198003319-9-26-2019-33-CC-AEIN-BGDSAQ-20190926134244

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198003319
Report Date: 09/26/2019
Date Signed: 09/26/2019 01:42:50 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	ARTZINIEGA FAMILY CHILD CARE		FACILITY NUMBER:	198003319
ADMINISTRATOR:	ARTZINIEGA, JUDITH&RAMIRO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 665-2114
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91205
CAPACITY:	14	CENSUS: 9	DATE:	09/26/2019
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Judith and Ramiro Artzinega, Licensees		TIME COMPLETED:	02:00 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	Licensing Program Analysts (LPA) Anomeh Eivazian and Alanna Gontarek conducted an unannounced required 3 year inspection. LPAs met with licensees, Judith and Ramiro Artzinega, Licensees and Amaya Lacarcel, licensee's assistant who guided analysts on a tour of the facility. Also present was Cecelia Lacarcel, licensee's assistant. There were 9 children present during this inspection, 3 being infants. Per licensees there are currently 11 children enrolled, children's roster was reviewed and is current. Disaster drill log was available, last drill was conducted on 06/21/19. This is a one story home which consists of day care room, 2 bedrooms, 1 bathroom adjacent to the kitchen, kitchen, front yard, backyard (fenced), detached converted garage, side yards, and two storages in the backyard. The children use day care room, bathroom adjacent to the kitchen, kitchen, and front part of backyard. Per licensee, areas off limits to children and parents include: 2 bedrooms, front yard, back of backyard, two storages in the backyard, two side yards, and detached converted garage. Family members residing in the home are 3 adults who have clearances on file and 0 children. Licensees provide food to children. Parents enter the facility through the main door which leads to the day care room. All areas used by children were inspected for safety, comfort, cleanliness, telephone, ventilation and heating (central). The licensees state that there are no poisons in the home. The licensees understand that any poisons must be locked with a key or combination lock. Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible in all areas in the home. Per licensees, there are no weapons, firearms or bodies of water on the premises. There is a dog on premises, vaccination on file. There were toys observed for children. Posting requirements were observed to be posted at the time of inspection. Children’s records were reviewed. REPORT CONTINUES ON NEXT PAGE 1 of 3

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ARTZINIEGA FAMILY CHILD CARE	FACILITY NUMBER: 198003319
	VISIT DATE: 09/26/2019

NARRATIVE

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The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 03/04/2019, as indicated on service tag. Smoke and carbon monoxide detector in day care room was tested, and is in operable condition. There are emergency supplies on the premises.

The licensees were observed to be operating within the licensed capacity and is not exceeding the required limitations. All adults present have obtained a criminal record clearance. The licensees and her assistants have proof of current pediatric first aid and CPR (expires: 03/13/2021). Licensees and their assistants completed required mandated reporter training, certificates on file.

The following was discussed:

INFANT CARE: Licensees state that they do care for infants. LPA discussed the licensees' plan for supervising sleeping infants.
Licensees state the following: Any infants in care will stay in the day care room where the licensees or assistant are.
LPAs advised the licensees to sleep infants where the infant can be directly supervised and advised against sleeping infants in a separate room. The licensees state that they will not sleep infants in a separate room. LPAs reviewed SIDs, Never Shake A Baby, and safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. Safe sleep concepts were provided.

Medication: 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) 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

No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into this category are not permitted in a family child care facility.

REPORT CONTINUES ON NEXT PAGE 2 of 3

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019

LIC809 (FAS) - (06/04)

Page: 2 of 3

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ARTZINIEGA FAMILY CHILD CARE	FACILITY NUMBER: 198003319
	VISIT DATE: 09/26/2019

NARRATIVE

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Per licensee, she does not carry liability insurance or a bond in accordance with standard established by Family Child Care statue. Signed statements (LIC282) on file. The law requires Family Child Care provider to carry liability insurance or bond in the amount of $300,000 annually or to maintain the singed statement in the facility file.

LPA reviewed and issued the LIC 311 - Forms/Records to Keep in Your Family Child Care Home.
LPA advised the licensee how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov

LPA consulted and explained Child Abuse Reporting, Updated Patent’s Rights Poster with Complaint Hotline information, Never Shake a Baby, Sudden Infant Death Syndrome (SIDS), and Safe Sleeping practices which always Baby is sleeping on his/her back. Capacity Handout (Small & Large) was provided during this inspection. 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). Licensees shall reveal each facility license number in all advertisements, publications, or announcements made with the intent to attract clients. Mandated reporter training must be completed every 2 years. www.mandatedreporterca.com

LPA issued the Confidential Names List (LIC 811) to the licensee during this inspection. The Confidential Names List documents the children’s files that were reviewed during this inspection.

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.

At this time, the licensees are in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

Exit interview was conducted with Amaya Larcarcel, Licensees' Assistant. Appeal rights explained & provided.
REPORT END 3 of 3

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019

LIC809 (FAS) - (06/04)

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