198006176-10-1-2019-33-CC-JMOA-BGJRG8-20191001130019

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198006176
Report Date: 10/01/2019
Date Signed: 10/01/2019 01:00:28 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	MAYTORENA FAMILY CHILD CARE		FACILITY NUMBER:	198006176
ADMINISTRATOR:	MAYTORENA, ALBA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 265-0638
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90033
CAPACITY:	14	CENSUS: 9	DATE:	10/01/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:05 PM
MET WITH:	Alba Maytorena		TIME COMPLETED:	01:15 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	Licensing Program Analyst (LPA) Judy Mora conducted an unannounced Annual/random inspection. Visit was conducted in Spanish. LPA met with licensee, Alba Maytorena, who guided analyst on a tour of the facility. The licensee's husband, Teodoro Maytorena and Licensee's assistant, Micaela Pasillas, were also present. There were 9 children present, 1 being an infant. Licensee states that there are currently 11 children enrolled, children's roster was reviewed and is current. Disaster drill log was available, last drill documented was 09/10/19. This is a two story home which consists of 5 bedrooms, 3 bathrooms, kitchen, dining room, living room, family room (FIREPLACE: inaccessible), laundry room, front and backyard (fenced). The children use the bathroom in the hallway, living room, family room, dining room, kitchen area and backyard. Per licensee, areas off limits to children and parents include: the second floor, 5 bedrooms, 2 bathrooms and laundry room. There is a gate blocking access to the second floor. Family members residing in the home are 2 adults (criminal record clearances on file). The LPA toured all areas used by children during this visit. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating (wall ac) for safety and comfort. There is a working telephone service maintained in the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible in all areas of the home. Licensee states that there are no poisons in the home. The licensee does understand that poison must be locked with a key or combination lock. Per licensee, there are no weapons, firearms or bodies of water on the premises. There were safe toys, play equipment and materials observed for children. Emergency Disaster Plan was observed to be posted at the time of visit. Children’s records were reviewed to ensure that each child has an Identification and Emergency form. The valve on the required 2A 10BC fire extinguisher indicates fully charged (serviced 02/08/19). Smoke detector and carbon monoxide detector were tested and are in operable condition. *REPORT CONTINUES ON THE NEXT PAGE

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy Mora	TELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2019

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MAYTORENA FAMILY CHILD CARE	FACILITY NUMBER: 198006176
	VISIT DATE: 10/01/2019

NARRATIVE

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The licensee has current Pediatric First Aid and CPR, which will expire 06/23/2021. Licensee's assistant, Micaela Pasillas, has current Pediatric First Aid & CPR which expires 10/21/2019.

Incidental Medical Services (IMS) policy was discussed. Per Licensee, there are no children on medication. 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

SB792 (Immunization Requirements for Staff and Employees) was discussed with the Licensee. The Licensee has immunization's on file.

AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: https://www.mandatedreporterca.com/training/child-care-providers. Licensee completed the training on 03/10/18. Licensee's assistant, Micaela Pasillas, completed the training on 03/11/18.

The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed.

LPA provided Licensee with PIN 19-02-CCP, Safe Sleep Awareness Campaign (Spanish Version).

The following was discussed: Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.

*REPORT CONTINUES ON NEXT PAGE

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy Mora	TELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2019

LIC809 (FAS) - (06/04)

Page: 2 of 3

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MAYTORENA FAMILY CHILD CARE	FACILITY NUMBER: 198006176
	VISIT DATE: 10/01/2019

NARRATIVE

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No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility. Effective January 1, 2010, licensees of family child care homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.

The licensee’s email address was obtained during this visit. The licensee was advised that email is public information.

LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

Exit interview was conducted with Licensee. The Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

*END OF REPORT

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy Mora	TELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2019

LIC809 (FAS) - (06/04)

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