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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198009741
Report Date: 05/10/2019
Date Signed: 05/10/2019 02:59:44 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:TORRES FAMILY CHILD CAREFACILITY NUMBER:
198009741
ADMINISTRATOR:TORRES, LAARNIE S.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 538-3995
CITY:POMONASTATE: CAZIP CODE:
91768
CAPACITY:14CENSUS: 8DATE:
05/10/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Larrnie Torres- Licensee TIME COMPLETED:
03:20 PM
NARRATIVE
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Licensing Program Analyst (LPA) Ketki Desai conducted an unannounced random inspection to the above facility. LPA met with Larrnie Torres, Licensee who guided analyst on a tour of the facility. Also present during this inspection, is Gilbert Torres, Licensee’s spouse and assistant. The licensee states that she currently has 18 children enrolled. Children's roster was updated in the presence of the LPA.
Facility operating hours per the poster is 24 hours, Licensee stated the first child come in at 4.00 am and last child leaves at midnight. So the new poster shall reflect the missing facility number and the change in operating hours as stated by the licensee.

This is a two story home consisting of three bedrooms, three bathrooms, kitchen, living room, dining area, and family room, Extended Den area is converted into (day care area). Per Licensee, children in care have access to the living room, dining area, family room, and the bathroom in the day care area. The kitchen and entire upstairs is off limits to children in care. LPA observed two (2) separate gates with a latch, preventing children from gaining access to the upstairs and kitchen area. The home was inspected for safety, comfort, cleanliness, ventilation, and telephone service (land line).

The licensee states that 3 adults and 0 children currently reside in the home. Licensee states that she currently has one assistant ( Spouse). All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home.

PHYSICAL PLANT
Detergents, cleaning compounds, medications, and other items which could pose a danger are accessible to children. ( Left on the shelf of the children's cubby) The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (323) 981-3351
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2019
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: TORRES FAMILY CHILD CARE
FACILITY NUMBER: 198009741
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/10/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/14/2019
Section Cited
CCR
102423(a)(2)
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Each child receiving services from a FCCH shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.This requirement is not
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Licensee to clean the backyard and cover the outlets by the due date and send the pictures
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Met by observation of thorny weeds and uncovered eletrical outlets in the day care area. This poses a potential risk to Health and safety to children in care.
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Type B
05/17/2019
Section Cited
HSC
1597.622©:
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Immunizations: Employees or volunteers at family day care home; immunization requirements; records; The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person’s personnel record that is maintained by the family day care home.
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Immunization records to be submitted by the due date
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This requirement is not met by evidence of Licensee and the assistant providing care and supervision are missing the Immunization records. This poses a potential risk to Health and safety to children in care.
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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: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (323) 981-3351
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2019
LIC809 (FAS) - (06/04)
Page: 8 of 8
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: TORRES FAMILY CHILD CARE
FACILITY NUMBER: 198009741
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/10/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/13/2019
Section Cited
CCR
102423(a)(2)
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Personal Rights. Each child shall be accorded safe, healthful and comfortable accommodations, furnishing and equipment.
This requirement is not met by LPA observing an infant left sleeping on the swing. This is an immediate risk to Health and Safety to children in care
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Licensee shall provide proper age approprite napping equipments to all children in care and submit a proof of correction by the due date.
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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: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (323) 981-3351
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2019
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: TORRES FAMILY CHILD CARE
FACILITY NUMBER: 198009741
VISIT DATE: 05/10/2019
NARRATIVE
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· UPDATE: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The licensee and all adults working with children have proof of immunizations.

· UPDATE: Health and Safety Code 1596.7995: Beginning January 1, 2018, all licensed providers, applicants, directors and employees to complete training as specified on mandated reporter duties. Training is available at: www.mandatedreporterca.com

Infant Care: Applicant states that she will care for infants. LPA advised the applicant to sleep infants where they can be directly supervised at all times and advised against sleeping infants in a separate room. The applicant states the following as a supervision plan for infants: Applicant states that infants will sleep in the living room where she will be providing supervision. LPA provided the applicant with a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. Online copy can be downloaded at: https://www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf



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.
( Applicant is a trained certified Nurse Assistant)

LPA advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.
Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (323) 981-3351
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2019
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: TORRES FAMILY CHILD CARE
FACILITY NUMBER: 198009741
VISIT DATE: 05/10/2019
NARRATIVE
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Upon receipt of a report documenting a Type A deficiency or substantiated complaint, the licensee shall do the following:

1. Health and Safety Code Section 1596.8595 (c) - A licensed child care facility or home shall provide to the parents of each child receiving services in the facility copies of any licensing report that documents any Type A citation that represents an immediate risk to the health, safety, or personal rights of children in care as specified in paragraph (1) of subdivision (a) of Section 1596.893b. Failure to comply with paragraph (1) shall result in an immediate civil penalty of one hundred dollars ($100).

