<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198005762
Report Date: 03/01/2023
Date Signed: 03/01/2023 03:33:46 PM


Document Has Been Signed on 03/01/2023 03:33 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:RIVAS FAMILY CHILD CAREFACILITY NUMBER:
198005762
ADMINISTRATOR:RIVAS, IRMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(424) 351-5536
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY:14CENSUS: 5DATE:
03/01/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Irma Rivas, LicenseeTIME COMPLETED:
04:00 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
On 03/01/2023 at 1:30 PM, Licensing Program Analyst (LPA)Katrina Chicote conducted an Unannounced Required – 1 Year inspection to the above facility. Upon arrival, LPA disclosed the purpose of the inspection and met with Licensee, Irma Rivas, who allowed entry and guided the LPA on a tour of the facility. Adults in the home were discussed and all have criminal record clearance. Also present was A1, Licensee’s Assistant. LPA observed four preschoolers and one infant, total census five, present during today’s inspection. Licensee states that there are currently 13 children enrolled. The children's roster was reviewed and is current. Required postings were observed at time of inspection. Disaster drill log was also available during today’s inspection, last disaster drill conducted on 01/06/2023.

This is a single-story home which consists of three bedrooms and two bathrooms, Kitchen, Dining Room, Living Room, and Den. Areas used by the children include the Living Room (located upon entry of the home), Dining Room (located to the left of entrance), Kitchen (located to the rear of the home) primarily used as walkway to access backyard, Den (located through door to the right of Living Room) and Bathroom 1 (located through doorway in Den). Per Licensee, areas off limits to children and parents include all three bedrooms and Bathroom 2. Per Licensee, off limit areas are also locked during operating hours, LPA observed doors to be locked at time of inspection.

All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. There is a working telephone maintained in the home. At 1:33 PM, LPA observed Living Room to have play pen for infants with soft plush toys and infant seating available inside. LPA observed a pack-n-play in Living Room for infant sleep. LPA observed couches and large TV in Living Room and a large desk in rear of Living Room with puzzles and age appropriate toys, free of loose and sharp parts available. At 1:35 PM, LPA observed three preschoolers sleeping on mats in Den. LPA observed Den to have various shelving filled with toys, puzzles, art materials, and other age appropriate toys. LPA observed two additional pack-n-plays in Den for Infant sleep.
Report continues- Page 1 of 3
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:
DATE: 03/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/01/2023
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 4


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: RIVAS FAMILY CHILD CARE
FACILITY NUMBER: 198005762
VISIT DATE: 03/01/2023
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
26
27
28
29
30
31
32
 At 1:38 PM, LPA observed Bathroom 1 to have operable toilet and sink, adequate hand washing supplies, and general area safety and sanitation. LPA observed operable child safety locks on under sink cabinet and medicine cabinet at time of inspection. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. At 1:43 PM, LPA observed these items stored in Kitchen with operable child safety locks on drawers and under sink cabinet. Licensee states poisons such as bug spray is stored in garage that is locked. The Licensee does understand that poison must be locked with a key or combination lock.

Per Licensee, the children will have access to backyard area for outdoor play. LPA observed backyard is accessible through backdoor in Kitchen. At 1:48 PM, LPA observed backyard has grass and adequate perimeter fencing through-out the yard. LPA observed bicycles, plastic play house, and other age appropriate toys free of loose and sharp parts available for the children in the backyard and all trees, shrubs, and plants are maintained.

Per Licensee, they provide food for children in care and use Dining Room for eating. LPA observed rectangular table with six chairs in Dining Room available. Licensee states children also use Den for eating.
Per Licensee, she has one dog that is kept separate from children in dog run in backyard. LPA observed dog run and did not observe dog bark during inspection. Per Licensee, isolation area for sick children is in Living Room.

At 1:42 PM, LPA observed the valve on the required 2A 10BC fire extinguisher indicates fully charged with service tag dated 03/08/2022. LPA observed smoke and carbon monoxide detectors are in operable condition at time of inspection. LPA observed First Aid kit stored in Den and was inventoried for necessary supplies. The Licensee has current Pediatric First Aid and CPR valid until 03/2024. Proof of immunization against influenza, pertussis, and measles was readily available during today’s inspection. LPA observed Licensee has taken the Mandated Reporter Training on 03/14/2022.

At 1:54 PM, LPA observed a firearm stored in off limits Bedroom to be stored according to Title 22 Regulation requirements. Per Licensee there are no bodies of water around the premises and none were observed by LPA.
Report Continues - Page 2 of 3
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: RIVAS FAMILY CHILD CARE
FACILITY NUMBER: 198005762
VISIT DATE: 03/01/2023
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
26
27
28
29
30
31
32
The following were discussed:
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 (or facility representative) 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.

Rooms that are off-limits need to be made inaccessible during operating hours. NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers and any other item that falls into that category are permitted in the facility. The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.



LPA discussed the safe sleep regulations with licensee [or facility representative] 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 [facility representative] 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 facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today, 03/01/2023.

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 was conducted and report was reviewed with the Licensee (or facility representative), Irma Rivas. Report Ends - Page 3 of 3

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Katrina ChicoteTELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4