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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198004119
Report Date: 08/24/2022
Date Signed: 08/24/2022 12:50:53 PM

Document Has Been Signed on 08/24/2022 12:50 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:VALENZUELA FAMILY CHILD CAREFACILITY NUMBER:
198004119
ADMINISTRATOR:VALENZUELA, ROSAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 562-2271
CITY:CUDAHYSTATE: CAZIP CODE:
90201
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 1DATE:
08/24/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Rosa Valenzuela, LicenseeTIME COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) Alicia Mooberry conducted an unannounced annual inspection in Spanish. LPA met with Licensee, Rosa Valenzuela, explained the purpose of inspection and provided the inspection Entrance Checklist, LIC 126. There was 1 child present. Licensee states that there are currently 7 children enrolled, children's roster was reviewed and is current. Per licensee operating hours are from 7:00 AM - 7:00 PM, Monday - Friday. Individuals living in the home were discussed and noted. All individuals present in the home have obtained a criminal record clearance. LPA toured all areas used by children during this visit.

This is a one story home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, living room front and backyard (fenced). The children use the living room, 1 bedroom (located near the front entrance) and front yard. Per licensee, areas off limits to children include: 2 bedrooms, bathroom in hallway by kitchen, kitchen and backyard. LPAs observed a safety gate at kitchen entrance. The licensee provides food for children in care.

Licensee states that she currently has one assistant.

Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for safety and comfort. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible in all areas of the home. The licensee understands that poison must be locked.

LPA observed the facility license posted in the living room. Licensee was advised to post the required documentation in a location visible to parent/guardians of children in care. Including Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPA observed completed facility records including; LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan.

LPA provided licensee with copy of PUB 394 with current Regional Office information.

Page 1 – Report Continues

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE: DATE: 08/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/24/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: VALENZUELA FAMILY CHILD CARE
FACILITY NUMBER: 198004119
VISIT DATE: 08/24/2022
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Smoke and carbon monoxide detectors were tested and are operable. Fire extinguisher indicated fully charged and was serviced on 05/2022, Licensee was reminded that fire extinguisher needs to be serviced yearly. The home maintains telephone service via cell phone. The bathroom that children use is located in bedroom/daycare room and observed to be clean and free of hazards.
Per Licensee there are no firearms or weapons stored in the home. Licensee has two dogs that are kept in the off limit backyard.
Isolation area for sick children waiting to be picked up is in living room, away from the other children.

LPA reminded licensee to stay current with COVID-19 recommendations, precautions and procedures from the LA Department of Health and by visiting CDSS.ca.gov

Infant Care: LPA informed licensee of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months, and provided PIN 20-24-CCP. Licensee states infants sleep in the daycare room, each infant has their own play yard.

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-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.

Currently, children are using the front yard for outdoor play. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with including a plastic play structure, with cushioned material under structure. LPA did not observe any objects that could be hazardous to children in care. LPAs observed shading and tables where children eat. Facility does not have a pool or similar bodies of water.

During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.

-------------------Page 2 – Report Continues

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2022
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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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: VALENZUELA FAMILY CHILD CARE
FACILITY NUMBER: 198004119
VISIT DATE: 08/24/2022
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Children’s records were reviewed. LPA observed that Immunization's Records were missing for 4 out of the 4 files reviewed, this poses a potential risk to the health and safety of children in care.

Licensee records were reviewed, licensee's Pediatric First Aid and CPR certification expires this month. Per licensee, they have scheduled to renew certification at the end of the month. LPA provided licensee with assistance with registering for Mandated Reporter Training.

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

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.



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.

Based on the LPA's observations and records review the following deficiencies will be cited today in accordance with California Title 22 Regulations.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Rosa Valenzuela

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2022
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Document Has Been Signed on 08/24/2022 12:50 PM - It Cannot Be Edited


Created By: Alicia Mooberry On 08/24/2022 at 12:04 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: VALENZUELA FAMILY CHILD CARE
FACILITY NUMBER: 198004119

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/24/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102418(g)
Immunizations
(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 4 out of 4 records reviewed were missing immunization records which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/07/2022
Plan of Correction
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Per licensee, they will request records for parent/guardian of Child1-4 and sent proof of correction to LPA by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Valarie Cook
LICENSING EVALUATOR NAME:Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:
DATE: 08/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/24/2022


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