198011214-7-3-2019-33-CC-LGOZ-BDR23Z-20190703170311

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198011214
Report Date: 07/03/2019
Date Signed: 07/03/2019 05:03:24 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:	TALAMANTES FAMILY CHILD CARE		FACILITY NUMBER:	198011214
ADMINISTRATOR:	TALAMANTES, AGUSTINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 441-9738
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90031
CAPACITY:	14	CENSUS: 3	DATE:	07/03/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:25 PM
MET WITH:	Agustina Talamantes		TIME COMPLETED:	05:10 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	A RANDOM INSPECTION WAS CONDUCTED IN SPANISH Licensing Program Analyst (LPA) Lissete Gonzalez conducted an unannounced annual random site inspection to ensure the health & safety standards as required by regulations governing family child care homes. Upon arrival, LPA met with Licensee, Agustina Talamantes, who provided LPA on a tour of the facility indoors and outdoors. Individuals residing in the home are 5 adults and no children. There were 3 children present. There is a total of 6 children enrolled. Licensee’s operating hours are from 6:00 a.m. to 6:00 p.m. from Monday through Friday. This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen, living room, rear family room, dining room, laundry room, front yard (fenced), back yard (fenced) and a detached garage. The children use the rear family room, 1 rear bathroom, and the back yard (fenced). Per licensee, areas off limits to children and parents include: 2 bedrooms, 1 bathroom, the living room, dining room, front yard, and the detached garage. Cleaning compounds and detergents are stored in a latched lower kitchen cabinet and are inaccessible to the children. Knives and sharp objects are stored in the kitchen and are inaccessible to the children. Licensee has the Parent’s Rights poster and other appropriate forms posted on a board in the family room. Licensee, Agustina’s First Aid/Infant CPR certificates are valid through 01/20/2021. Licensee's disaster drill log notes last drill was conducted on 05/08/19. Licensee has a working telephone. LPA observed the 2A10BC fire extinguisher located in the kitchen was last serviced on 3/11/2019 and is fully charged. There is an operational smoke detector and an operational carbon monoxide detector in the home. There is an air conditioning unit in family room and heating available in the home. LPA observed the rear family room used by the children to be organized. No hazards or violations were observed. The bathroom used by the children was inspected. No hazards or violations were observed. The home has electrical outlet REPORT CONTINUES ON THE NEXT PAGE: 1 OF 2

SUPERVISOR'S NAME: Adriana Hernandez	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Lissete Gonzalez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019

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: TALAMANTES FAMILY CHILD CARE	FACILITY NUMBER: 198011214
	VISIT DATE: 07/03/2019

NARRATIVE

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

The following deficiencies listed on the attached LIC 809d 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.

Exit interview was conducted with Licensee, Agustina Talamantes. The Licensee was provided a copy of the appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

END OF REPORT PAGE: 3 OF 3

SUPERVISOR'S NAME: Adriana Hernandez	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Lissete Gonzalez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: TALAMANTES FAMILY CHILD CARE	FACILITY NUMBER: 198011214
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/03/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/17/2019 Section Cited CCR 102518(g)	1 2 3 4 5 6 7	Immunizations The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. This requirement was not met as evidenced by: Licensee did not have an immunization record for C4. This	1 2 3 4 5 6 7	Per Licensee, she will submit a copy of C4's immunization record via to LPA.
	8 9 10 11 12 13 14	poses a potential risk to the health and safety of children in care.	8 9 10 11 12 13 14
Type B 07/17/2019 Section Cited HSC 1597.622	1 2 3 4 5 6 7	Employee and Volunteer Immunization This requirement was not met as evidenced by: Licensee does not have proof of measles vaccine and TB test. Staff #1 does not have proof of measles and pertussis vaccinations. This poses a potential risk to the health and safety of the children in care.	1 2 3 4 5 6 7	Per Licensee, proof of immunization for Staff #1 and Licensee will be submitted to LPA via
	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: Lissete Gonzalez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019

LIC809 (FAS) - (06/04)

Page: 4 of 4

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: TALAMANTES FAMILY CHILD CARE	FACILITY NUMBER: 198011214
	VISIT DATE: 07/03/2019

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covers throughout and maintains a First Aid Kit. There are adequate age appropriate toys, books, and games. There are no firearms present on the premises as stated by Licensee. There are no poisons in the home as stated by Licensee. LPA inspected the back yard. LPA observed age appropriate toys, padded flooring around the play equipment, a fence surrounding the back yard, and there is shade available. The detached garage located in the back yard is maintained locked and is inaccessible. Currently there are no pets.

Children's Roster and Staff files were reviewed. Staff files were found to be incomplete. Licensee’s file did not contain proof of TB test and measles vaccine. Licensee is in the process of obtaining letter from the doctor. Staff #1 did not have proof of measles and pertussis vaccinations. Children’s files were reviewed and child #4 (C4) did not have the immunization record on file.

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 baby bouncers, No Johnny jumpers, No exersaucers and any other item that falls into that category. LPA discussed disaster drills, posting requirements, children records requirements, mandated child abuse and injury/death reporting. LPA reviewed LIC 311D with licensee, reminding her of required forms. LPA reviewed SIDs, Never Shake A Baby, and safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space.

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

A qualified Assistant must be present and actively involved in caring for children whenever nine (9) or more children are present at the facility in a large family child care home.

REPORT CONTINUES ON NEXT PAGE: 2 OF 3

SUPERVISOR'S NAME: Adriana Hernandez	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Lissete Gonzalez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019

LIC809 (FAS) - (06/04)

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