198010964-5-21-2019-33-CC-KDEI-BCDU6U-20190521151854

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198010964
Report Date: 05/21/2019
Date Signed: 05/21/2019 03:19:05 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:	ZAMORA FAMILY CHILD CARE		FACILITY NUMBER:	198010964
ADMINISTRATOR:	ZAMORA, VERONICA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 400-4000
CITY:	WHITTIER	STATE: CA	ZIP CODE:	90604
CAPACITY:	14	CENSUS: 14	DATE:	05/21/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Licensee Zamora Veronica		TIME COMPLETED:	03:35 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	An unannounced Annual / Random inspection was conducted on this day by Licensing Program Analyst ( LPA) Ketki Desai. Upon arrival the door was attended by the Licensee Veronica Zamora who immediately gave access to the home. This is a Large family child care home with 14 children and there were 14 children present ( 2 infants/ 1 child enrolled in Kinder garden and the rest were Preschool age children. There were observed napping with an assistant who was providing additional care and supervision. Assistant is live scanned and cleared. Operating hours 6.30 am - 5.30 PM ( M- F) LPA was guided on a tour by the Licensee both inside and outside. This is a single story home with three bedrooms and two bathrooms. Residing in the home are three adults; licensee Veronica, husband Ron, and daughter Brittany. One child age 17 lives in the home as well. The following were inspected today: Kitchen/ Den- Day care area/ Dining room and living area, along with the laundry room and children's bathroom which is across the dining room. Bathroom was observed to be free of hazardous items. Kitchen cabinets were sharp objects and cleaning supplies are stored was observed to be locked making them inaccessible to children. Laundry detergents and cleaning supplies are stored in a cabinet above the laundry machines. Day care area (den) is used mainly for daily activities as well as napping room. There are age appropriate napping equipment (Cribs/ Blue mats/ linens) for the children in care. The open backyard has bodies of water a properly barricaded pool. There is a mesh fence that is five feet and self latching that surrounds the perimeter of the pool. The entire backyard is off limits. Licensee has a camera and security system that sounds when the doors are opened. The front yard is used for outdoor activity space. The home has a water fountain with the bowl filled with dirt. There is a decorative fireplace located in the living room. Licensee does have two small dogs and a turtle in the open glass case which is kept in the day care area, LPA have recommended to cover the glass case with a mesh so children cannot put their hands in it. The following areas are designated off-limits to the day-care children: Backyard with Pool and the three bedrooms and the bathroom on the west side of the house. The garage is kept locked during day-care hours. There are bedroom doors were observed to be closed .

SUPERVISOR'S NAME: Adriana Hernandez	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019

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: ZAMORA FAMILY CHILD CARE	FACILITY NUMBER: 198010964
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/21/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/23/2019 Section Cited CCR 102417(f)	1 2 3 4 5 6 7	Operation of Family Chidl care home: If food is brought from the children's homes, the container shall be labeled with the child's name and properly stored or refrigerated. This requirement is not met by evidence and observation of two Strawberry bags brought by two day care children left on the kitchen counter not refrigirated and both the bags	1 2 3 4 5 6 7	Licensee to submit a written plan how the food shall be stored and labelled by the due date.
	8 9 10 11 12 13 14	were not labelled. This poses a potential risk to Health and Safety to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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 Hernandez	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019

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: ZAMORA FAMILY CHILD CARE	FACILITY NUMBER: 198010964
	VISIT DATE: 05/21/2019

NARRATIVE

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Licensee was also made aware of the Child Advocacy program so she could receive the updated Quarterly reports and other information in a timely manner. ChildCareAdvocatesProgram@dss.ca.gov

LPA advised the Licensee to access forms and regulations on line at: www.ccld.ca.gov

Deficiency cited during today's visit in accordance to the California Code of Regulations Title 22, Division 12, Chapter 1. Home meets the regulatory requirements for governing a Large Family Child Care home.

Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty.

Exit interview was conducted with Licensee Zamora Veronica and appeal rights given

SUPERVISOR'S NAME: Adriana Hernandez	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019

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: ZAMORA FAMILY CHILD CARE	FACILITY NUMBER: 198010964
	VISIT DATE: 05/21/2019

NARRATIVE

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LPA observed a child gate placed next to the bedroom door, but all the bedroom doors were closed.
The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. As Licensee stated that she does transport the day-care children, ( twice a week during afternoon session only) uses a 17 passenger Chevy van with three car- seats and three booster seats.
Licensee provides two meals and snacks and is enrolled with Angles food program.
Posting requirements are posted at the entrance of the home on the side bulletin board.
Per Licensee, there are no firearms or weapons on the premises. The home has central air and heat and optimal temperature was maintained in the home. Licensee does not administer any medications to the enrolled children if needed the parents come in to the home and administer the required medication to the child.
Licensee has a fire extinguisher, size 2-A:10-B:C, which is mounted on a wall in the kitchen; it is serviced annually in 4/2019. There are smoke detectors in the home installed in the ceiling of every room while the ; carbon monoxide detector is mounted in the hallway, it was tested and is operable. The home is kept clean and orderly, with heating and ventilation for safety and comfort.
Licensee and the assistant providing care and supervision to children are current on the required Pediatric and CPR certification valid through 3/2020, all immunization's (MMR/ Tdap/ Flu) are current and both have completed the Child Abuse Mandated Reporting training. ( Records reviewed)

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

The following were discussed: Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being in the presence of the children in care. Individuals within one month of their 18th birthday must be fingerprinted immediately. No smoking, No infant walkers, No Johnny jumpers, No exersaucers and any other item that falls into that category be on the premises. Discussed disaster drills, posting requirements, children records requirements, mandated child abuse training and injury/ death reporting, criminal records clearance, child abuse clearance, and criminal records transfer requirements.

SUPERVISOR'S NAME: Adriana Hernandez	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (323) 981-3351
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019

LIC809 (FAS) - (06/04)

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