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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016634
Report Date: 09/25/2019
Date Signed: 09/26/2019 09:14:10 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:HOY & CACERES FAMILY CHILD CAREFACILITY NUMBER:
198016634
ADMINISTRATOR:HOY,DULCE&CACERES,MAURICIOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 404-0614
CITY:LA MIRADASTATE: CAZIP CODE:
90638
CAPACITY:14CENSUS: 5DATE:
09/25/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Hoy Caceres, LicenseeTIME COMPLETED:
01:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Villa conducted an unannounced annual random inspection to ensure the health & safety standards as required by regulations governing family child care homes are met. Upon arrival LPA Villa was greeted by Licensee Hoy Caceres. All adults present during this inspection have obtained a criminal record clearance prior to working or residing in the home. Census was obtained during today’s inspection there were 4 infants and one toddler present during the inspection. The facility was observed to be over capacity. This is a large family child care home licensed for 14 children. Upon arrival licensee was alone with no assistant and over the capacity for the children’s ages. This poses an immediate risk to the health and safety of the children in care. Assistant Miriam Caceres and spouse Mauricio Caceres arrived about an hour after LPAs arrival. Licensee states her hours of operation are from 2:30am to 5:30pm. Licensee states there are 11 children enrolled in the day care.

An updated children roster was available during this inspection. A tour of the home was conducted inside and outdoors. Per Licensee there are 2 adult residing in the home. This is a 4 bedroom and 2-bathroom residence. The children use the living room, the bedroom adjacent to the living room and the restroom located in the hallway. The off-limit areas are the three bedrooms located in the hallway and other restroom located inside the master bedroom. LPA Villa observed all of the off-limit areas locked during this inspection. LPA informed licensee to install door knob protectors on the bedroom doors to prevent access.

During todays inspection LPA Villa observed the children’s restroom with a large area on the wall with chipped paint. The restroom was also malodorous, with stains on the toilet and on the floor and required overall cleaning.The restroom window had a large spiderweb (pictures were taken). LPA Villa also observed the carpet in the children’s play room dirty with stains, requiring a carpet shampoo. This poses a potential risk to the health and safety of the children in care. The children use the backyard patio of the home for outdoor play time. There are no bodies of water located on the property.

SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia VillaTELEPHONE: (714) 293-9465
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: HOY & CACERES FAMILY CHILD CARE
FACILITY NUMBER: 198016634
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/25/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/02/2019
Section Cited

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Operation of a family child care home. 102417(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: This requirement was not met as evidence by: LPA Villa observed a large section of chipped paint in the childrens restroom.
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This poses a potential risk to the health and safety of the children in care.
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Type B
10/02/2019
Section Cited

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Childs records 102421(b) The licensee shall maintain, in each child's record, a copy of the emergency information card required in Section 102417(g)(7). This requirement was not met as evidence by Licensee had a missing file for child#1. No childrens records were present. Per Licensee child has been enrolled since January of 2019 on and off.
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This poses a potential risk to the health and safety of 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: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia VillaTELEPHONE: (714) 293-9465
LICENSING EVALUATOR SIGNATURE:
DATE: 09/25/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/25/2019
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: HOY & CACERES FAMILY CHILD CARE
FACILITY NUMBER: 198016634
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/25/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/02/2019
Section Cited

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Operation of a family child care home 102417(b) The home shall be kept clean and orderly, with heating and ventilation for safety and comfort. This requirement was not met as evidence by: LPA observed the childrens restroom w stains on the toilet and on the floor. The childrens play rooms carpet also was observed to be stained and dirty.
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there were spider webs on the window of the restroom (pictures were taken). This poses a potential risk to the health and safety of 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: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia VillaTELEPHONE: (714) 293-9465
LICENSING EVALUATOR SIGNATURE:
DATE: 09/25/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/25/2019
LIC809 (FAS) - (06/04)
Page: 5 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: HOY & CACERES FAMILY CHILD CARE
FACILITY NUMBER: 198016634
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/25/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/26/2019
Section Cited

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Staffing Ratio and Capacity 102416.5(e)
If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).
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This requirement was not met as evidence: Licensee had 4 infants and one toddler present with no assistant during LPAs arrival/inspection. This poses an immediate risk to the health and safety of 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: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia VillaTELEPHONE: (714) 293-9465
LICENSING EVALUATOR SIGNATURE:
DATE: 09/25/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/25/2019
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: HOY & CACERES FAMILY CHILD CARE
FACILITY NUMBER: 198016634
VISIT DATE: 09/25/2019
NARRATIVE
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The backyard was observed to be fenced with age appropriate toys and free of hazards. Licensee has the Parent’s Rights poster and other appropriate forms posted. Pediatric First Aid/CPR certificates are valid thru 06/2021 for licensee. Staff files were reviewed for Immunizations, MMR, TDAP and Influenza and Mandated Reporter certificate for Licensee and assistant. All files were observed to be complete. Children records were reviewed for LIC700 and Immunization cards. All records were not observed to be complete. Licensee was reminded that the Mandated reporter training expires every two years. She is exempt as Spanish is her primary language. Licensee had the fire disaster drill log up to date. Licensee has a working telephone via cell phone and home phone. Detergents and cleaning supplies were inaccessible to the children in care. Fire extinguisher was inspected and met state regulations. There is an operational smoke detector and carbon monoxide in the facility. The licensee maintains a first aid kit in the home. There are adequate age appropriate toys, books, and games. There are no firearms present on the premises as stated by licensee. 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 is to be in the home. LPA discussed disaster drills, posting requirements, children records requirements, mandated child abuse and injury/death reporting. LPAs reviewed SIDs, safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. Safe sleep guidelines flyer was provided during today’s visit. Incidental Medical Services (IMS) policy was discussed. Licensee states there are no children requiring medication in her care. 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.htmLPA advised the Licensee to access forms and regulations on line at: www.ccld.ca.gov, Licensee was advised where to access the quarterly updates.

The following citations will be cited on the 809D page.



The Notice of Site Visit (LIC 9213) – must remain posted for 30 consecutive 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 and Appeal rights were provided and explained. Licensee was informed that appeals must be submitted in writing within 15 days of a citation.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia VillaTELEPHONE: (714) 293-9465
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019
LIC809 (FAS) - (06/04)
Page: 2 of 5