198014224-8-19-2022-54-CC-RDEO-CHFSEN-20220819134901

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198014224
Report Date: 08/19/2022
Date Signed: 08/19/2022 01:49:11 PM

Document Has Been Signed on 08/19/2022 01:49 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	OLMOS FAMILY CHILD CARE		FACILITY NUMBER:	198014224
ADMINISTRATOR:	OLMOS, EUSEBIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 422-0896
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90805
CAPACITY:	14	CENSUS: 9	DATE:	08/19/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:50 AM
MET WITH:	Licensee - Eusebia Olmos		TIME COMPLETED:	02:00 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) R. Derraco conducted an unannounced required one year inspection to the above facility on 08/19/22. LPA arrived at the facility at 11:50 and met with licensee, Eusebia Olmos, who guided analyst on a tour of the facility. Also present during this inspection were assistants S2 and S3. Both assistants provided a translation for LPA and licensee. Per Licensee, there are 14 children that are currently enrolled. There were 9 children present upon arrival. This is a one-story home which consists of 4 bedrooms, 2 bathrooms, kitchen/dining room, living room, garage, front yard and backyard (fenced). The off limit areas include 2 bedrooms, garage, and front yard. The main care area is located in the back of the home in bedroom 2. LPA observed age appropriate toys, sleeping cots, child sized tables, child sized chairs, art supplies, a wall mounted air conditioning unit, a baby crib, and a wall mounted television. LPA observed bedroom 1 to have a baby changing station, a metal crib, a futon couch, and a desk. A gate was observed at the entrance of bedroom 1 making the hallway inaccessible. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted in the living room. Per licensee, children are dropped off at the front door and taken through the living room directly to bedroom 1 or bedroom 2. Licensee also states that the dining are is used by children during lunch time. The licensee states that she provides food for children in care. LPA observed the kitchen cabinets and drawers to have children locks making contents inaccessible to children in care. Detergents, cleaning compounds, and other items which could pose a danger to children were observed to be kept in the off limits garage. The door leading to the off limits garage was observed to have a door knob cover. The licensee understands that storage areas for poisons must be locked, not just inaccessible. The bathrooms designated for children in care were observed to be clean with an operable toilet and sink. Locks were observed beneath the bathroom sink making contents inaccessible to children in care. LPA observed the backyard to have perimeter fencing, outdoor play equipment, a basketball hoop, picnic tables and adequate (page 1 of 3)

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022

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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Document Has Been Signed on 08/19/2022 01:49 PM - It Cannot Be Edited

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: OLMOS FAMILY CHILD CARE	FACILITY NUMBER: 198014224
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/19/2022

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) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/29/2022
	Plan of Correction
1 2 3 4	Licensee will email LPA a copy of Mandated Reported AB 1207 compliant training certificate

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: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022

LIC809 (FAS) - (06/04)

Page: 2 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: OLMOS FAMILY CHILD CARE	FACILITY NUMBER: 198014224
	VISIT DATE: 08/19/2022

NARRATIVE

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shade provided by a tent. LPA did not observe any objects that can pose a danger to children in care. No bodies of water were observed in the back yard play area. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs. Per licensee, isolation area for children showing signs of illness will be located in the living room while child awaits parent pick up. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Individuals who reside in the home were noted and discussed. Licensee 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. Licensee states that there are no firearms stored in the home.

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 a landline. LPA observed air conditioning units in bedrooms 1, 2 and the kitchen/dining area. Day care area was observed with safe toys, play equipment and materials. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 05/23/22, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable.

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-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.

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 in 05/2023 LPA observed that the Licensee does not have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. LPA advised licensee that a citation under Health and Safety Code section 1596.8662(b)(1) will be issued. File review was observed to have proper mandated immunization records. Children’s records were
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SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: OLMOS FAMILY CHILD CARE	FACILITY NUMBER: 198014224
	VISIT DATE: 08/19/2022

NARRATIVE

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reviewed, including emergency information and were observed to be complete. A current children’s roster was available for review.

Incidental Medical Services (IMS):
IMS was discussed with licensee. Per licensee, there are no children enrolled that require IMS at this time. 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.

LPA advised the licensee to access forms, regulations and quarterly updates online at: www.cdss.ca.gov. LPA provided and discussed Recently Approved Safe Sleep Regulations - PIN 20-24-CCP, assistant file checklist, and licensee's file checklist.

The following deficiencies listed on the attached LIC 809 (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 & safety.

A notice of site visit 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 the licensee Eusebia Olmos.

(page 3 of 3)

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy Derraco	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022

LIC809 (FAS) - (06/04)

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