198011744-8-1-2023-33-CC-NTCG-CUARBT-20230801125316

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198011744
Report Date: 08/01/2023
Date Signed: 08/01/2023 12:53:21 PM

Document Has Been Signed on 08/01/2023 12:53 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	OLIVARES FAMILY DAY CARE		FACILITY NUMBER:	198011744
ADMINISTRATOR:	OLIVARES, FRANCISCA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 304-1053
CITY:	PASADENA	STATE: CA	ZIP CODE:	91106
CAPACITY:	14	CENSUS: 14	DATE:	08/01/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Francisca Olivares - Licensee		TIME COMPLETED:	01:10 PM

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INSPECTION CONDUCTED IN SPANISH

Licensing Program Analysts (LPAs) Nolan Tcheng and Mary Silva conducted an unannounced annual random inspection to the above facility. At 11:15am, LPAs met with licensee, Francisca Olivares. Licensee is primarily Spanish speaking. Also present during this inspection, is Licensee’s assistant. The licensee states that she currently has 14 children enrolled. A current children’s roster is available and is current. Licensee’s hours of operation are 5:30am-6:30pm, Monday-Friday.
This is a two-story home which consists of 5 bedrooms, 3 bathrooms, kitchen, dining room, living room, garage, front yard and backyard (fenced). The children use living room, kitchen, dining room, 1 bathroom by living room, and backyard (fenced). Per licensee, areas off limits to children and parents include: second floor bedrooms, 2 bathrooms, front yard, and garage. All areas identified on the facility sketch were inspected. The licensee provides food for children in care.

The licensee states that 3 adults and 3 minors currently live in the home. Persons residing in the home are identified on the attached LIC811. Licensee states that she currently has three assistants. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. Per licensee, there are no weapons, firearms or bodies of water on the premises.

PHYSICAL PLANT

At 11:25am, LPAs were lead on a tour of the facility by the licensee. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are observed to be posted by the front entrance. To the left, the dining room and kitchen was reviewed. LPA observed that sharp knives were kept up high out of reach of children in care. Directly on the other side of the kitchen was a small nook attached to the living room. There was napping equipment in the form of play yards and cots for children in care. Per licensee, the living room will be used as an area for an ill child until an authorized representative comes to pick up child. The living room had ventilation and there were couches and toys for children in care.
REPORT CONTINUES PAGE 1 of 3

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023

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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: OLIVARES FAMILY DAY CARE	FACILITY NUMBER: 198011744
	VISIT DATE: 08/01/2023

NARRATIVE

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Smoke and carbon monoxide detectors were tested and are operable. Where children are less than five years old are in care, stairs are fenced or barricaded. There is a child safety gate which keeps stairs inaccessible to children. By the living room, there is a bathroom for children in care to use. Detergents, cleaning compounds, medications, and other items which could pose a danger are inaccessible to children. There are first aid supplies available. At 11:40am, a fire extinguisher was observed. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 08/11/2022, as indicated on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock. Licensee states that both a cell phone and a landline are used at the facility.

At 11:48am, LPAs observed the back yard area. The outdoor play area was observed to be fenced. At this time, children are using the back yard for outdoor play time. There is a play house, toys, academic activities, bikes, carts, and play equipment available for children to use. The licensee is observed to be operating within the license capacity limitations.

FACILITY RECORDS:

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 09/2023. Licensee and personnel have completed mandated reporter training that expires on 12/01/2023. The licensee doe have proof of immunization against influenza, tuberculosis, pertussis, and measles. Children’s records were reviewed, including but not limited to, a copy of the emergency information card that contains all the information specified by regulation.

The following was discussed:

-There are no pets on the premises.
-Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that falls into these categories are not permitted in a family child care facility.
-Smoking is prohibited in a license family child care home.

LPA advised the licensee how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov. AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com/

REPORT CONTINUES PAGE 2 of 3

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: OLIVARES FAMILY DAY CARE	FACILITY NUMBER: 198011744
	VISIT DATE: 08/01/2023

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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

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] 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.

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/.

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.

During the exit interview, the Licensee Francisca Olivares confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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

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

Exit interview conducted and report was reviewed with the licensee Francisca Olivares, at 12:55pm.

END OF REPORT PAGE 3 of 3

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) -98-3391
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 08/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023

LIC809 (FAS) - (06/04)

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