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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198007609
Report Date: 07/02/2024
Date Signed: 07/02/2024 04:50:40 PM

Document Has Been Signed on 07/02/2024 04:50 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:LORENZO FAMILY CHILD CAREFACILITY NUMBER:
198007609
ADMINISTRATOR/
DIRECTOR:		ADRIANA LORENZOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 688-8309
CITY:LOS ANGELESSTATE: CAZIP CODE:
90033
CAPACITY: 10TOTAL ENROLLED CHILDREN: 10CENSUS: 7DATE:
07/02/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:16 PM
MET WITH:ADRIANA LORENZO, LicenseeTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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On 07/02/2024, Licensing Program Analyst (LPA) Staicy Perry conducted an unannounced Annual inspection to the above facility. A COVID risk assessment was conducted upon entry. LPA was greeted by Licensee ‘s assistant Diana Olvera whom the reason for the visit was explained. Also present during inspection was licensees mother Bertha Leyva. Licensee Adriana Lorenzo was not present due to getting car serviced and at the doctors. Shortly after licensee Adrianna arrived to facility and took over the inspection. Per Licensee, there are 10 children currently enrolled. There were 7 children, and 4 adults present in the home upon arrival. Facility capacity is in compliance for a Large Family Child Care Home. Per Licensee hours of operation are M-F 6:00am-6:00pm.

This is one story home which consists of 3 bedrooms, 2 bathrooms, kitchen, living room, front yard and side yard. Per Licensee, areas off limits to children and parents include: two bedrooms and one bathroom. Primary care is provided in the living room, bedroom and kitchen area . Children use the bathroom next to the living room. LPA observed a wall heater in the hallway which is inaccessible. There is a wall ac in the living room. The Licensee's yard is split into two areas which is gated. Currently children are using the front yard for outdoor play. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that could be hazardous to children in care.

During this visit, all areas identified that are accessible for children to use were inspected for the safety, comfort, and cleanliness. Licensees mother Bertha guided LPA on the tour of the home. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for safety and comfort.There are toys and other age-appropriate materials available for children.

The bathroom was reviewed, LPA did not observe anything that can pose danger to the children in care. The kitchen was observed to be clean and organized. Knifes were seen to be placed in a locked cabinet in the kitchen making it inaccessible to the children via a child safety lock. The living room area was observed to be
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE: DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: LORENZO FAMILY CHILD CARE
FACILITY NUMBER: 198007609
VISIT DATE: 07/02/2024
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clean and orderly. At approximately 1:19 pm LPA observed C#1 to be in playpen watching TV drinking a bottle of milk, Per Bertha, C#1 is her grandchild and is normally not here but was an emergency. LPA advised Bertha that if C#1 is here during hours of operation all Title 22 regulations need to be followed and C#1 will be included in ratio. Bertha understood. Technical provided. The bedroom was observed next at approximately 1:40pm, LPA observed 3 playpens’, one with C#2 sleeping with a blanket as well as C#3 inside of playpen with a bottle and blanket and C#4 was also observed to be inside of playpen with a blanket and bottle. Per licensee C#3 and C#4 are over 2 years of age but are accustomed in sleeping in playpens at home and are in process of transitioning to mats. Technical provided. LPA observed a six panel play portable play yard with C#5 playing inside of it in the bedroom, which poses a risk to the health and safety of the children in care. Home was observed to have plenty of age-appropriate toys for the children to use. Applicant had latches on cabinets with any potentially hazardous material.

All equipment did not meet the US Consumer Product Safety Commission safety standards which poses an potential risk to the health and safety of the children in care. At approximately 1:45pm LPA observed a swing in the bedroom. Per licensee the swing is used for her daughter after hours of operation. LPA Perry observed licensee place the swing in the storage shed in the back of the house.

