, licensees of family child care homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.

LPA reviewed and issued the LIC 311 - Forms/Records to Keep in Your Family Child Care Home.
CHILDREN’S FORMS/RECORDS, FACILITY FORMS/RECORDS and INFORMATION TO BE POSTED, Disaster drills, posting requirements, children records requirements, mandated child abuse and injury/ death reporting, criminal record transfer requirements, criminal record and child abuse clearances were also discussed during this visit.

The licensee’s email address was obtained during this visit. The licensee was advised that email is public information.

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

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

The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22 and/or the Health and Safety Code. Please see attached LIC 809d. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

Exit interview was conducted with Licensee. The Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

*END OF REPORT

SUPERVISOR'S NAME: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Judy Mora	TELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2019

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: URIZAR FAMILY CHILD CARE	FACILITY NUMBER: 197493287
	VISIT DATE: 08/21/2019

NARRATIVE

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Emergency Disaster Plan was posted at the time of visit. LPA advised Licensee to complete an updated LIC 610 (Emergency Disaster Plan) for regional office file; form was provided. Children’s records were reviewed to ensure that each child has an Identification and Emergency form. LPA observed that children #'s 5, 6 & 7 do not have a current file and no Identification and Emergency form are available; this is a potential risk to the health and safety of children in care. The valve on the required 2A 10BC fire extinguisher indicates fully charged (serviced 03/11/19). Smoke detector and carbon monoxide detector in the bedroom were tested, and are in operable condition. The licensee has current Pediatric First Aid and CPR, which will expire 02/2020. Licensee's husband also has current Pediatric First Aid & CPR certification, expires 05/12/20.

Incidental Medical Services (IMS) policy was discussed. Per Licensee, there are no children on medication. 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) 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

SB792 (Immunization Requirements for Staff and Employees) was discussed with the Licensee. The Licensee and Licensee's husband have current immunization.

AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: https://www.mandatedreporterca.com/training/child-care-providers. Licensee has completed the Mandated Reporter Training, certificate is on file dated 06/16/2018.

The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed.

The following was discussed: Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.

*REPORT CONTINUES ON NEXT PAGE

SUPERVISOR'S NAME: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Judy Mora	TELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2019

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: URIZAR FAMILY CHILD CARE	FACILITY NUMBER: 197493287
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/21/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/31/2019 Section Cited CCR 102417(g)(7)	1 2 3 4 5 6 7	Operation of a Family Child Care Home An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the	1 2 3 4 5 6 7	Licensee states she will complete children's file and submit a copy to LPA by POC due date of 08/28/19.
	8 9 10 11 12 13 14	parent's authorization for the licensee or registrant to consent to emergency medical care. This requirement was not met as evidenced by childrens file review. LPA observed that children #'s 5, 6 & 7 do not have a current file and no Identification and Emergency form are available; this is a potential risk to the health and safety of children in care.	8 9 10 11 12 13 14
Type B 08/31/2019 Section Cited CCR 102417(8)	1 2 3 4 5 6 7	Operation of a Family Child Care Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement was not met as evidenced by review of facility roster. LPA observed roster to not be current. This is a potential risk to the health and safety of children in care.	1 2 3 4 5 6 7	Licensee states she will complete children's roster and submit a copy to LPA by POC due date of 08/28/19.
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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: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Judy Mora	TELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2019

LIC809 (FAS) - (06/04)

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