198005139-9-19-2024-33-CC-VMGA-D99UBS-20240919152648

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198005139
Report Date: 09/19/2024
Date Signed: 09/19/2024 03:27:01 PM

Document Has Been Signed on 09/19/2024 03:27 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:	ORNELAS FAMILY CHILD CARE		FACILITY NUMBER:	198005139
ADMINISTRATOR:	DOMINGA ORNELAS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 721-5415
CITY:	MONTEBELLO	STATE: CA	ZIP CODE:	90640
CAPACITY:	14	CENSUS: 2	DATE:	09/19/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:50 PM
MET WITH:	Dominga Ornelas		TIME COMPLETED:	03:40 PM

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This inspection was conducted in Spanish.

Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced Annual/Random inspection at the above facility on 09/19/24 at 12:50 p.m. LPA met with Dominga Ornelas, licensee who guided LPA on a tour of the facility. Also present was the licensee’s husband Juan Ornelas and licensee's grandson Jeramiah Ornelas. LPA observed 02 children in care. Per licensee, 05 children are enrolled. Operation hours are Monday through Friday 06:00am – 06:30pm.

This is a one-story home which consists of 3 bedrooms, 1 bathroom, living room, dining room, kitchen, front yard, back yard (fenced), and detached garage. Areas accessible to children include the dining room, 1 bathroom, 1 bedroom (located in the back). Areas off limits to children and parents include: front yard, living room, kitchen, 2 bedrooms, and detached garage. Licensee states, there are no pets on the premises. Per licensee, family members residing in the home are 4 adults and 0 minors. According to the licensee, her adult grandson lives in the home and is not fingerprint cleared. LPA reviewed the facility roster and confirmed that the licensee's grandson Jeramiah Ornelas is not associated.

LPA toured all areas identified on the facility sketch used by children during this visit and were inspected for safety, comfort, and cleanliness. Tour began in the children’s bathroom which is in the hallway between the living room and the bedrooms. The children’s bathroom was observed to be in safe and in sanitary conditions. LPA then toured the back bedroom which is converted into a playroom where LPA observed safe toys, play equipment and materials for children. The playroom has a well mounted child proof gate that prevents children from accessing areas that are off-limits. The dining room is connected to the living room and children have access to the dining room during snack time. Adjacent to the dining room is the kitchen. Per licensee, the kitchen if off-limits to children. LPA observed child proof locks on the kitchen cabinet. There’s also a first aid kit readily available.

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SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-Garza	TELEPHONE: (323) 558-2710
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024

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: ORNELAS FAMILY CHILD CARE	FACILITY NUMBER: 198005139
	VISIT DATE: 09/19/2024

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LPA observed the following required posted documentation in the dining room of the facility: Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPA reviewed facility records LIC 610- Emergency Disaster Plan and Disaster drill log. 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 conducted on 08/09/24. Children’s roster was available during this inspection.

LPA did not observe any pools, spas, hot tubs, fishponds, or similar bodies of water during the inspection.

Licensee does understand that licensing staff may have access to off-limit areas during inspection visit if necessary. **Rooms that are off-limits need to be made inaccessible during operating hours**

Per licensee, snacks are provided to the school age children and parents provide food to the younger children in care. Licensee was advised that if food is brought from the children’s homes, all containers must be labeled with the child’s name and properly stored or refrigerated. There is telephone service via a cell phone and remains in the facility during operation hours. There is ventilation and heating.

Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock. Per licensee, there are no firearms or weapons stored in the home.

At 01:15 pm. smoke and carbon monoxide detectors were tested and are operable. The valve on the required 2 A10 BC fire extinguisher indicates fully charged; however, there was no attached receipt or proof of service. Per State Fire Marshall standards, fire extinguishers shall be serviced annually.

The isolation area for sick children waiting to be picked up is in the living room with supervision.

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

Currently children are using the back yard for outdoor play. Licensee understands that children should be supervised at all times. LPA advised licensee to check with the American Standard Testing Materials for Playground Guidelines and/or to use the manufactures recommendations for the playground equipment in efforts to be more in line with safety guidelines.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization's Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, and LIC 995A Notification of Parents’ Rights, LIC 9227- Infant sleep form (0-12 months, and documentation of 15-minute Infant Sleep Check (0-24 months). LPA observed all children’s files to be complete.

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SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-Garza	TELEPHONE: (323) 558-2710
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024

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: ORNELAS FAMILY CHILD CARE	FACILITY NUMBER: 198005139
	VISIT DATE: 09/19/2024

NARRATIVE

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Licensee's records were reviewed for approved Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. Licensee’s Mandated Reporter Training AB1207 expires on 06/24/25. Licensee’s Pediatric CPR/FA expires on 12/07/25.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018, any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers

The licensee is operating within proper capacity and ratios. LPA observed licensee to be present at the home and providing adequate care and supervision.

Licensee does not care for infants. 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.

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/.

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.

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SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-Garza	TELEPHONE: (323) 558-2710
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024

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: ORNELAS FAMILY CHILD CARE	FACILITY NUMBER: 198005139
	VISIT DATE: 09/19/2024

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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

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.

Licensee Dominga Ornelas confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Licensee had to leave the facility at 01:35pm to pick up the older children from school. LPA left the facility and returned at 02:45pm to complete the report.

The following deficiencies were cited in accordance with Title 22 of the California Code of Regulations and Health & Safety Codes. Please see 809D for documentation of deficiencies.

Exit interview conducted and report was reviewed with the licensee Dominga Ornelas.

Type A citation

LPA Veronica MartinezGarza informed licensee Dominga Ornelas that this report dated 09/19/24 document(s) 1 Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Veronica MartinezGarza informed the licensee Dominga Ornelas to provide a copy of this licensing report dated 09/19/24 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-Garza	TELEPHONE: (323) 558-2710
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/19/2024 03:27 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: ORNELAS FAMILY CHILD CARE	FACILITY NUMBER: 198005139
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/19/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

HSC

1596.871(c)(1)(A)

Administration of Child Day Care Licensing

Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility. 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 in licensee's grandson Jeramiah Ornelas lives in the home and is not fingeprint cleared which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 09/23/2024
	Plan of Correction
1 2 3 4	Per licensee, Jeramiah Ornelas will get fingerprinted on 09/20/2024 and will submit proof to LPA by POC date. LPA provided LIC 9163.

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: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-Garza	TELEPHONE: (323) 558-2710
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/19/2024 03:27 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: ORNELAS FAMILY CHILD CARE	FACILITY NUMBER: 198005139
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/19/2024

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 in licensee's fire extinguisher does not have a service tag or proof of purchase which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/03/2024
	Plan of Correction
1 2 3 4	Per licensee, she will service the fire extinguisher and will submit proof to LPA by POC due date.

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: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-Garza	TELEPHONE: (323) 558-2710
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024

LIC809 (FAS) - (06/04)

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