197494272-11-6-2019-30-CC-DMIA-BHNQPL-20191106112057

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494272
Report Date: 11/06/2019
Date Signed: 11/06/2019 11:21:07 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	ZARZOUR & MARCOS FAMILY CHILD CARE		FACILITY NUMBER:	197494272
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 1	DATE:	11/06/2019
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Evoun Zarzour, Licensee and Maged Marcos, co-licensee		TIME COMPLETED:	11:20 AM

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 11/6/19 8:15am, Licensing Program Analyst (LPA) Denise Miranda conducted a case management visit to the family child care home for the purpose of an increase in capacity. The licensee is applying for a large family child care home. Upon arrival, LPA met with the licensee and co-licensee. LPA confirmed with the licensees that all adults residing in the home have obtained a criminal record/TB clearance. The fire clearance was granted for 14 children on 10/9/2019 by Inspector Cindy Struel from Los Angeles City Fire Department. The facility is a 4 bedroom, 2-bathroom home that consists of living room, dining room, family room, kitchen, front yard, back yard with patio and hot tub, and attached garage. Main care is provided in the family room, dining room, living room and nook area and the outside area licensee and co-licensee will use the right back side of the house. The off-limits areas are: master bedroom with master bathroom, bedroom#1#2 and #3 and front yard area, backyard area with hot tub and attached garage. The attached garage, that is used only for storage. Per licensee the attached garage is used only for storage. There was 1 infant in care present during the inspection. Licensee states there were no weapons/firearms in the home, and none observed by LPA. There are bodies of water present at the facility. LPA observed two dogs at the left side of the house (off limit) and two birds. At this time, the licensee does not provide Incidental Medical Services (IMS). The following was discussed with the licensee: The licensee was informed to have a qualified assistant when the capacity exceeds 8 children. The assistant must be at least 14 years of age, but can not be left alone with the children in care. If the assistant is 18 years of age and older, the assistant must have current Adult/Infant & Pediatric First Aid certificates if left alone with children while the licensee is out of the home. Each assistant must also have TB clearance, valid criminal record clearance and be associated to the facility license.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Denise Miranda	TELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2019

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ZARZOUR & MARCOS FAMILY CHILD CARE	FACILITY NUMBER: 197494272
	VISIT DATE: 11/06/2019

NARRATIVE

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The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot line at 1-800-540-4000. Also call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).

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 regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA information Line at (800) 514-0301 (voice)/(800) 524-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

The following was disclosed with licensees:

Licensee and licensee's were informed, Absence of Supervision: including, but not limited to, a child left unattended, a child left alone with a person under 18 years of age, and lack of supervision resulting in a child wandering away. (HSC 1597.58(c)(2)). Regulation(s): 102417(k)(1) Children shall not be left in parked vehicles. Civil penalty applies when a child is left unattended in a parked vehicle.
-A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.
-Annual fees must be paid promptly and by the due date or a late fee shall be assessed, and/or the License shall be terminated.
-The fire extinguisher type 2A10BC must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should check and batteries replaced as needed.
-Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.
-Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. (use LIC624B for written report)
-Fire and safety drills must be performed every six months and documented for review by the Department.
-Smoking is prohibited in a family child care home. -Children and Staff records must be maintained and updated as needed and must be available for review by the Department.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Denise Miranda	TELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2019

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ZARZOUR & MARCOS FAMILY CHILD CARE	FACILITY NUMBER: 197494272
	VISIT DATE: 11/06/2019

NARRATIVE

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-Dog(s) and or pets are recommended to be isolated from children in care.
- 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.

During this inspection, LPA also provided, consulted and explained the following documents about SIDS. 1) A Child Care Provider’s Guide to Safe Sleep by the American Academy of Pediatrics, 2) Never ever shake a baby by the California Department of Social Services 3) California School Immunization Record form CDPH286, 4) Pillows and babies don’t mix, 5) Brochure Prohibited items in family child care homes per health &Safety Code$1596.846 (b) and (c) and 5) LIC311D Child Care.

During this inspection licensee and co-licensee provide a declaration that the detached garage will be off limit.

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

LPA recommended and licensee and co-licensee agreed to provide the following proof of correction no later than 11/14/2019.
Barricade the fireplace located at the living room.
Place a latch at the gate located at the back yard.

An exit interview was conducted and a copy of this report was provided to Ms. Zarzour, licensee and Mr. Marcos, co licensee at the conclusion of this inspection.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Denise Miranda	TELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2019

LIC809 (FAS) - (06/04)

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