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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198004623
Report Date: 12/15/2021
Date Signed: 12/15/2021 12:50:55 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:ESPINOZA FAMILY CHILD CAREFACILITY NUMBER:
198004623
ADMINISTRATOR:AMARO, CECILIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 422-5598
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY:14CENSUS: 8DATE:
12/15/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Licensee - Cecilia EspinozaTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) R. Derraco conducted a required 1 year inspection to the above facility on 12/15/21. LPA arrived at the facility at 10:00 AM and met with Cecilia Espinoza, who guided analyst on a tour of the facility. Also present during this inspection were the licensee's adult children. Per Licensee, there are 11 children that are currently enrolled. There were 8 children present upon arrival, one of which is an infant.

This is a one-story home which consists of 3 bedrooms, 1 bathrooms, kitchen/dining room, living room, a , front yard and backyard (fenced). A second living area is located in the backyard play area and made inaccessible by a locked metal gate and a locked front door. Per licensee, the house number is different from the facility address. The off limit areas include all 3 bedrooms, the front yard, both sides of the house and the second living area.

The main care area is located in the living room. LPA observed required postings, a station for personal protective equipment, a storage cubby for children's personal belongings, sleeping mats, a wall mounted television, a wall mounted security monitor, age appropriate toys and materials. A raised dining table and chairs were also observed in the kitchen/dining area. LPA observed the kitchen area to have locked cabinets and drawers. Cleaning products were observed to be locked in a cabinet beneath the kitchen sink. Sharp objects were also observed to be locked in the kitchen drawers. The bathroom designated for children use was observed to be clean and free of defects. Cleaning supplies were observed to be locked beneath the bathroom sink. Additional bathroom supplies were observed to be locked in a storage cabinet next to the bathroom sink. The outdoor play area is located in the backyard. LPA observed perimeter fencing, a basketball hoop that is padded at the base, a pop up tent for shade, additional age appropriate toys and materials, a child sized table and chairs, and two sets of laundry appliances. Metal side gates were observed on both sides of the house making the area inaccessible. LPA observed detergents and cleaners to be kept in the off-limits side area of the backyard. Per licensee, the tenants use the other off-limits side of the home
(page 1 of 4)
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 18
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: ESPINOZA FAMILY CHILD CARE
FACILITY NUMBER: 198004623
VISIT DATE: 12/15/2021
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for storage and access to the off limits living area. LPA observed a locked door and a locked metal gate leading into the off-limits living area making it inaccessible to children in care. No bodies of water were observed in the back yard play area. There are no pets on the premises.

The licensee states that she provides food for children in care. Meals area taken in the kitchen area where a child sized table and chairs were observed. Per licensee, isolation area for children showing signs of illness will be located in the dining area while parents are contacted for pickup.

Individuals who reside in the home were noted and discussed. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed childcare home. 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. Licensee states that there are no firearms stored in the home.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety,


comfort, and cleanliness. There is telephone service via a land line. Per Licensee, the home is equipped with central heating and air conditioning. Day care area was observed with safe toys, play equipment and materials.

The valve on the required 2A 10BC fire extinguisher indicates fully charged with a purchase receipt dated 06/28/21. Smoke and carbon monoxide detectors were tested and are operable. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs.

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
(page 2 of 4)
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
LIC809 (FAS) - (06/04)
Page: 2 of 18
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: ESPINOZA FAMILY CHILD CARE
FACILITY NUMBER: 198004623
VISIT DATE: 12/15/2021
NARRATIVE
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equipment.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 06/2022. LPA observed that the Licensee does not have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. LPA advised licensee that a citation will be issued under Health and Safety Code section 1596.8662(b)(1). Children’s records were reviewed, including emergency information and were observed to be complete. A current children’s roster was available for review.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.



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

Incidental Medical Services (IMS):
IMS was discussed with licensee. Per licensee, there are no children enrolled that require IMS at this time. 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.

LPA advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov. LPA also discussed and provided the Provider Information Notices (PINS) on Recently Approved Safe Sleep Regulations in Effect: PIN 20-24-CCP, Infant Sleep Chart and the Individual Infant Sleeping Plan (LIC 9227).



The following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Health and Safety code. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

To improve the quality and value of the new inspection process, a survey will be sent to the email address
(page 3 of 4)
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
LIC809 (FAS) - (06/04)
Page: 3 of 18
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: ESPINOZA FAMILY CHILD CARE
FACILITY NUMBER: 198004623
VISIT DATE: 12/15/2021
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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

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

Exit interview conducted and report was reviewed with the licensee Cecilia Espinoza.

(page 4 of 4)

SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
LIC809 (FAS) - (06/04)
Page: 4 of 18
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: ESPINOZA FAMILY CHILD CARE
FACILITY NUMBER: 198004623
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/15/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date:
Plan of Correction
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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: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:
DATE: 12/15/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/15/2021
LIC809 (FAS) - (06/04)
Page: 5 of 18
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: ESPINOZA FAMILY CHILD CARE
FACILITY NUMBER: 198004623
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/15/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date:
Plan of Correction
1
2
3
4
Section Cited
Deficient Practice Statement
1
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4
POC Due Date:
Plan of Correction
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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: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:
DATE: 12/15/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/15/2021
LIC809 (FAS) - (06/04)
Page: 12 of 18