198012366-3-5-2020-54-CC-TTRN-BMEVMK-20200305153339

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198012366
Report Date: 03/05/2020
Date Signed: 03/05/2020 03:33:46 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:	VILLALOBOS FAMILY CHILD CARE		FACILITY NUMBER:	198012366
ADMINISTRATOR:	VILLALOBOS, MARTHA ELENA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 923-4185
CITY:	DOWNEY	STATE: CA	ZIP CODE:	90242
CAPACITY:	14	CENSUS: 5	DATE:	03/05/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:55 PM
MET WITH:	Licensee		TIME COMPLETED:	03:45 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 Analyst (LPA) T. Tran arrived at the above facility to conduct a required inspection. LPA met with licensee, Licensee's mother-in-law, adult's daughters, and an adult daughter's friend with 5 children in care. Upon arrival, LPA observed an adult daughter's friend was leaving the home. About 2:20 p.m. we toured the accessible areas of the home. All adults have fingerprinted cleared and associated to the licensed facility. LPA observed proper care and supervision of children and ratios. Per licensee stated, as of 03/04/2020 the facility is no longer obtained the foster license. This is a two story dwelling home consists of 3 bedrooms and 2 bathrooms upstairs , downstairs has 3 bedrooms 2 bathrooms, living room, kitchen/dining room, laundry area, guest house, and an attached garage. Childcare conducted in living room and a converted bedroom. Children do have access to the kitchen/dining area, and one bathroom. The rest of the areas in the home are off-limits to children. Licensee acknowledged that children may never enter these off-limit areas. LPA observed a safety gate by the stairs accessing the second floor. Per licensee, children play in the backyard. LPA observed to be fenced in, safe and clean. LPA observed a swimming pool in the backyard properly fenced and latched that meet the regulation requirement. Licensee is reminded that smoking is prohibited on the premises during hours of operation. LPA observed all posting requirements located in the office area accessible to all parents. Licensee had current CPR/First Aid certificates (Exp. 6/2020), fire extinguisher, carbon monoxide and smoke detector meet regulations. Cleaning materials and medications are inaccessible, there is a working telephone. Licensee stated there are no firearms in the home. The home conducted emergency disaster drill once every three month however, licensee failed to provide of drills conducted. LPA reviewed children's record to be complete and orderly. 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

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie Tran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: VILLALOBOS FAMILY CHILD CARE	FACILITY NUMBER: 198012366
	VISIT DATE: 03/05/2020

NARRATIVE

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LPA informed the effects of lead exposure for children between ages 1-6 years old are the most at risk for lead poisoning. A copy of lead exposure was provided.
Licensee was informed of responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also call the Community Care Licensing office and follow up with a written Unusual Incident/Injury Report (LIC 624B). Licensee is reminded that smoking is prohibited on the premises. The facility was informed that the presence of any adults in the facility without Criminal Record Clearance or Exemption will be cited and civil penalty assessed for $100 per day. The facility may find additional information and forms on the Department’s website at www.ccld.ca.gov including information on the Live Scan application (LIC 9163). Appointments can be made for Live Scan at 1-800-315-4507. LPA advised to read the Child Care quarterly updates every season as the come out to stay informed of any changes or updates to the regulations. LPA informed the Child Care Advocate Program (CCAP) provide many other helpful resources to the licensees and the public. Visit www.cdss.ca.gov to receive important updates. Beginning January 1, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Existing licensees must meet requirements by March 30, 2018. New employees shall have 90 days from date of employment to complete training as required. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. Visit: www.mandatedreporterca.com LPA discussed and provided the safe sleep for baby pamphlet. Each infant shall be constantly supervised and under direct visual observation by an adult person at all times. Under no circumstances shall any infant be left unattended. In order to visually observed and supervise sleeping infants there should be no obstruction to the view of the infants, which could include transparency walls and/or half walls. LPA recommend that infants sleep safest in crib with no bumpers, pillows, blankets, or toys, and on their backs, and every sleep time counts to reduce the risk of SIDS and other sleep-related causes of infant death.

Type B deficiency was cited during today's inspection. An Exit interview was conducted. The copy of this report was provided to licensee.

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie Tran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: VILLALOBOS FAMILY CHILD CARE	FACILITY NUMBER: 198012366
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/05/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/20/2020 Section Cited	1 2 3 4 5 6 7	Operation of a Family Childcare home This requirement is not met as evidenced by based on record review facility failed show proof of emergency disaster drills conducted which poses a potential health and safety risk to children in care.
	1 2 3 4 5 6 7
	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: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie Tran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020

LIC809 (FAS) - (06/04)

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