198013729-10-21-2021-33-CC-JGUN-C7ZQ92-20211021115738

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198013729
Report Date: 10/21/2021
Date Signed: 10/21/2021 11:57:47 AM

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:	JUAREZ FAMILY CHILD CARE		FACILITY NUMBER:	198013729
ADMINISTRATOR:	JUAREZ, JUANA & MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 356-4350
CITY:	PASADENA	STATE: CA	ZIP CODE:	91104
CAPACITY:	14	CENSUS: 2	DATE:	10/21/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:02 AM
MET WITH:	Juana and Maria Juarez, Licensee		TIME COMPLETED:	12:05 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) Jose Guzman conducted an unannounced required inspection. A risk assessment was conducted prior to entering the facility. LPA met with Licensees, Maria and Juana Juarez, during today’s inspection. There were 2 children present. Also present were licensee's older children. The children's roster was reviewed and is current. Disaster drill log was also available during today’s inspection. This is a one-story home which consists of 5 bedrooms and 2 bathrooms. Areas used by the children include the living room, 3 bedrooms, 1 bathroom, kitchen, patio, and front yard. Per licensees, areas off limits to children and parents include 2 bedrooms, 1 bathroom, backyard, and garage. Rooms that are off-limits need to be made inaccessible during operating hours. The licensees provide food for children in care. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. Family members residing in the home are 4 adults (criminal record clearances on file) 2 children. There is a working telephone maintained in the home. There is a pet bird in the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. Per Licensee there are no poisons in the home. The licensees do understand that poison must be locked with a key or combination lock. Per Licensee, there are no weapons, firearms or bodies of water on the premises. There are safe toys, play equipment and materials observed for children. Emergency Disaster Plan was posted at the time of inspection. Licensees understand that fire extinguishers need to be serviced yearly or a new fire extinguisher can be purchased. A smoke and carbon monoxide detector located in the living room were tested and are in operable condition. The licensees have an expired Pediatric First Aid and CPR, which expired on 08/15/2019. Page 1 of 2

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jose Guzman	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2021

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: JUAREZ FAMILY CHILD CARE	FACILITY NUMBER: 198013729
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/21/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, and record review, the licensees did not comply with the section cited above in two out of two licensees were missing the mandated reporter training which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/04/2021
	Plan of Correction
1 2 3 4	Licensees will complete the mandated reporter training and submit proof to the Department by POC due date.

Type B

Section Cited

CCR

102416(c)

Personnel Requirements

(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, and record review, the licensees did not comply with the section cited above in two out of two pediatric first aid/CPR certificates were expired which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/04/2021
	Plan of Correction
1 2 3 4	Licensees will complete pediatric first aid/CPR training and submit proof to the Department by POC due date.

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: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jose Guzman	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2021

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: JUAREZ FAMILY CHILD CARE	FACILITY NUMBER: 198013729
	VISIT DATE: 10/21/2021

NARRATIVE

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The licensees have not taken the Mandated Reporter Training.
The licensees were advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Licensee 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 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

Licensees were 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.
A notice of site visit was given and must remain posted for 30 days.
The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22 and/or the Health and Safety Code. Please see attached LIC 809D. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.
Exit interview was conducted with Licensees, Maria and Juana Juarez.
Page 2 of 2

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jose Guzman	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2021

LIC809 (FAS) - (06/04)

Page: 3 of 3