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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198008700
Report Date: 07/13/2021
Date Signed: 07/13/2021 01:44:47 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:NAVARRO FAMILY CHILD CAREFACILITY NUMBER:
198008700
ADMINISTRATOR:NAVARRO,RITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
2137411091
CITY:LOS ANGELESSTATE: CAZIP CODE:
90011
CAPACITY:14CENSUS: 8DATE:
07/13/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:11 AM
MET WITH:Rita Navarro, LicenseeTIME COMPLETED:
01:40 PM
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Prior to entrance to the facility, LPA Mayra Rivera conducted a Covid 19 assessment and based on the licensee responses to the facility assessment questions, LPA Rivera determined safe to proceed. On Tuesday, July 13, 2021 at 10:11 AM, Licensing Program Analyst (LPA) Mayra Rivera conducted an unannounced Annual/Required site inspection to ensure the health & safety standards as required by regulations governing family child care homes are being met. LPA met with Licensee Rita Navarro who guided LPA Rivera on a tour of the facility.

During the inspection, 8 children ( one toddler, six preschool and one school age) and assistant Veronica Gomez were present. LPA Rivera observed 7 children doing gross motor activities with the assistant and the toddler with the licensee as the child is new to the daycare. Family members residing in the home was been discussed with licensee and are cleared. Operating hours are Monday to Friday, 7:00 AM to 5:30 PM and care for children ages 0 to 13 years.

This facility is a two-story home that consists of four bedrooms, 3 full bathrooms, kitchen, living room, dinning area, front yard (gated), and backyard (fenced). Areas that are accessible to children and identified on the facility sketch were inspected by LPA Rivera;, play room, kitchen, dining room, restroom (by the kitchen) and backyard.

Areas off limits to children include: all second floor, bedroom next to the front entrance, bedroom by the kitchen and front yard. At 10:15 AM, LPA observed the door that leads to the second floor closed and locked with a dead bolt lock.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021
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: NAVARRO FAMILY CHILD CARE
FACILITY NUMBER: 198008700
VISIT DATE: 07/13/2021
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At 10:19 AM LPA Rivera entered the daycare room area to inspect for safety, comfort, cleanliness, ventilation and working phone (land line). For ventilation, LPA Rivera observed thermostat for heater and central air and the vents located on high ceiling walls. LPA observed the thermostat temperature at 74 degrees. LPA did not see a fireplace during the inspection. LPA observed a cubby storage with children personal belongings, children materials such as art supplies, puzzles, dramatic play items and manipulative. LPA observed the furniture and children materials to be in good condition and age appropriate. LPA observed the mats with the children's blankets making contact. LPA advised to place the mats inside a plastic bags or mat storage to avoid contamination.

At 10:25 AM, LPA Rivera entered the restroom and observed the toilet, running water, hand soap and paper towels. Inside the bottom cabinets, LPA observed cloth towels and did not observe items that can pose a potential hazard to children. LPA observed the restroom to be in good condition.

At 10:29 AM LPA observed cleaning compounds items stored inside a high up kitchen cabinet. Inside the cabinet LPA observed sealed containers with food items and the cleaning compounds above the containers. LPA advised licensee to remove cleaning compound and to place them in an area away from food and inaccessible to children. Also, LPA observed kitchen knives stored inside the high kitchen cabinet making it inaccessible to children to reach. Licensee understands that any poisons or firearms must be locked with a key or combination lock. For drinking water LPA observed water bottles and cups.

LPA Rivera asked if there are any pets, poisons, firearms, weapons or bodies of water. Licensee stated she has no pets, firearms, or weapons nor water bodies of water. LPA did not observe firearms or weapons, pets, poisons, nor bodies of water. Licensee was advised that if any poisons (ex; drano, rat poison or items with skull hazard symbol), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately.



