198010667-2-28-2020-54-CC-KCHE-BM8S5F-20200228123417

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198010667
Report Date: 02/28/2020
Date Signed: 02/28/2020 12:34:26 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:	ROSA FAMILY CHILD CARE		FACILITY NUMBER:	198010667
ADMINISTRATOR:	ROSA, ROSA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 582-2577
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90002
CAPACITY:	14	CENSUS: 4	DATE:	02/28/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:20 AM
MET WITH:	Rosa Rosa, Licensee		TIME COMPLETED:	01:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA)Katrina Chicote conducted an Unnanounced Required Annual inspection to the above facility on 2/28/2020 at 11:20 am. Upon arrival, LPA met with Licensee Rosa Rosa who guided the LPA on a tour of the facility. There are four adults living in the home and all have criminal record clearance. There were four day care children present during today’s inspection. Licensee states that there are currently nine children enrolled. The children's roster was reviewed and is current. Per licensee, the facility’s hours of operation are 23 hours, 7 days a week. Emergency Disaster Plan, License, and Parents’ Rights were posted at the time of inspection. Disaster drill log was also available during today’s inspection, last disaster drill conducted on 12/5/2019. This is a two-story home which consists of five bedrooms and three bathrooms, kitchen, living room, dining room and attached garage. Per Licensee, areas off limits to children and parents include entire upstairs where all five bedrooms and two bathrooms are located and the back yard. LPA observed that there is a baby gate at the bottom of the stairs and a sliding glass door making upstairs and back yard inaccessible to children in care. All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. Main care areas used by the children is the entire bottom floor: the living room, dining room, kitchen, and attached garage. LPA observed Graco pack-n-play in main care area used for napping. Children will use bathroom next to main care area. Per Licensee, attached garage is only used to do homework for school-age children. LPA observed attached garage to only have an aquarium and a couch. LPA advised Licensee that attached garage space is only utilized for activity space and not for napping or eating. There is a working telephone maintained in the home. LPA observed age appropriate toys, free of loose and sharp parts. LPA observed child proof lock under kitchen sink where cleaning compounds are kept and knives kept in cabinet on a high shelf. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. Report continues- Page 1 of 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

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: ROSA FAMILY CHILD CARE	FACILITY NUMBER: 198010667
	VISIT DATE: 02/28/2020

NARRATIVE

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The Licensee states that there are no poisons in the home. Licensee states that she has someone come in to fumigate once a year. The Licensee does understand that poison must be locked with a key or combination lock.

Per Licensee, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPA observation did not see any bodies of water around the premises. Per licensee, they provide food for children in care. Per licensee, she has a dog that is kept outside, in off limits area, separate from children in care.

The valve on the required 2A 10BC fire extinguisher indicates fully charged. Smoke and carbon monoxide detectors are in operable condition. LPA observed First Aid kit kept on the kitchen counter and was inventoried for necessary supplies. The Licensee has current Pediatric First Aid and CPR. Proof of immunization against influenza, pertussis, and measles was readily available during today’s inspection. The Licensee has also taken the Mandated Reporter Training
—CPR Card valid until: 1/12/2022
—Fire Extinguisher was last serviced on: 10/2019
—Mandated Reporter AB1207 Completed: 12/7/2018
—Children records and required licensing forms were discussed as well as mandated child abuse reporting and criminal record clearance requirement.

The following were discussed:
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

Rooms that are off-limits need to be made inaccessible during operating hours. NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers and any other item that falls into that category are permitted in the facility.

Report continues- Page 2 of 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2020

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: ROSA FAMILY CHILD CARE	FACILITY NUMBER: 198010667
	VISIT DATE: 02/28/2020

NARRATIVE

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The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed. A hard copy of A Child Care Provider’s Guide to Safe Sleep and Lead Handout was provided.

AB 1207: Beginning on January 1, 2018, this law 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: http://www.mandatedreporterca.com/www.mandatedreporterca.com

Senate Bill 792: this bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the visit.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today 2/28/2020

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Licensee Rosa Rosa, copy of this report was given and appeal rights were issued and discussed.
Report ends- Page 3 of 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2020

LIC809 (FAS) - (06/04)

Page: 3 of 3