198011139-1-24-2020-54-CC-KCHE-BL5RC5-20200124115346

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198011139
Report Date: 01/24/2020
Date Signed: 01/24/2020 12:31:25 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:	MATEOS FAMILY CHILD CARE		FACILITY NUMBER:	198011139
ADMINISTRATOR:	MATEOS, LUCILA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 752-3914
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90003
CAPACITY:	14	CENSUS: 7	DATE:	01/24/2020
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Licensee, Lucila Mateos		TIME COMPLETED:	12:45 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 Analysts (LPAs) Katrina Chicote and Timothy Fields conducted an Unannounced Required Annual inspection to the above facility on 1/24/2020 at 9:30am. Upon arrival, LPAs met with Licensee Lucila who guided the LPAs on a tour of the facility. Also present was Licensee's daughter, who lives in the home and has their criminal background clearance. There were 7 children present during today’s inspection. Licensee states that there are currently 14 children enrolled. The children's roster was reviewed and is current. Per licensee, the facility’s hours of operation are Monday thru Friday from 6am to 6pm. Emergency Disaster Plan was posted at the time of inspection. Disaster drill log was also available during today’s inspection, last disaster drill conducted on 01/09/2020. This is a single-story home which consists of 3 bedrooms, 2 bathrooms, kitchen, living room, back covered patio, backyard, and detached shed. Areas used by the children include the living room, which is used just for napping, a standard white crib and sleeping mats were observed for the children to use for sleep. Children have access to 2 bathrooms, one in the hallway and one in the backyard. Kitchen area is used for eating and main day care area is in the back patio and backyard area. Per Licensee, areas off limits to children and parents include all 3 bedrooms and detached shed where gardening tools are kept. Per licensee, off limit areas are also locked during operating hours, LPAs observed doors to be locked. 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. There is a working telephone maintained in the home. LPAs observed age appropriate toys, free of loose and sharp parts. Per licensee, there are is a dog that is kept separate from the children during operating hours. LPAs observed knives and other sharp objects are kept in a child locked drawer. The Licensee states that there are no poisons in the home. Detergents, cleaning compounds, and other items which can pose a danger to children are kept under the kitchen in a child locked cabinet. The Licensee does understand that poison must be locked with a key or combination lock. 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: 01/24/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2020

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: MATEOS FAMILY CHILD CARE	FACILITY NUMBER: 198011139
	VISIT DATE: 01/24/2020

NARRATIVE

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Per Licensee, the children will have access to backyard area. LPAs observed backyard has dome climbing structure and a plastic play structure with floor cushioning that is sufficient to Title 22 Regulation requirements. There is adequate perimeter fencing through-out the yard. There is a bathroom in the backyard that children have access to and also laundry area that LPAs observed to be locked. LPAs advised Licensee that outdoor supervision is required at all times. LPAs observed age appropriate toys free of loose and sharp parts available for the children in the backyard and all trees, shrubs, and plants are maintained.

Per Licensee, they provide food to children in their care.

Per Licensee, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPAs observation did not see any bodies of water around the premises.

Children’s records were reviewed to ensure that each child has an Identification and Emergency form. The valve on the required 2A 10BC fire extinguisher indicates fully charged. Smoke and carbon monoxide detectors are in operable condition. Per Licensee, First Aid kit is kept in the hallway area near the bathroom, LPAs observed First Aid kit and was inventoried for necessary supplies. The Licensee has current Pediatric First Aid and CPR. Proof of immunization against influenza, pertussis, and measles were readily available during today’s inspection. The Licensee has also taken the Mandated Reporter Training.
—CPR Card valid until: 05/2021
—Fire Extinguisher was last serviced on: Jan/2020
—Mandated Reporter AB1207 Completed: 04/21/2018
—Child Care Roster, Disaster Plan, and Children's Records were reviewed and discussed.
—Children records and required licensing forms were discussed as well as mandated child abuse reporting and criminal record clearance requirement.

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 trampolines and any other item that falls into that category are permitted in the facility. Effective January 1, 2010, licensees of family child care homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.

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: 01/24/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2020

LIC809 (FAS) - (06/04)

Page: 3 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: MATEOS FAMILY CHILD CARE	FACILITY NUMBER: 198011139
	VISIT DATE: 01/24/2020

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 was provided.

The following were discussed: 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. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.

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 facility was found in compliance per Title 22 regulations, Type A & B violations will not be cited today 1/24/2020. Exit interview was conducted, copy of this report and a Notice of Site Visit was issued and explained to the licensee. Appeal rights were issued and discussed.

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.

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: 01/24/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2020

LIC809 (FAS) - (06/04)

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