At 10:43 AM LPA inspected the outdoor area used by children in care for safety, comfort and cleanliness, LPA observed backyard to be fenced all around and the side gates locked. LPA also observed two cars parked on the side of the yard and two all the way in the back. The four cars doors were lock making it inaccessible to children to open the doors. LPA observed two tomato plants and informed licensee the plant is a poisonous plant and advised to place a barrier around it so children don't have access to the plant. LPA also observed a small homemade metal oven and advised licensee to install a safety barrier to avoid children access to the oven.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021
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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: NAVARRO FAMILY CHILD CARE
FACILITY NUMBER: 198008700
VISIT DATE: 07/13/2021
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LPA also observed the central AC unit compressor and advised licensee to place a barrier around the compressor to avoid an injury. LPA observed a storage room closed and hard to open the door but advised licensee to lock or place a child proof lock to make it inaccessible to children. LPA observed a shed closed with a self lock and inaccessible to children. LPA observed, balls, trick bikes and playhouse and observed the play equipment to be in good condition and age appropriate.

At 10:50 AM LPA Rivera observed the required 2A10BC fire extinguisher located in the kitchen and the valve on the green area indicating fully charged and serviced dated 2/4/21. At 10:52 AM LPA asked licensee to press on the smoke detector located in the dining room room and play room and the carbon monoxide alarm that is located in the kitchen. LPA heard the sounds of the smoke and carbon monoxide alarms. The alarms are operating.

LPA Rivera observed licensee pediatric First Aid/CPR certification (expires 05/01/2023) and has proof of immunization against pertussis, measles and influenza declination dated July 13 2021. LPA also observed assistant Veronica Gomez pediatric First Aid/CPR certification (expires 05/01/2023) Licensee has completed the mandated reporter (AB 1207) training on 4/24/2020. Licensee was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com.

At 11:15 PM LPA observed on the bulletin wall the LIC 610 Emergency Disaster plan, Parents Rights, License, LIC 9148 Earthquake preparedness checklist, and facility sketch and fire/earthquake drill. Last drill conducted on 6/16/21.


The following was discussed:

INFANT CARE: LPA Rivera reviewed and discussed Safe Sleeping Practices information with licensee and a plan for supervising sleeping infants. LPA advised the licensee to sleep infants in an area where infants can be directly supervised. Place infants on their backs to sleep, on a firm mattress with fitted sheet that fits snugly in crib or play yard. LPA also advised against sleeping infants in a separate room with no direct supervision and no pillows, crib bumpers, swaddling, head covered, and pacifiers must not have anything attached. Safe sleep brochure was provided.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: NAVARRO FAMILY CHILD CARE
FACILITY NUMBER: 198008700
VISIT DATE: 07/13/2021
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LPA Rivera also reviewed Sudden Infant Death Syndrome (SIDS), Never Shake A Baby, and Lead Exposure information with licensee. LPAs also explained to licensee that car seat, stroller are only and only for transportation, highchair is only and only for feeding and stated items cannot be misused. No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into this category are not permitted in a family child care facility.

Medication: 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

LPAs advised the licensee how to access forms, regulations and quarterly updates , and Providers Information Notices (PIN) online at: www.ccld.ca.gov



LPA issued the Confidential Names List (LIC 811) to the licensee during the inspection. The Confidential Names List documents the children’s and staff files that were reviewed during this inspection. LPA observed the filed to be completed. LPA infomed Licensee assistant Natalia Arenas may not start assisting until the clearance is received.

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.



Licensee has been given an advisory notice to removed cleaning compounds and place them in an area away from food and inaccessible to children, place a barriers around the tomato plants, outdoor homemade oven, and AC compressor. Also, to add a lock to the outdoor storage room. Due date given to licensee to make the corrections 7/27/21.

Exit interview was conducted and plans of correction were reviewed and developed with Licensee, Rita Navarro. Appeal rights explained & provided. A copy of this report and appeal rights were discussed and left with licensee, Rita Navarro whose signature on this form confirms receipt of these documents.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3368
LICENSING EVALUATOR NAME: Mayra RiveraTELEPHONE: (323) 629-7782
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4