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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198007809
Report Date: 10/19/2023
Date Signed: 10/19/2023 03:45:29 PM


Document Has Been Signed on 10/19/2023 03:45 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:CARDENAS FAMILY CHILD CAREFACILITY NUMBER:
198007809
ADMINISTRATOR:CARDENAS, I.,L.& O.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 362-8807
CITY:LA PUENTESTATE: CAZIP CODE:
91744
CAPACITY:14CENSUS: 2DATE:
10/19/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Irma & Leticia CardenasTIME COMPLETED:
03:50 PM
NARRATIVE
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On 10/19/2023, Licensing Program Analyst (LPA), Carolyn Tuba conducted an unannounced annual inspection for the above facility. Covid risk assessment was conducted. LPA met with Licensees, Irma and Leticia Cardenas. During today’s inspection LPA observed 2 children in care. A facility roster was available. Per Licensee, operating hours are from Monday - Friday 6:00 am – 8:00 pm and cares for children ages birth to 12 years of age. The licensee provides breakfast, AM/PM snack, lunch and dinner to the children in care and is part of a food program. The facility is currently a large family daycare.

This is a one-story home which consists of a living room, dining room, kitchen, garage, front yard, back yard, side yard, 4 bedrooms and 2 bathrooms. During the visit Licensee updated indoor facility sketch as it did not match current facility sketch on file. Areas used by the children are the living room, dining room, 1 bathroom, and front yard. Per Licensee, areas off limits to children and parents include 4 bedrooms, backyard, side yard, garage and 1 bathroom located inside of master bedroom.

The licensee states that 4 adults currently live in the home. Per Licensee, they may be updating application and removing one of the Licensees as there are currently 3 people listed and one of the licensees no longer resides in the home. 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.

Licensee states that there are no firearms stored in the home. LPA observed a baby gate between the kitchen and dining room as the kitchen is used as a walkway for children to have access to the living room and
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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 10/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2023
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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Document Has Been Signed on 10/19/2023 03:45 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: CARDENAS FAMILY CHILD CARE
FACILITY NUMBER: 198007809

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/19/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)1
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. 1. The licensee shall document the drills, including the date and time of each drill. This documentation shall kept at the family child care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in documenting drills which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/23/2023
Plan of Correction
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Per Licensee she will conduct and document drills and email a copy to LPA.

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: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 10/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/19/2023 03:45 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: CARDENAS FAMILY CHILD CARE
FACILITY NUMBER: 198007809

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/19/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, the licensee did not comply with the section cited above in documenting which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/23/2023
Plan of Correction
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Per Licensee, she will begin documenting a sleep log for the children under 24 months and email a copy to the LPA
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in providing proof of the mandated reporting certificate which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/26/2023
Plan of Correction
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Per Licensee mandated reporter training will be taken by persons working directly with children in care. (3 Licensees-Irma, Leticia and Odalys)
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: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 10/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2023
LIC809 (FAS) - (06/04)
Page: 3 of 7


Document Has Been Signed on 10/19/2023 03:45 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: CARDENAS FAMILY CHILD CARE
FACILITY NUMBER: 198007809

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/19/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as CPR/1st Aid expired on June 2023 which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/20/2023
Plan of Correction
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Per Licensee (Leticia & Irma) will be renewing their Pediatric CPR/1st Aid training including the ESMA sticker and will email a copy to the LPA.
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: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 10/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2023
LIC809 (FAS) - (06/04)
Page: 4 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CARDENAS FAMILY CHILD CARE
FACILITY NUMBER: 198007809
VISIT DATE: 10/19/2023
NARRATIVE
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restroom. The Licensee states that they always have supervision on the children.

The home was inspected for safety, comfort, cleanliness, ventilation, and telephone service.
Fire and safety drills must be performed every 6 months and documented for review by the Department. Licensee conducted Earthquake Drills on April 2023 No one smokes in the family childcare home.

In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR training, Immunization's (TB, TDAP, MMR, Influenza), mandated reporter training and a valid criminal record clearance associated to the facility license.



Detergents, cleaning compounds, medications, and other items, which could pose a danger, were determined to be inaccessible to children in care during this inspection.

LPA observed the required 2:A-10:B-C fire extinguisher and per Licensee they will be purchasing or servicing existing fire extinguisher. Per State Fire Marshall standards, fire extinguishers shall be service annually. The smoke detector and carbon monoxide detector were working properly. Per Licensee there are no bodies of water on the premises. Currently facility has 3 dogs, 2 birds, 1 duck and 1 turtle. The Bigger dog is kept locked up either in the back yard or side patio, along with the duck and turtle which is off-limits to children in care. The 2 smaller dogs are kept in the living room and per licensee the smaller dogs are supervised with the children in care.

LPA advised the Licensee with regards to safe sleep and that infants under 24 months shall be checked on every 15 minutes and the time of each 15-minute check shall be documented with child’s name, date and initials of the person who checked on the child. LPA provided Licensee a booklet on Safe Sleep both in English and Spanish. The LIC 9227 Individual Infant Sleeping Plan shall be completed for each infant up to 12 months of age. LPA advised Licensee the Provider Information Notice (PIN) 20-24 CCP: Recently Approved Safe Sleep Regulations in Effect. Per Licensee children are checked but is not documenting the 15-minute sleep check. The licensee is observed to be operating within the license capacity limitations. LPA did not observe any children left in parked vehicles. Car seats shall only be used for transportation. LPA did not observe any children sleeping in car seats. The Licensee was reminded to utilize play yards, cribs and highchairs for what they are intended for and not leave children in them for any other reason.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2023
LIC809 (FAS) - (06/04)
Page: 5 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CARDENAS FAMILY CHILD CARE
FACILITY NUMBER: 198007809
VISIT DATE: 10/19/2023
NARRATIVE
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The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR, which includes the EMSA Sticker, but the Pediatric First Aid and CPR expired on 6/2023. There are first aid supplies available. Licensees do not have the mandated reporting training certificate AB 1207, accessible. LPA advised that Mandated reporting training needs to be conducted every 2 years.

Currently, children are using the front yard for outdoor play time. The outdoor play area was observed to be enclosed with an iron gate and parents have a gate to utilize for access. LPA observed that the outdoor yard has toys and other materials for children to play with.



Children and Staff records must be maintained and updated as needed and must be available for review by the Department. If Children and Staff leave the day care all records must be maintained for 3 years after leaving. LPA observed that children’s files were complete.


To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process. ample sheet and Licensee will be begin checking today October 11, 2023.

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 [or 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.



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
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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2023
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CARDENAS FAMILY CHILD CARE
FACILITY NUMBER: 198007809
VISIT DATE: 10/19/2023
NARRATIVE
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Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

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, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Please see LIC809-D pages for deficiencies cited during today's visit in accordance to the California Code of Regulations Title 22, Division 12, Chapter 1.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Leticia Cardenas

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2023
LIC809 (FAS) - (06/04)
Page: 7 of 7