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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014905
Report Date: 10/17/2019
Date Signed: 10/17/2019 05:33:32 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:CARDONA FAMILY CHILD CAREFACILITY NUMBER:
198014905
ADMINISTRATOR:JUAN CARDONAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 587-8766
CITY:HUNTINGTON PARKSTATE: CAZIP CODE:
90255
CAPACITY:14CENSUS: 3DATE:
10/17/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Juan Cardona, LicenseeTIME COMPLETED:
05:50 PM
NARRATIVE
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A RANDOM INSPECTION CONDUCTED IN SPANISH
Licensing Program Analysts Alicia Mooberry and Cynthia Reyes conducted an unannounced annual random site inspection to ensure the health & safety standards as required by regulations governing family child care homes. Upon arrival, LPA met with Licensee, Juan Cardona and toured the facility. There were 3 children present and licensee's assistant (Ivon Angulo) who was observed in the kitchen with licensee's son (Juan Cardona) who is not fingerprint cleared or associated and left after being questioned regarding presence in the facility. Licensee's son stated he helps with transporting licensee and day-care children due to licensee's leg injury. During the inspection, a licensed therapist arrived to provide services to child #01.

Individuals residing in the home are the licensee (Juan Cardona) and adult daughter (Karina Cardona). Licensee’s operating hours are Monday-Saturday 23 hour care from 6am to 5am.

The home is a two story, 3-Bed, 2 1/2 Bath home. The following areas are used for day-care: Living Room, 1/2 bath and back yard. Off Limit Areas (downstairs): Dining Room, kitchen, laundry room and adjacent small den, garage and storage shed (in back yard). Off Limit Areas Upstairs: Master bedroom w/ bath, 1 bathroom, and 2 bedrooms.

Licensee has the Parent’s Rights poster and other appropriate forms posted on wall in the living room. Licensee's First Aid/CPR certificate are valid thru 10/16/21. Licensee's disaster drill log notes last drill conducted on March 20, 2019. Licensee has a working telephone.

Detergents and cleaning supplies were . Fire extinguisher has been serviced in the last year, card on extinguisher notes December 2019. There is an operational smoke detector and carbon monoxide in the kitchen. Page 1 of 3

SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019
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 6
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: CARDONA FAMILY CHILD CARE
FACILITY NUMBER: 198014905
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/17/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/25/2019
Section Cited

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Operation of a Family Child Care Home-The home shall be free from defects or conditions which might endanger a child. This requirement was not met as evidenced by LPAs observed outdoor play are in disarray due to items being stored including bags of clothes, recyclable, tarp torn and hanging. This is a potential risk to the health and safely to children in care.
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Type B
10/25/2019
Section Cited

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OPERATION OF A FAMILY CHILD CARE HOME: Where children are less than five years old are in care, stairs shall be fenced or barricaded. This requirement was not met as evidenced by LPAs observed the gate leadiing to the upstairs and open as well as the gate to the kitchen which is off limits. This poses a potential risk to the health and safety to the children in care.

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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: Brandi VanOostenTELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 10/17/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/17/2019
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: CARDONA FAMILY CHILD CARE
FACILITY NUMBER: 198014905
VISIT DATE: 10/17/2019
NARRATIVE
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The home has electrical outlet covers throughout and maintains a First Aid Kit. There are adequate age appropriate toys, books, and games. There are no firearms present on the premises as stated by licensee. LPAs inspected the backyard and found the garage locked. There are no pools or spas, or other bodies of water. LPAs observed two small dogs, pet food and water bowls in upstairs off limits area of home. Children's Roster is readily available and updated. Children’s Files were reviewed.

The following were discussed: Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being in the presence of the children in care. Individuals within one month of their 18th birthday must be fingerprinted immediately. No smoking, No infant walkers, No baby bouncers, No Johnny jumpers, No exersaucers and any other item that falls into that category. LPAs discussed disaster drills, posting requirements, children records requirements, mandated child abuse and injury/death reporting.

· LPA reviewed LIC 311D with licensee, reminding her of required forms. LPA reviewed SIDs, Never Shake A Baby, and safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space.

· 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

· A qualified Assistant must be present and actively involved in caring for children whenever nine (9) or more children are present at the facility in a large family child care home.

Deficiencies were cited in accordance with California Code of Regulations Title 22. See 809-D.
LPA advised the Licensee to access forms and regulations on line at: www.ccld.ca.gov
Page 2 of 3
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: CARDONA FAMILY CHILD CARE
FACILITY NUMBER: 198014905
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/17/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/17/2019
Section Cited

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Criminal Record Clearance - Prior to the Department issuing a license, the applicant(s) and all adults residing in the home shall obtain a California criminal record clearance or exemption.
The requirement is not met as evidenced by LPA observed licensee's adult son in the home on this date and not fingerprint
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cleared. This poses an immediate risk to the health and safely to the children in care.

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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: Brandi VanOostenTELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 10/17/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/17/2019
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: CARDONA FAMILY CHILD CARE
FACILITY NUMBER: 198014905
VISIT DATE: 10/17/2019
NARRATIVE
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AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com/

Civil Penalties Assessed: The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Whenever a type A is cited: “Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.”

Exit interview was conducted with Licensee, Juan Cardona. Appeal rights discussed and explained.

Page 3 of 3
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: CARDONA FAMILY CHILD CARE
FACILITY NUMBER: 198014905
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/17/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/25/2019
Section Cited

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Availability of information regarding detecting and reporting child abuse and neglect; training for mandated reporter on or before March 30, every two years following 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided
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pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training the date on which he or she completed the initial mandated reporter training & submit proof of completion. The requirement is not met as evidenced by No staff have proof mandated cert on file. This poses a potential risk to the H & S of children
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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: Brandi VanOostenTELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 10/17/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/17/2019
LIC809 (FAS) - (06/04)
Page: 6 of 6