198003193-3-7-2024-33-CC-CRES-D35QZL-20240307113655

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198003193
Report Date: 03/07/2024
Date Signed: 03/07/2024 11:37:06 AM

Document Has Been Signed on 03/07/2024 11:37 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. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	MARTIN FAMILY CHILD CARE		FACILITY NUMBER:	198003193
ADMINISTRATOR:	MARTIN, LORENA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 917-0798
CITY:	WEST COVINA	STATE: CA	ZIP CODE:	91790
CAPACITY:	14	CENSUS: 4	DATE:	03/07/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Lorena Martin		TIME COMPLETED:	11:45 AM

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Licensing Program Analyst (LPA) Cynthia Reyes conducted an unannounced annual inspection on this date. This inspection is to ensure the health and safety standards as required by the regulations governing child care homes are met. LPA met with Lorena Martin, Licensee. A copy of the Entrance Checklist for Child Care homes form (LIC 126) was provided. The facility operating hours are Monday through Sunday 23 hours with over night care. A Covid risk assessment was conducted upon entry. Individuals residing in the home are 2 adults and 1 children.

Areas used by children were inspected as follows: Living room, dining room, 1 bedroom, master bedroom 2 bath rooms (1 in the back yard), and Garage (day care room) front and back yard

Areas off limits include: Kitchen, 1 Bedroom (sons room), and the master bathroom..**Rooms that are off-limits need to be made inaccessible during operating hours** The Licensee does understand that licensing staff may have access to off-limit areas during inspection visit if necessary.

Licensee has the License, Parent’s Rights poster and other required forms posted in the day care room visible for all to see. Licensee First Aid/CPR certificate are valid thru 03/19/2025 for licensee.Mandated Reporter certificate are valid thru 12/19/2025.

Cleaning supplies were observed in a latched cabinet in the kitchen. The home has electrical outlet covers throughout and maintains a First Aid Kit in the home. There are adequate age appropriate toys, books, and games. There are no weapons, *swimming pool or spa on the premises. There is a firearm in the home. The backyard is adequately fenced with age appropriate toys and play equipment. Continue on next page

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MARTIN FAMILY CHILD CARE	FACILITY NUMBER: 198003193
	VISIT DATE: 03/07/2024

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Licensing staff observed the following required posted documentation in the day care room: Facility License, Publication (PUB) 394- Notification of Parent Rights and other Licensing Forms. LPA reviewed facility records for LIC 9040- Facility Roster and LIC 610- Facility Disaster Plan.

Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, and made inaccessible to children. Isolation area for sick children waiting to be picked up is in the living room and other children will be away from the sick child in the day care room.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, A current children’s roster was available and reviewed with "15" children enrolled.

Licensee records were reviewed, LPA reviewed the LIC 508- Criminal Record Statement. Licensee has Proof of immunization's against measles and TDAP. Influenza declination is on file, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse.

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/.

The following was observed and reviewed during this inspection. All areas identified on the facility sketch were inspected for safety, comfort, and cleanliness. There is telephone service via a land line and a cellphone that stays at the facility during operation hours. There is ventilation and heating. Detergents, cleaning compounds, and medications were observed to be inaccessible to children. The restroom that children use was observed to be safe and sanitary.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MARTIN FAMILY CHILD CARE	FACILITY NUMBER: 198003193
	VISIT DATE: 03/07/2024

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LPA Reyes observed the valve on the required 2A10BC fire extinguisher indicates fully charged, tag service date is 09/11/2023. Smoke detector and carbon monoxide was tested and is operable. LPA advised that all Large family day care homes shall conduct fire and disaster drills at least once every 3 months and a small day care is every 6 months, and document the date and time of each drill. Last drill conducted and documented on 02/11/2024. Emergency Disaster Plan.

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

LPA did not observe any objects that can pose a danger to children in care. The licensee is observed to be operating within the license capacity limitations.

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/process.

The department has On Duty Workers available for questions Monday through Friday at (323) 981-3350 from 8:00 AM - 5:00 PM.

LPA advised the licensee how to access forms and regulations on line at: www.ccld.ca.gov.

Criminal Record Clearance: 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.

Report continues on next page

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MARTIN FAMILY CHILD CARE	FACILITY NUMBER: 198003193
	VISIT DATE: 03/07/2024

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AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com.

Infant Care: LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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. Per licensee no infants are in care at the moment.

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.

There are deficiencies being cited on this date. See 809D and Technical Advisory pages. LPA provided consultation during this inspection. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Lorena Martin, Licensee.

During the exit interview, the Licensee Lorena Martin, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/07/2024 11:37 AM - 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MARTIN FAMILY CHILD CARE	FACILITY NUMBER: 198003193
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/07/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(5)

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: (5) All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA observation the licensee did not comply with the section cited above in 1 count which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/18/2024
	Plan of Correction
1 2 3 4	102417(g)(5) - Licensee has several small water fountains around the back yard with water in them. Licensee states will remove water from all fountains and replace with rocks or plants. Licensee will send photos of the entire back yard where all the water fountains are located.

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: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

LIC809 (FAS) - (06/04)

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