2. Each licensed child day care facility shall post a copy of any licensing report pertaining to the facility that documents either a facility inspection or a complaint investigation that results in a citation for a violation that, if not corrected, will create a direct and immediate risk to the health, safety, or personal rights of children in care. Failure to comply with paragraph (1) shall result in an immediate civil penalty of one hundred dollars ($100).

3. Upon enrollment of a new child in a facility, the licensee shall provide to the parents or legal guardians of the newly enrolling child copies of any licensing report that the licensee has received during the prior 12-month period that documents any Type A citation that represents an immediate risk to the health, safety, or personal rights of children in care as set forth in paragraph (1) of subdivision (a) of Section 1596.893b.

4. The licensee shall require each recipient of the licensing report described to sign a statement (LIC 9224) indicating that he or she has received the document and the date it was received. The Acknowledgement form (LIC 9224) must be maintained in each child’s file immediately upon receipt from parent. A copy of the parent Acknowledgement of Receipt of Licensing Reports Form was provided during this inspection.

Exit interview was conducted with Larrine Torres, Licensee, including, but not limited to Appeal Procedures, Site Visit and Initial Appeal Rights.
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (323) 981-3351
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2019
LIC809 (FAS) - (06/04)
Page: 6 of 8
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: TORRES FAMILY CHILD CARE
FACILITY NUMBER: 198009741
VISIT DATE: 05/10/2019
NARRATIVE
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Fireplaces and open face heaters are inaccessible to prevent access by children. The valve on the required 2A 10BC fire extinguisher indicates fully charged and is serviced annually, as indicated on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. Smoke and carbon monoxide detectors were tested and are operable.

The home is observed to be clean and orderly. There is Central heating and ventilation for safety and comfort. Where children are less than five years old are in care, stairs are fenced or barricaded. There is a child safety gate which keeps stairs inaccessible to children. There are toys/ Educational material available for children.

The licensee states that a cell phone is used and stays at the facility during operating hours.

The outdoor play area was observed to be fenced. At this time, children are using the back yard for outdoor play time. Back yard was observed to have horny weeds around the edge along with open trash box- Licensee has been advised to clean the back yard making it safe for children to play outside.
The licensee is observed to be operating within the license capacity limitations.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 12/2019 There are first aid supplies available.

Children’s records were reviewed, including but not limited to, a copy of the emergency information card that contains all the information specified by regulation.

H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The licensee does not have proof of immunization against influenza, pertussis, and measles.

LPA issued a Confidential Names List (LIC 811) to the licensee which documents staff and children’s files reviewed during this inspection.
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (323) 981-3351
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2019
LIC809 (FAS) - (06/04)
Page: 3 of 8
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: TORRES FAMILY CHILD CARE
FACILITY NUMBER: 198009741
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/10/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/13/2019
Section Cited
CCR
102417(g)(4)
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Operations of FCCH: The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to:Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.
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Licensee to store cleaning supplies in an area inaccessible to children.
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This requirement is not met by observation of cleaning supplies stored in children's cubby which remained accesible to children in care.
This poses a potential risk to H&S to children in care
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Type B
05/13/2019
Section Cited
CCR
102417(8)
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Operations of a FCCH: Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841..This requirement is not met by evidence of licensee failing to maintain a current roster
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Licensee to maintain a current roster and submit a copy by due date.
Licensee updated the roster in presence of the LPA>
CLEARED
Type B
05/17/2019
Section Cited
CCR
102359(a)
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Licensees shall reveal each facility license number in all advertisements, publications, or announcements made with the intent to attract clients.This requirement is not met by evidence of missing facility number on the facility Advertised poster posted outside. This poses a potential risk to H&S to children incare.
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Licensee to place a new Facility poster with change in operating hours and facility number.
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: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (323) 981-3351
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2019
LIC809 (FAS) - (06/04)
Page: 7 of 8
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: TORRES FAMILY CHILD CARE
FACILITY NUMBER: 198009741
VISIT DATE: 05/10/2019
NARRATIVE
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The following items were also discussed with licensee during this inspection.

The following was discussed with the applicant:
· Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Civil Penalties will be assessed if not in compliance.
· 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 certification and a valid criminal record clearance associated to the facility license.
· Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License may be terminated.
· The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked and batteries replaced as needed.
· Reporting Requirements: Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.
· Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.
· Fire and safety drills must be performed every six months and documented for review by the Department.
· Smoking is prohibited in a family child care home.
· Children and Staff records must be maintained and updated as needed and must be available for review by the Department.
· No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility. Smoking on the premises is prohibited.
· All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.
· Licensees shall reveal each facility license number in all advertisements, publications or announcements with the intent to attract clients.
· Liability Insurance: Per applicant, she will be obtaining liability insures. LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information.
SUPERVISOR'S NAME: Adriana HernandezTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (323) 981-3351
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2019
LIC809 (FAS) - (06/04)
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