198007023-9-9-2022-54-CC-JESA-CJ4R3Z-20220909124045

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198007023
Report Date: 09/09/2022
Date Signed: 09/09/2022 12:41:00 PM

Document Has Been Signed on 09/09/2022 12:41 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:	GALVEZ FAMILY CHILD CARE		FACILITY NUMBER:	198007023
ADMINISTRATOR:	GALVEZ, CAROL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 229-2355
CITY:	NORWALK	STATE: CA	ZIP CODE:	90650
CAPACITY:	14	CENSUS: 7	DATE:	09/09/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:34 AM
MET WITH:	Licensee Carol Galvez		TIME COMPLETED:	12:50 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 9/9/22 Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced required 1 year inspection at the above facility. LPA met with the Licensee Carol Galvez and informed her of the purpose for the visit. LPA provided Licensee with a copy of the Facility Entrance Checklist. One staff, Licensee's assistant and Licensee's spouse were also present during the inspection. Licensee's spouse guided LPA on a tour of the facility. There were 7 children present. All residents of the home were noted and verified. Facility provides care to children ages 12 months to 12 years old. Facility is open Monday to Friday 7AM to 5:00 PM. This is a two story, five bedroom, three bathroom home. On the first floor there are three bedrooms and two restrooms, kitchen, dining area, 2 living rooms and 2 day care rooms. On the second floor there are two bedrooms and one restroom. There is also a fenced backyard. Per Licensee areas on limits to children are: The living room/dining room/kitchen area, the restroom in the hall way, the day care room next to the dining room and the fenced backyard. Per Licensee areas off limits to children are: The two bedrooms on the first floor are off limits. LPA was advised that construction was completed on an added area of the home. Added areas include the second day care room, a restroom in the second day care room, a laundry room, the second living room and the second story with two bedrooms and one restroom. The second story, the second living room and the laundry room are off limits. Licensee has requested to use the second day care room as an on limits area. LPA inspected the second day care room and observed age appropriate toys and materials for children, a combination smoke/carbon monoxide detector, inaccessible electrical outlets and a safety gate blocking access to the other part of the home addition. There is a latched storage shed in this room that contains day care materials. There is a latched storage cabinet in the restroom that will be latched. LPA observed cleaning products in the cabinet under the sink. LPA advised a latch also be installed on the cabinet-Licensee will send a picture to LPA. This added area is accessed through a door in the kitchen and it is kept locked during operating hours. The Licensee has been advised that this second day care room and second restroom cannot be used until they are approved by the Department.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GALVEZ FAMILY CHILD CARE	FACILITY NUMBER: 198007023
	VISIT DATE: 09/09/2022

NARRATIVE

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All areas that are accessible to children were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection: LPA observed required posted documentation- Facility license, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPA observed and reviewed a current roster LIC 9040 and a current disaster drill log. Last disaster drill was performed on August 10, 2022. There is an operable carbon monoxide detector in the living room and an operable smoke detector in the day care room. LPA observed a 2A10BC Fire Extinguisher in the facility which indicated full and was last serviced September 2022. The home maintains telephone service (cell phone). Food is provided by Licensee. Licensee was reminded if children bring food from home it must be labeled with the child’s name and properly stored or refrigerated.
There are toys and other age appropriate materials available for children to use in the day care room. Sharp objects, detergents and cleaning compounds were inaccessible to children in care. Knives are kept in an upper cabinet in the kitchen, cleaning compounds are in a latched cabinet under the sink and detergents are kept in the off limits laundry room.
Personal medication is stored in an upper cabinet in the kitchen, inaccessible to children in care. Per Licensee, no children enrolled require medication. The facility has central air and heating. Children nap in the living room and they are provided appropriate napping equipment. Children use the restroom in the hallway.
Children use the backyard for outdoor play. The backyard is fully fenced. There is a locked storage shed in the backyard. Per Licensee, children are supervised while playing outside. Poisons are kept in the off limits area of the backyard. Children do not have access to the off limits area. The off limits area is kept locked. Licensee understands that all poisons must be locked, not only inaccessible to children. Isolation area for sick children waiting to be picked up is in the living room. Per Licensee, there are no firearms or weapons stored in the home. LPA did not observe any pools or spas, or other bodies of water. Per Licensee, there are no pets in the home.
Infant Care: Currently licensee has 4 infants enrolled. All infants are over 12 months old. Per Licensee infants nap on cots. Napping equipment does not block entrances or exits. Licensee was advised Infants shall not be swaddled in care. Car seats shall not be used for sleeping. Infants did not have the required 15 minute sleep log on file. LPA discussed the new Safe sleep regulation, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months, LPAs provided a copy of PIN 20-24-CCP and the infant safe sleep regulation 102425.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GALVEZ FAMILY CHILD CARE	FACILITY NUMBER: 198007023
	VISIT DATE: 09/09/2022

NARRATIVE

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Overnight Care: There is no overnight care provided at the moment. LPAs discussed the following: Licensee is aware that they must remain awake while children are awake. If children sleep in separate area from licensee, the door must remain open. If licensee cannot hear children when they wake up, video or audio device can be used.
Children's records were reviewed: Children's records contained (LIC) 282- Affidavit Regarding Liability Insurance, Immunization Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights.4 out of 4 children present did not have the 15 minute infant sleep logs.
Staff records were reviewed: Licensee's pediatric first aid/cpr expires on 9/10/22 and the Assistant's cpr/pediatric first aid expires on 8/2023. Staff had proof of required immunizations. All adults had proof of TB clearance. Licensee's Mandated Reporter training was completed in 10/3/21 and Assistant's was completed on 8/10/22. All adults had LIC 508 criminal record statement on file. Assistant had LIC 9052 on file.
During inspection the child present was observed to be treated with dignity and respect, and free from corporal and/or unusual punishment.
Incidental Medical Services (IMS): 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm
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.
LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep https://www.cdss.ca.gov/inforesources/child-care-licensing/ public -information-and-resources/safe-sleep as an additional resource.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GALVEZ FAMILY CHILD CARE	FACILITY NUMBER: 198007023
	VISIT DATE: 09/09/2022

NARRATIVE

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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.

To improve the quality and value of the new inspection process, a survey will 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 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.

The deficiency listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809-D for Type B citation. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

Exit interview conducted and report was reviewed with the Licensee, Carol Galvez . A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 09/09/2022 12:41 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: GALVEZ FAMILY CHILD CARE	FACILITY NUMBER: 198007023
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/09/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(j)

(j) The provider shall supervise infants while they are sleeping and adhere to the following requirements: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review and interview the licensee did not comply with the section cited above. Four out of four children's files did not contain an infant sleep log which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/16/2022
	Plan of Correction
1 2 3 4	Licensee will review regulation 102425 (j) which informs that the provider shall physically check on sleeping every 15 minutes and documentation shall be kept which shall include the date, infant's name and time of 15 minute check. Licensee will provide infant sleep logs for 4 infants enrolled and will submit a picture to LPA.

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: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022

LIC809 (FAS) - (06/04)

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