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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198009291
Report Date: 05/24/2019
Date Signed: 05/24/2019 03:42:12 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:ORTIZ FAMILY CHILD CAREFACILITY NUMBER:
198009291
ADMINISTRATOR:ORTIZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 261-5735
CITY:LOS ANGELESSTATE: CAZIP CODE:
90023
CAPACITY:14CENSUS: 5DATE:
05/24/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:LicenseeTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Tiffanie Tran arrived at the above facility to conduct an annual random inspection. Upon arrival, LPA met with licensee, an employee with 5 children in care. About 2:40PM we toured areas of the home. All adults have fingerprinted cleared and associated to the licensed facility. LPA observed proper care and supervision of children and ratios.

LPA observed all posting requirements by the entrance. Licensee had current CPR/First Aid certificates (Exp. 6/2020), fire extinguisher, carbon monoxide and smoke detector meet regulations. Cleaning materials and medications are inaccessible, there is a working telephone, and toys appear to be safe. Licensee stated there are no fire arms or weapons in the home. The home conducted emergency disaster drill on a monthly basis. LPA reviewed children's record to be complete and orderly. This is a single dwelling home consists of two bedrooms, one bathroom, living room, kitchen, and dinning room. Child care conducted in living room, and a converted dining room for quiet room. Children do have access to the kitchen to go the bathroom. LPA observed kitchen cabinets had proper latched. The rest of the areas in the home are off-limits to children. Licensee acknowledged that children may never enter these off-limit areas. Per licensee, backyard is off-limit to children. Children play at the side backyard. LPA observed to be fenced in, safe and clean. There are no bodies of water in the home.

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

Licensee was informed of responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also call the Community Care Licensing office and follow up with a written Unusual Incident/Injury Report (LIC 624B).

SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2019
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ORTIZ FAMILY CHILD CARE
FACILITY NUMBER: 198009291
VISIT DATE: 05/24/2019
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LPA reminded that it is the facility responsibility to know the regulations as well as anyone who assists in providing care. LPA advised on how to access quarterly reports, forms, and regulations for Child Care online at www.cdss.ca.gov. to stay informed of any changes or updates to the regulations.

LPA shared the Child Care Advocate Program (CCAP) participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. Facility may also register on CCAP website for the new quarterly report to be notified. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541. Email address: childcareadvocatesprogram@dss.ca.gov

Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com

LPA discussed and provided the safe sleep for baby pamphlet. Each infant shall be constantly supervised and under direct visual observation by an adult person at all times. Under no circumstances shall any infant be left unattended. In order to visually observed and supervise sleeping infants there should be no obstruction to the view of the infants, which could include transparency walls and/or half walls. LPA recommend that infants sleep safest in crib with no bumpers, pillows, blankets, or toys, and on their backs, and every sleep time counts to reduce the risk of SIDS and other sleep-related causes of infant death.

The licensee was informed that the presence of adults in the home without Criminal Record Clearance or Exemption will be cited and civil penalty assessed for $100 per day. The licensee may find additional information and forms on the Department’s website at www.ccld.ca.gov including information on the Live Scan application (LIC 9163). Appointments can be made for Live Scan at 1-800-315-4507.

Licensee is reminded that smoking is prohibited on the premises during hours of operation.

No deficiency is cited during today’s visit. An exit interview conducted. Licensee had a copy of this report.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2019
LIC809 (FAS) - (06/04)
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