198016060-11-1-2019-33-CC-AALN-BHHQCG-20191101120306

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198016060
Report Date: 11/01/2019
Date Signed: 11/01/2019 12:03:14 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:	MENDOZA FAMILY CHILD CARE		FACILITY NUMBER:	198016060
ADMINISTRATOR:	MENDOZA, GLADYS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 498-3665
CITY:	BALDWIN PARK	STATE: CA	ZIP CODE:	91706
CAPACITY:	14	CENSUS: 1	DATE:	11/01/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:10 AM
MET WITH:	Gladys Mendoza		TIME COMPLETED:	12:15 PM

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Licensing Program Analyst, Ariel Cazares conducted an unannounced annual random site inspection to the facility. Upon arrival, LPA met with Licensee Gladys Mendoza and toured the facility. There was one (1) child present. Individuals residing in the home are the licensee and son. Licensee’s operating hours are Sunday through Saturday, with variable hours.

The home is a one story, 3-Bed, 3-Bath home. The following areas are used for day-care: living room, dining room, 1 restroom, the kitchen and front yard and a side patio area. Off limit areas include: 3 bedrooms, 2 bathrooms, the detached garage and the backyard.

LPA observed the required postings in the facility. LPA inspected the areas accessible to daycare children. There are age appropriate toys, books, and games. LPA did not observe exposed electrical outlets. The fire extinguisher located in the kitchen was last serviced on 3/14/19. There is an operational smoke detector and carbon monoxide in the kitchen, which was tested by LPA and found operational. The facility does have a First Aid Kit located in the a pantry cabinet in the kitchen along with cleaning compounds, out of reach of children. Licensee preparews and cooks food and meals for children. Children can bring their own food if preferred. Kitchen was observed clean and free of pests. Knives are kept out of reach of children. Per Licensee, there are no firearms present on the premises. There are no pets in the home. No hazards or violations were observed.

LPA inspected the outdoor spaces used by children. There is a detached garage that is kept off-limits. There are no pools or spas, or other bodies of water observed. There are age appropriate toys and play equipment observed. No hazards or violations were observed.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel Almazan	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2019

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: MENDOZA FAMILY CHILD CARE	FACILITY NUMBER: 198016060
	VISIT DATE: 11/01/2019

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Children’s roster and files were reviewed. Licensee has completed the mandated reporter training on 12/19/18. Licensee’s First Aid/CPR certificates are valid through 08/2016. Licensee's disaster drill log notes last drill conducted on 9/5/19. Licensee has a working telephone.

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.

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. To access forms and regulations on line visit: www.ccld.ca.gov. Mandated reporter training must be completed every 2 years. www.mandatedreporterca.com

Incidental Medical Services (IMS) policy was discussed. 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. There are no children in care with IMS needs.

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. (Only applies to Large)

No Deficiencies were cited on this visit.

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 Gladys Mendoza. A copy of this report and appeal rights were provided and explained.

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel Almazan	TELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2019

LIC809 (FAS) - (06/04)

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