198015403-2-8-2023-54-CC-JESA-CNUSP5-20230208130235

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198015403
Report Date: 02/08/2023
Date Signed: 02/08/2023 01:02:51 PM

Document Has Been Signed on 02/08/2023 01:02 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:	ELIZARRARAZ & CALDERON FAMILY CHILD CARE		FACILITY NUMBER:	198015403
ADMINISTRATOR:	SILVIA, MIGUEL E.,& ANA A.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 219-9887
CITY:	NORWALK	STATE: CA	ZIP CODE:	90650
CAPACITY:	14	CENSUS: 4	DATE:	02/08/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:05 AM
MET WITH:	Licensee Silvia Elizarraraz		TIME COMPLETED:	01:10 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	On 2/8/2023 Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced annual required inspection at the above facility. LPA met with Licensee Silvia Elizarraraz who guided analyst on a tour of the facility. There were 4 children present when LPA arrived. Also present was Licensee Ana Yazmin Alvarez Acosta. Facility capacity is in compliance for a Large Family Child Care Home. Individuals residing in the home have been discussed and noted. All adults present in the home have obtained a criminal record clearance or exemption. This is a one story home which consists of 4 bedrooms, 2 bathrooms, kitchen and living room, day care rooms, garage, front yard and enclosed back yard. On limit areas include the living room and kitchen used in passing to the day care area. The day care area consists of two large rooms, one bedroom in the day care area and one bathroom in the day care area. A section of the backyard is also accessible to children. Per licensee, areas off limits to children and parents include: 3 bedrooms, one bathroom, front yard, part of the backyard and garage. There are two separate rooms in the backyard which are off limits; an ADU and a laundry room. These rooms are inaccessible to children in care. The portion of the backyard that is off limits is fenced. Hours of operation are Mon-Fri 6AM to 6PM and care is provided to children 0 to 12years old. Food is provided by Licensee. Licensee was reminded if children bring food from home it must be labeled with the child’s name and properly stored or refrigerated. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection: LPA observed required posted documentation for Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. Facility records were reviewed for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster drill log, last drill conducted on 12/8/2022. Licensee had a copy of the Roster available during the inspection. There is a smoke detector in the day care room and a carbon monoxide detector in the kitchen, both are operable. The 2A10BC Fire extinguisher located in the kitchen indicated fully charged.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023

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: ELIZARRARAZ & CALDERON FAMILY CHILD CARE	FACILITY NUMBER: 198015403
	VISIT DATE: 02/08/2023

NARRATIVE

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The receipt for the fire extinguisher was dated 9/2021 which poses a potential safety risk to children in care The home maintains telephone service (cell phone). The home is observed to be clean and orderly. There are toys and other age appropriate materials available for children. There is an A/C unit available in the day care area and per Licensee, a portable heater is used when needed. Sharp objects, detergents and cleaning compounds and medication are inaccessible to children in care. Sharp objects and cleaning compounds are kept in the kitchen in latched cabinets. Personal medication is kept in one of the off limit bedrooms. Per Licensee, no children enrolled require medication.
Children nap in the day care room and use the restroom in the day care room. Per Licensee, children who use the restroom, are escorted and supervised. LPA observed that the outdoor yard has toys and other materials for children to play with. Per Licensee, children are supervised while playing outside.
Per Licensee there are no poisons in the home. Licensee understands that all poisons must be locked, not only inaccessible to children. Isolation area for sick children waiting to be picked up is in the bedroom in the day care area. Per Licensee, there are no firearms or weapons stored in the home. There are no pools or spas, or other bodies of water.
Infant Care: Currently licensee cares for 1 infant. Infant sleeps on a napping mat. Napping equipment does not block entrances or exits. LPA discussed infant sleep requirements for cribs and play yards. LPA advised cribs shall not have loose objects, bumpers, objects hanging, or objects attached.
Overnight Care: There is no overnight care provided at the moment. LPA discussed the following: Licensee is aware that if overnight care is provided they must remain awake while children are awake. If children sleep in a separate area from licensee, the door must remain open. If licensee cannot hear children when they wake up, video or audio device can be used.

Children’s records were reviewed and contained (LIC) 282- Affidavit Regarding Liability Insurance, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, documentation of 15-minute Infant Sleep Check (0-24 months). Licensee was advised to keep keep updated immunization records for children enrolled.
Staff records were reviewed and contained Pediatric First aid/ CPR certification issued by the American Red Cross. Certification expires on 06/2023 for Licensee Silvia Elizarraraz and Licensee Ana Yazmin Alvarez Acosta. Certification for Licensee Miguel Calderon expires 4/2024. Licensees had proof of immunization against measles and pertussis. Mandated Reporter training for child care providers for all three Licensees expires on 7/21/23.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023

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: ELIZARRARAZ & CALDERON FAMILY CHILD CARE	FACILITY NUMBER: 198015403
	VISIT DATE: 02/08/2023

NARRATIVE

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During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.
Incidental Medical Services (IMS):
Incidental Medical Services (IMS) policy was discussed. Per Licensee, no children who are enrolled require medication. 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm 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. LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep 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.
To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.
Based on the LPA's record review the deficiencies on page LIC 809 D are being cited today.
Exit interview conducted and report was reviewed with the Licensee, Silvia Elizarraraz. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/08/2023 01:02 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: ELIZARRARAZ & CALDERON FAMILY CHILD CARE	FACILITY NUMBER: 198015403
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/08/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(1)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above by not having proof that the fire extinguisher was purchased or serviced within one year which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/17/2023
	Plan of Correction
1 2 3 4	Licensee will purchase another fire extinguisher and will provide the receipt with the date of purchase via picture.

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: Valarie Cook	TELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette Estrada	TELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023

LIC809 (FAS) - (06/04)

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