198015701-11-13-2019-33-CC-JCHZ-BHVRGJ-20191113120050

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198015701
Report Date: 11/13/2019
Date Signed: 11/13/2019 12:00:56 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	GUEVARRA FAMILY CHILD CARE		FACILITY NUMBER:	198015701
ADMINISTRATOR:	GUEVARRA, MIRABELLE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 960-8528
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90004
CAPACITY:	14	CENSUS: 9	DATE:	11/13/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Mirabelle Guevarra, Licensee		TIME COMPLETED:	12:15 PM

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AN ANNUAL INSPECTION CONDUCTED IN ENGLISH

Licensing Program Analyst, Janeth Chavez conducted an unannounced annual random site inspection to ensure the health & safety standards as required by regulations governing family child care homes are met. Upon arrival, LPA met with Licensee, Mirabelle Guevarra who guided LPA on a tour of the facility. There are 9 children present (2 of them are infants) and 3 adults. Individuals residing in the home are the licensee, spouse and 2 minor children. Licensee’s operating hours are Monday-Friday 6am-6pm. Present during this inspection is licensee, spouse and licensee’s mother. All adults living in the home have obtained a Criminal Record clearance. There is a back house with the same address. As per the licensee her mother lives in the back house. Licensee stated that her spouse, mother and assistant help her with the children in care. Licensee stated she carries Liability Insurance for a family child care home from DCI and expires on 04/2020.

The home is a one story, 4-Bed, 2-Bath home. The following areas are used for day-care: Living, Dining, bedroom adjacent to living room, licensee’s office, hallway restroom, front porch, front yard (fenced), and backyard (fenced). Off limit areas include: Licensee’s master bedroom and children’s bedroom, kitchen, and laundry room. LPA observed a metal safety gate in the kitchen to prevent access to the other two bedrooms and the laundry room. License stated that the children nap in the bedroom and eat at the dining table. The licensee stated that the parents drop off and pick up the children through the front door.

Licensee has two Graco Pack and Plays where infants sleep. Licensee stated there are two infants enrolled in the facility. The Pack and Plays are in her office and she stated that the infants are supervised while they are sleeping by either herself or her assistant. 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.

Licensee has the Parent’s Rights poster and other appropriate forms posted on wall in the living room area. Licensee’s, spouse & assistant’s Pediatric First Aid/CPR certificates are valid thru 11/2020. Licensee's disaster drill log notes last drill conducted on 10/17/2019. Licensee has a working land line telephone and cell phone in the home.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) -98-3417
LICENSING EVALUATOR NAME: Janeth Chavez	TELEPHONE: (323) 981-3376
LICENSING EVALUATOR SIGNATURE:	DATE: 11/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2019

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GUEVARRA FAMILY CHILD CARE	FACILITY NUMBER: 198015701
	VISIT DATE: 11/13/2019

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Detergents and cleaning supplies were inaccessible and are kept in the laundry area. Fire extinguisher has been serviced in the last year, card on extinguisher notes 05/10/2019. There is an operational smoke detector and carbon monoxide in the bedroom. 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. LPA did not observe any firearms or weapons in the home. LPA did not observe any pools or spas, or other bodies of water. Licensee stated there are no pets. There is only a fish tank in the living room area.

Children's Roster is readily available and updated. Children’s Files were reviewed. Licensee has completed AB 1207 Mandated Training on 01/09/19. Licensee’s assistant has completed AB 1207 Mandated Training on 01/07/2019. Licensee has met SB 792 requirements. Licensee’s spouse has met SB 792 requirements. Licensee’s assistant has met SB 792 requirements.

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. LPA discussed disaster drills, posting requirements, children records requirements, mandated child abuse and injury/death reporting.

· 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.

LPA advised the Licensee to access forms and regulations on line at: www.ccld.ca.gov.
There are no deficiencies cited on today's inspection.
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. Exit interview was conducted with Licensee, Mirabelle Guevarra. Appeal rights discussed and explained.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) -98-3417
LICENSING EVALUATOR NAME: Janeth Chavez	TELEPHONE: (323) 981-3376
LICENSING EVALUATOR SIGNATURE:	DATE: 11/13/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2019

LIC809 (FAS) - (06/04)

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