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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198005588
Report Date: 10/26/2022
Date Signed: 10/26/2022 12:26:15 PM


Document Has Been Signed on 10/26/2022 12:26 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:ALBA FAMILY CHILD CAREFACILITY NUMBER:
198005588
ADMINISTRATOR:ALBA, LUZ AND VANESSAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 260-5793
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY:14CENSUS: 1DATE:
10/26/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:co - licensee - Luz Maria and Vanessa AlbaTIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) R. Derraco conducted an unannounced required one year inspection to the above facility on 10/26/22. LPA arrived at the facility at 8:45 AM and met with co- licensee, Luz Maria Alba, who guided analyst on a tour of the facility. Also present during this inspection was an co-licensee Vanessa Alba, S3 and S4. Per Licensee, there are 9 children that are currently enrolled. There was 1 infant present upon arrival.

This is a one-story home which consists of 3 bedrooms, 3 bathrooms, kitchen/dining room, living rooms, garage, covered patio, sun room, front yard and backyard (fenced). The off limit areas include three bedrooms, two bathrooms, back yard area, sun room and garage

The main care area is located in the living room. Two couches, a television and a play yard was observed in the main care area. Per licensee, the covered patio area is used as an activity space for children in care. LPA observed child sized table, child sized chairs, age appropriate toys, art supplies, a Graco feeding high chair, and baby changing station. A first aid cabinet was observed in the covered patio area to be inaccessible to children in care. Licensee states that she prepares food for children in care. The kitchen/dining area is also used for children to eat meals. Child locks were observed beneath the kitchen sink. No sharp or pointy objects were observed to be accessible in the kitchen area. LPA observed the bathroom designated for use by children in care to be clean with an operable sink and toilet. Per licensee, cleaning supplies are kept in the off limits garage area and in a locked cabinet located in the bathroom. Licensee understands that storage areas for poisons must be locked, not just inaccessible. LPA observed the front yard to have perimeter fencing. Outdoor play equipment and a climbing structure was observed in the front yard. Per licensee, isolation area for children showing signs of illness will be located in the living room. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs. No bodies of water were observed in the back yard play area. There are no pets on the
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SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:
DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/26/2022
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 7


Document Has Been Signed on 10/26/2022 12:26 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754


FACILITY NAME: ALBA FAMILY CHILD CARE
FACILITY NUMBER: 198005588

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/26/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102370(d)(1)
Criminal Record Clearance
(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or

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: 11/04/2022
Plan of Correction
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Licensee states will send LIC 9182 via fax and mail document to MPSW RO to have S3 and S4 associated to facility
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 [(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: 11/04/2022
Plan of Correction
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Licensees state will send LPA proof of immunization records via email.

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: 10/26/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/26/2022
LIC809 (FAS) - (06/04)
Page: 2 of 7


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: ALBA FAMILY CHILD CARE
FACILITY NUMBER: 198005588
VISIT DATE: 10/26/2022
NARRATIVE
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premises. 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.

Individuals who reside in the home were noted and discussed. LPA observed S3 and S4 were not associated to the facility. LPA R. Derraco spoke to LPA A. Mooberry via phone call during inspection to confirm that S3 and S4 had current background clearance. LPA A. Mooberry confirmed via Guardian search that both individuals had background clearance but were not currently associated to the above mentioned facility. LPA advised licensee that a citation under California Code of Regulation (CCR) section 102370(d)(1) will be issued. Per licensee, there are no firearms or weapons stored at 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 A 2A-10BC fire extinguisher indicates fully charged and was serviced on 01/17/22, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable.

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.

The licensees have completed training on preventive health practices including Pediatric First Aid and CPR. The licensees Pediatric First Aid and CPR expires on 03/2023. LPA observed that the Licensees do have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. File review was observed to have proper mandated immunization records. Children’s records were reviewed, however licensee did not have immunization records for current child in care. LPA advised that a citation under CCR section 102418(g) will be issued. A current children’s roster was available for review.
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SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022
LIC809 (FAS) - (06/04)
Page: 6 of 7
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: ALBA FAMILY CHILD CARE
FACILITY NUMBER: 198005588
VISIT DATE: 10/26/2022
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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.cdss.ca.gov. LPA also discussed and provided LIC 311D - Forms to Keep in your Family Child Care Home.

The following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the co-licensees Vannessa Alba and Luz Maria Alba.

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

DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022
LIC809 (FAS) - (06/04)
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