Detergents, cleaning compounds, and medications were observed to be inaccessible to children kept in a locked cabinet under the sink via a child safety lock. Medications are stored in the off-limit room. Per Licensee, there are no poisons in the home. LPA advised that any poisons should be locked under key or combination lock. Licensee states that are no firearms or weapons stored in the home. The living room couch is used as an isolation area for an ill child until an authorized representative arrives to pick up the child.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and LPA observed proof of purchase date of July 2, 2024. Which indicates it is fully charged and in green. Smoke and carbon monoxide detectors were tested and are operable and were observed to be in the hallway area.

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 documented was conducted on 5/29/2024. The home is observed to be clean and orderly. There are first aid supplies available. LPA observed licensee to have a first aid kit available and is
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
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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: LORENZO FAMILY CHILD CARE
FACILITY NUMBER: 198007609
VISIT DATE: 07/02/2024
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located in the living room area.

Per licensee, breakfast, AM snack, lunch, PM snack and dinner is provided by licensee. Licensee uses a food program called Angels Food Program. Licensee was advised that food brought from the children’s homes, all containers must be labeled with child’s name and properly stored or refrigerated. Licensee does not transport the children.

LPA toured the outdoor play area and inspected its safety and condition. LPA observed perimeter fencing which is free of miscellaneous debris/hazards. All trees, shrubs and plants are maintained. Outdoor play yard was observed to have toys for the children to play. LPA did observe outside are to have adequate shade. LPA observed plenty of age-appropriate toys.

Licensees’ records were reviewed. Immunization's were observed to be on file for licensee and assistant. The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. Pediatric First Aid and CPR expires 6/25/25. Licensee assistant CPR expires on 6/25/25.

LPA did observe that Licensees to have proof of Mandated Reporter AB 1207 compliant Child Care Training Certificate on file for the department to review. www.mandatedreporterca.com. Licensees training expires 4/12/25.Licensee assistant MRT expires 4/12/25 and licensee another assistant expires on 4/12/25.

LPA observed children’s records were reviewed, including emergency information, and were observed to be complete.

LPA created an LIC 857, Children’s Record Review, and LIC 811, confidential names which documents persons living in the home and children’s files reviewed during this inspection.

Per licensees, there are no pets on the premises.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensees, no one smokes in the home.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
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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: LORENZO FAMILY CHILD CARE
FACILITY NUMBER: 198007609
VISIT DATE: 07/02/2024
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LPA did observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that fall into these categories are not permitted in a family childcare facility.

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/.

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.

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.


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.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
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: LORENZO FAMILY CHILD CARE
FACILITY NUMBER: 198007609
VISIT DATE: 07/02/2024
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Infant Care: LPA reviewed Safe sleep regulations / documents, 15-minute sleep check documentation for infants 0-24 months were reviewed and on file for the department. LPA observed and inspected sleeping equipment for infants. LPA was informed by licensee that mats are used and playpins for the infants for 0-12 months of age. Each infant has their individual bedding and is washed weekly as required. Soiled bedding is replaced when wet or soiled and is placed in an area inaccessible to infants.

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

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California

During the exit interview, Licensee, Adriana, confirmed that there are no Registered Sex Offenders living in the facility.

Currently, the licensee, Licensee, Adriana is not compliance with California Code of Regulations Title 22. deficiencies cited will be on a LIC 809D page.

A notice of site visit was given and must remain posted for 30 days. Appeal rights were discussed and provided.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
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Document Has Been Signed on 07/02/2024 04:50 PM - It Cannot Be Edited


Created By: Staicy Perry On 07/02/2024 at 04:00 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LORENZO FAMILY CHILD CARE
FACILITY NUMBER: 198007609

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/02/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(b)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations and interview, the licensee did not comply with the section cited above in C#2 sleeping in crib with a blanket, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/08/2024
Plan of Correction
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Per licensee they will continue to work with child to transition over to a mat. Licensee will sign declaration stating that no child will be placed to sleep in a play pin with an loose articles or objects. Licensee will also watch safe sleep videos on ccld website.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Brandi VanOosten
LICENSING EVALUATOR NAME:Staicy Perry
LICENSING EVALUATOR SIGNATURE:
DATE: 07/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/02/2024


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