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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011744
Report Date: 08/17/2022
Date Signed: 08/17/2022 02:16:18 PM


Document Has Been Signed on 08/17/2022 02:16 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:OLIVARES FAMILY DAY CAREFACILITY NUMBER:
198011744
ADMINISTRATOR:OLIVARES, FRANCISCAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 304-1053
CITY:PASADENASTATE: CAZIP CODE:
91106
CAPACITY:14CENSUS: 7DATE:
08/17/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Francisca Olivares - LicenseeTIME COMPLETED:
02:30 PM
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At 11:40 am Licensing Program Analysts (LPAs) Nolan Tcheng and Veronica Martinez-Garza conducted an unannounced required 1-year inspection to the above facility. A COVID risk assessment was conducted upon entry- appropriate PPE was used. LPAs met with Francisca Olivares, Licensee who guided analysts on a tour of the facility. Licensee is primarily Spanish speaking. LPA Martinez-Garza assisted in interpreting the inspection for Licensee. Per Licensee, there are currently 14 children enrolled. A current children’s roster was available for review. There were 7 children present upon arrival. Also present during inspection was assistant Josefina Manzo. Day care days and hours are Monday – Sunday 5:30 am – 6:30 pm. Licensee provides food for the children in care.

The licensee states that 2 adults currently live in the home. Per Licensee, they currently have 2 assistants. One assistant was present during inspection. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed childcare home.

Licensee states that there are no firearms stored in the home.

This is a two-story home which consists of 5 bedrooms, 3 bathrooms, living room, dining room, kitchen, attached garage, front and backyard (fenced). The children have access to living room, dining room, 1 bathroom next to the living room and back yard (fenced).

Per licensee, areas off limits to children and parents include the entire second floor 5 bedrooms, 2 bathrooms, kitchen, front yard (fenced), and garage. The LPAs toured all areas used by children during this visit. LPAs observed all off limit areas to be locked.



All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via landline and cell phone. There is ventilation and heating (central). The following was observed and reviewed during this inspection.
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SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Nolan TchengTELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2022
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 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: OLIVARES FAMILY DAY CARE
FACILITY NUMBER: 198011744
VISIT DATE: 08/17/2022
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Detergents, cleaning compounds, and medications were observed to be inaccessible to children. Per licensee there are no poisons in the home. The restroom that children use was observed to be safe and sanitary.

LPAs did not observe a fireplace. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 08/12/22, as indicated on service tag. 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 documented was conducted on 07/18/22.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted in the day care room.

The home is observed to be clean and orderly. There are toys available for children. Appropriate sleeping arrangements in form of cots and cribs were observed.

Licensee states that they are currently not caring for infants. LPAs discussed the safe sleep regulations with licensee Francisca Olivares and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPAs also informed licensee Francisca Olivares of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPAs did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that fall into these categories are not permitted in a family child care facility.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Currently, children are using the back yard for outdoor play time. The outdoor play area was observed to be fenced. LPAs observed that the outdoor yard has toys and other materials for children to play with. LPAs did not observe any objects that can pose a danger to children on the outdoor yard.
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SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Nolan TchengTELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022
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: OLIVARES FAMILY DAY CARE
FACILITY NUMBER: 198011744
VISIT DATE: 08/17/2022
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Per Licensee, there are no pets on the premises.

The licensee is observed to be operating within the license capacity limitations.

Children’s records were reviewed, including emergency information, and were observed to be complete. Staff records were reviewed, including immunization's, and were observed to be complete

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 09/03/23. There are first aid supplies available.

LPAs observed that the Licensee and assistant do have proof of immunization record.

Licensee, Francisca Olivares and 2 assistants have the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file.

LPAs issued a copy of the LIC 857 Children’s Records Review and the LIC 859 Staff Records Review to the licensee during this inspection.

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

LPAs advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov.


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SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Nolan TchengTELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022
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: OLIVARES FAMILY DAY CARE
FACILITY NUMBER: 198011744
VISIT DATE: 08/17/2022
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Licensee, Francisca Olivares was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

A notice of site visit (LIC 9213) was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Licensee, Francisca Olivares

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SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Nolan TchengTELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4