198011648-7-23-2024-33-CC-SLII-D7FTL4-20240723144855

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198011648
Report Date: 04/23/2024
Date Signed: 07/23/2024 02:49:05 PM

Document Has Been Signed on 07/23/2024 02:49 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	BARRIENTOS FAMILY CHILD CARE		FACILITY NUMBER:	198011648
ADMINISTRATOR/ DIRECTOR:	BARRIENTOS, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(909) 461-6040
CITY:	POMONA	STATE: CA	ZIP CODE:	91766
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 5	DATE:	04/23/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:15 PM
MET WITH:			TIME VISIT/ INSPECTION COMPLETED:	03:30 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	On 7/23/24 at 01:15pm, Licensing Program Analysts (LPA)s Stephanie Li and Mary Silva conducted an unannounced required annual inspection to the above facility. A risk assessment was conducted upon entry. LPA’s met with Licensee Maria Barrientos, who guided analyst on a tour of the facility. There was 5 children and 1 adult present during visit. Per Licensee, there is currently 8 children enrolled. A current children’s roster was available for review. This is a one story home which consists of 4 bedrooms, 2 restrooms, living room, dining room, kitchen, play room, garage and back yard (fenced). The children have access to living room, kitchen, playroom, 1 bathroom, and back yard. The licensee states that 2 adults and 0 children currently live in the home. Per Licensee, there are no firearms or weapons stored in the home. No bodies of water were observed. Per licensee, areas off limits to children and parents include all 4 bedrooms, 1 restroom, and garage. LPA’s toured all areas used by children during this visit. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection. LPA’s observed cleaning compounds and poisons are NOT accessible to children. Medications were observed to be inaccessible to children. The restroom that children use was observed to be sanitary. LPA’s observed razors in the showers and advised licensee to make them inaccessible. Licensee moved them immediately. There is telephone service via cellphone that stays at the facility during operation hours. The home is observed to be clean and orderly with ac and heater unit. There are toys available for children. Per licensee, the children are not napping now but she has cots in the closet for them. Page 1 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 04/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: BARRIENTOS FAMILY CHILD CARE	FACILITY NUMBER: 198011648
	VISIT DATE: 04/23/2024

NARRATIVE

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At 1:30pm, LPA’s observed the required 2A 10BC fire extinguisher but no purchase receipt was available. LPA’s advised licensee to keep the purchase receipt with the extinguisher. Smoke and carbon monoxide detectors were tested and are operable. All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill was conducted on 1/4/2024. LPA's observed a fire place that was barricaded by toys and their storage. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted on the parent board in the living room

Currently, children are using the back yard for outdoor play time. The outdoor play area was observed to be fenced adequately. LPA’s observed the outdoor yard to have appropriate toys and other materials for children to use. LPA’s did not observe any objects that can pose a danger to children in the outdoor yard. LPA’s observed a large trampoline and advised that licensee needs to keep active supervision of children while in use. The licensee is observed to be operating within the license capacity limitations.

At 1:45 pm, children and adult records were reviewed. The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. The licensee Pediatric First Aid and CPR expired on 12/3/2024 . There are first aid supplies available. Licensee has not completed the Mandated Reporter AB 1207 Training and has not had a visit since 2019. A technical violation is being issued. Licensee understands that Mandated Reporter Training must be completed every two years. LPA’s advised that the training can be done online and is now offered in Spanish. Licensee is also a part of the union and knows that it is offered through them as well.

Children records were available for review. Childrens file review was noted on LIC857.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024

LIC809 (FAS) - (06/04)

Page: 2 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: BARRIENTOS FAMILY CHILD CARE	FACILITY NUMBER: 198011648
	VISIT DATE: 04/23/2024

NARRATIVE

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Licensee stated no IMS is being provided at this time. Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

LPA’s discussed the safe sleep regulations and discussed the Child Care Licensing Safe Sleep webpage at http://www.cdss.ca.gov/inforescources/child-care-licensing/public-information-and-resoucrces/safe-sleep as an additional resource. LPA also informed applicant/licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at http://www/cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Megan’s Law - Family Child Care Homes During the exit interview, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

LPA’s advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024

LIC809 (FAS) - (06/04)

Page: 3 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: BARRIENTOS FAMILY CHILD CARE	FACILITY NUMBER: 198011648
	VISIT DATE: 04/23/2024

NARRATIVE

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MyChildCarePlan.org – Centers and Family Child Care Homes Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California

Based on Licensing staff observations and records review, the following deficiencies listed on the attached LIC 809D (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 and safety.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Licensee Maria Barrientos.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 07/23/2024 02:49 PM - It Cannot Be Edited

Created By: Stephanie Li On 07/23/2024 at 02:14 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: BARRIENTOS FAMILY CHILD CARE	FACILITY NUMBER: 198011648
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/23/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102418(g)

Immunizations

(g) 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 is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in one out of eight children's files was missing their immunizations in their file, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/30/2024
	Plan of Correction
1 2 3 4	Per licensee, she will obtain a copy of child's immunizations and text a photo of them to LPA by phone by 7/30/2024. LPA's business card was provided.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Christina Gabelman

LICENSING EVALUATOR NAME:

Stephanie Li

LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024

LIC809 (FAS) - (06/04)

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