198000524-1-30-2024-33-CC-SLII-CZYS4T-20240130123316

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198000524
Report Date: 01/30/2024
Date Signed: 01/30/2024 12:35:54 PM

Document Has Been Signed on 01/30/2024 12:35 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	MISTONE, CATHERINE FAMILY DAY CARE		FACILITY NUMBER:	198000524
ADMINISTRATOR:	MISTONE, CATHERINE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(951) 733-7108
CITY:	LA VERNE	STATE: CA	ZIP CODE:	91750
CAPACITY:	12	CENSUS: 12	DATE:	01/30/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Licensee-Catherine Mistone		TIME COMPLETED:	12:45 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 Analysts (LPA) Stephanie Li and Carolyn Tuba conducted an unannounced required 3 year inspection to the above facility. A risk assessment was conducted upon entry. LPA met with Licensee Catherine Mistone, who guided analyst on a tour of the facility. Per Licensee, there are currently 17 children enrolled. A current children’s roster was available for review. There were 12 children and 2 adults present upon arrival. The licensee states that 2 adults and 0 children currently live in the home. Per Licensee, they currently have 3 part time assistants. Licensee states that there are no firearms stored in the home. This is a one story home which consists of 3 bedrooms, 1 restroom, living room, family room, kitchen, garage, which is converted into the classroom and backyard (fenced). The children have access to classroom, living room, dining room, and the restroom located in the hallway. There is a pool in the backyard. LPA's inspected with bodies of water checklist and fencing meets Title 22 regulations. Children's outdoor play space has latched gate separating pool yard from the play yard. There is a sliding glass door that leads into the pool yard from the living room with a key lock at the top making it inaccessible. Per licensee, areas off limits to children and parents include entire 3 bedrooms, kitchen, and pool yard. The LPAs toured all areas used by children during this visit. LPA’s observed a baby gate in hallway separating bedrooms making it inaccessible. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. At 10:15am, LPA’s observed a fire place in the dining room with no barricade making it accessible to children, this poses a potential health and safety risk to children in care. Page 1 of 4

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Stephanie Li	TELEPHONE: (626) 366-3362
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MISTONE, CATHERINE FAMILY DAY CARE	FACILITY NUMBER: 198000524
	VISIT DATE: 01/30/2024

NARRATIVE

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The following was observed and reviewed during this inspection. Cleaning compounds, and medications were observed to be inaccessible to children. Per licensee, there are no poisons kept in the home. The restroom that children use was observed to be safe and sanitary. The home is observed to be clean and orderly. There are toys available for children. Appropriate sleeping arrangements and play yards were observed. There is telephone service via cellphone that stays at the facility during operation hours. There is central heating and air.

At 10:30 am, LPA’s observed the required 2A 10BC fire extinguisher. Licensee stated that it was purchased this year but have receipt. LPA’s advised licensee that per State Fire Marshall standards that fire extinguishers shall be serviced annually and if self purchasing to keep the receipt with the fire extinguisher. Smoke and carbon monoxide detectors 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 documented was conducted on 01/16/2024.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted on the parent board in the classroom.

LPA’s did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that fall into these categories are not permitted in a family child care facility. LPA’s advised that high chairs can only be used for meal time.

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SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Stephanie Li	TELEPHONE: (626) 366-3362
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MISTONE, CATHERINE FAMILY DAY CARE	FACILITY NUMBER: 198000524
	VISIT DATE: 01/30/2024

NARRATIVE

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

Currently, children are using the side yard for outdoor play time. The outdoor play area was observed to be fenced. LPA’s observed the outdoor yard to have appropriate toys and other materials for children to use. LPA’s did not observe any objects that can pose a danger to children in the outdoor yard. There are pets on the premises. There is two small dogs in the home that reside in the bedroom or back pool yard during operating hours.

The licensee is observed to be operating within the license capacity limitations.

At 10:45 am, children and adult records were reviewed, including emergency information and were observed to be complete. The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. The licensee has Pediatric First Aid and CPR expires on 2/2024. There are first aid supplies available. Licensee and assistant do have proof of immunization record and the Mandated Reporter AB 1207 Training Certificate on file exp 10/2025.

Licensee stated IMS is not being provided. 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/.

LPA discussed the safe sleep regulations and discussed the Child Care Licensing Safe Sleep webpage at http://www.cdss.ca.gov/inforescources/child-care-licensing/public-information-and-resoucrces/safe-sleep as an additional resource. LPA also informed applicant/licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at http://www/cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. Safe sleep brochure provided for review.

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SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Stephanie Li	TELEPHONE: (626) 366-3362
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MISTONE, CATHERINE FAMILY DAY CARE	FACILITY NUMBER: 198000524
	VISIT DATE: 01/30/2024

NARRATIVE

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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.

Megan’s Law - Family Child Care Homes During the exit interview, the Licensee Catherine Mistone, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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

MyChildCarePlan.org – Centers and Family Child Care Homes 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

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiencies 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.

Exit interview conducted and report was reviewed with Licensee Catherine Mistone.

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SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Stephanie Li	TELEPHONE: (626) 366-3362
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2024

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 01/30/2024 12:35 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MISTONE, CATHERINE FAMILY DAY CARE	FACILITY NUMBER: 198000524
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/30/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(1)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above as the fireplace does not have a screen or barricade preventing access which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/09/2024
	Plan of Correction
1 2 3 4	Licensee will purchase and install a metal screen attached with a hook and will submit a photo via email of installed metal screen.

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: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Stephanie Li	TELEPHONE: (626) 366-3362
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2024

LIC809 (FAS) - (06/04)

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