197493535-11-29-2023-30-CC-SGAA-CY2NBJ-20231129091912

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197493535
Report Date: 11/27/2023
Date Signed: 11/29/2023 09:19:20 AM

Document Has Been Signed on 11/29/2023 09:19 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:	MUTUC FAMILY CHILD CARE		FACILITY NUMBER:	197493535
ADMINISTRATOR:	MUTUC,CATHERINE&CHARMAINE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 308-6851
CITY:	WILMINGTON	STATE: CA	ZIP CODE:	90744
CAPACITY:	14	CENSUS: 9	DATE:	11/27/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Licensees, Catherine Mutuc & Charmaine Mutuc		TIME COMPLETED:	05:00 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

On 11/27/2023 at 2:30pm, Licensing Program Analyst (LPA), Sarah Garcia conducted an unannounced Annual Required Inspection at the above-mentioned facility. LPA was greeted by licensees, Catherine Mutuc and Charmaine Mutuc. Present during today’s inspection was, staff #1, Jaia Ballantyne and staff #2, Marta Rocio, and licensee's husband, Lawrence Mutuc.

During the initial inspection, LPA observed 9 children in care.

Facility operates Monday through Friday from 7:00 a.m. to 5:00 p.m. Currently licensees are available to care for children 18 months to 9 years old. Facility is Large Family Child Care Home with a max capacity of 14. Licensee does not provide transportation to the children.

LPA toured the home inside and outside. The home is a single-family home with 3 bedrooms and 2 bathrooms, play area, the living room, kitchen area, outdoor area, and garage. Licensees confirmed the following areas are designated for day care only: bedroom #1 (nap room), bathroom #1, living room as needed, play area, and outdoor area including deck area. The bathroom #1 that children use is located outside the play area. LPA inspected the bathroom #1 and observed safety latches under the two bathroom sinks to ensure medications, toxins or cleaning compounds are inaccessible to the children in care. LPA inspected the living room and observed the space to be clean and orderly. LPA inspected the play area and observed age-appropriate toys and materials. LPA inspected the bedroom #1 (nap room) and observed children's asleep on cots. LPA inspected the kitchen and observed the knives and sharp objects to be out of reach to the children. LPA observed a safety latch under the kitchen sink cabinet to ensure all poisons, detergents, cleaning compounds, medications and other items which can pose a risk to children in care made inaccessible.

The following areas are OFF LIMITS to the children in care: Bedroom #2, bedroom #3, bathroom #2, kitchen, and garage.
Page 1

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Sarah Garcia	TELEPHONE: (424) 301-3066
LICENSING EVALUATOR SIGNATURE:	DATE: 11/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023

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

Document Has Been Signed on 11/30/2023 03:21 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 11/30/2023 03:07 PM

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: MUTUC FAMILY CHILD CARE	FACILITY NUMBER: 197493535
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/27/2023

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
1 2 3 4	Based on observation, interview, record review, the licensee, Catherine Mutuc did not measles immunization which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/28/2023
	Plan of Correction
1 2 3 4	Licensee willl provide proof of measles immunizations to LPA via email by 5pm on 11/28/2023.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Sarah Garcia	TELEPHONE: (424) 301-3066
LICENSING EVALUATOR SIGNATURE:	DATE: 11/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023

LIC809 (FAS) - (06/04)

Page: 2 of 6

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: MUTUC FAMILY CHILD CARE	FACILITY NUMBER: 197493535
	VISIT DATE: 11/27/2023

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
26
27
28
29
30
31
32

LPA inspected the outdoor area including deck area and observed safe toys and play equipment. LPA observed age-appropriate toys and children's tables. Outdoor area is clean and free from debris. The outdoor area is properly fenced. Per the licensee, there are no weapons or firearms on premises. Per the licensee, there are no bodies of water or pools on the premises. There are no pets 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 and smoke detector in the home. One charged fire extinguisher was observed, 2:A10:BC. Licensee confirmed program provides meals and snacks. LPA discussed the importance of maintaining a system where allergies and food restrictions are noted. LPA observed a first aid kit with a working thermometer.

Licensee currently does administer medication. LPA observed the IMS plan. Adequate heating and ventilation for safety and comfort were observed in the space. The home has working telephone service and LPA confirmed the phone number (310) 308-6851.

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 reviewed 5 children’s files and observed files to be complete. LPA reviewed staff files. 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, Catherine Mutuc's Pediatric CPR and First certification and observed certification with an expiration date of 05/2025. LPA reviewed, Licensee, Catherine Mutuc's Mandated Reporter training and observed certification with an expiration date of 11/2025.

Page 2

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Sarah Garcia	TELEPHONE: (424) 301-3066
LICENSING EVALUATOR SIGNATURE:	DATE: 11/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023

LIC809 (FAS) - (06/04)

Page: 4 of 6

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: MUTUC FAMILY CHILD CARE	FACILITY NUMBER: 197493535
	VISIT DATE: 11/27/2023

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
26
27
28
29
30
31
32

Licensees were 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 licensees 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.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

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 licensees, Catherine Mutuc and Charmaine Mutuc, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Page 3

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Sarah Garcia	TELEPHONE: (424) 301-3066
LICENSING EVALUATOR SIGNATURE:	DATE: 11/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023

LIC809 (FAS) - (06/04)

Page: 5 of 6

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: MUTUC FAMILY CHILD CARE	FACILITY NUMBER: 197493535
	VISIT DATE: 11/27/2023

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
26
27
28
29
30
31
32

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.

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.

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.

Page 4

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Sarah Garcia	TELEPHONE: (424) 301-3066
LICENSING EVALUATOR SIGNATURE:	DATE: 11/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023

LIC809 (FAS) - (06/04)

Page: 6 of 6