198016656-9-10-2021-33-CC-SROZ-C6QV88-20210910161218

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198016656
Report Date: 08/30/2021
Date Signed: 09/10/2021 04:12:27 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:	FLORES FAMILY CHILD CARE		FACILITY NUMBER:	198016656
ADMINISTRATOR:	FLORES, MAYRA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 819-3562
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90029
CAPACITY:	14	CENSUS:	DATE:	08/30/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Kenia Herrera Assistant & Mayra Flores Licensee		TIME COMPLETED:	11:50 AM

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	Licensing Program Analysts (LPA) Steven Rodriguez conducted an unannounced annual required inspection at the above facility on 8/30/21 at 10:30 AM. LPA met with Kenia Herrera, Licensee assistant who guided analysts on a tour of the facility at 10:35 am. Licensee was also contacted via telephone who also provided additional information. There were four children and two adults present when LPA's arrived. This is a one-story home which consists of three bedrooms, one bathroom, kitchen, living room. Areas accessible to children were inspected as follows: Kitchen, living room, 3 bedroom and 1 bathroom, rear side yard. Licensee also stated she takes the children to nearby park. Main care is provided in the playroom which is also the living room and can be accessed from the main side entrance. The children use the bathroom that is down the hall from the living room on the left side. LPA observed there is no wall heater or fireplace. The house contains central air. Per Licensee, the off-limit area is the licensees master bedroom, side entrance where the driveway is. Only areas used are play area, restroom. Bedroom #2, Bedroom #3 for sleeping, and the kitchen for eating purposes while be supervised. Hours of operation is Monday-Friday 7am-6pm. Individuals residing in the home have been discussed and noted. There is one adult total living in the home. All have clearance and have been associated. Licensee states that there are no firearms or weapons stored in the home. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is operable telephone service at the facility via cell phones.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Steven Rodriguez	TELEPHONE: (323) 430-3179
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2021

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: FLORES FAMILY CHILD CARE	FACILITY NUMBER: 198016656
	VISIT DATE: 08/30/2021

NARRATIVE

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The following was observed and reviewed during this inspection:
LPA's observed that cleaning products are stored in the laundry area on a high shelf with a child lock, inaccessible to children. The licensee states that there are no poisons stored in the home. Isolation area for sick children waiting to be picked up is located in one of the rooms that is not occupied away from other children.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and has a service date of 08/31/2020. Smoke and carbon monoxide detectors were tested and are operable (dual).

The home is observed to be clean and orderly. There are toys and other age appropriate material available for children. Children nap on cots in bedroom #2. The bathroom that children use was observed to be clean and free of hazards.

Infant Care: Currently licensee cares for one infant, 10 months old. Older children nap on cots in bedroom #2. LPA informed licensee of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15 minute check documentation for infants 0-24 months, and provided PIN 20-24-CCP.

Currently, children do not use the front yard for outdoor play. Licensee takes children to a nearby park. LPA did not observe any objects that could be hazardous to children in care. There are no pools or spas, or other bodies of water.

Children’s records were reviewed for emergency information and are complete.

The licensee and Staff one and staff two (S1) (S2) do have proof of Pediatric CPR and first aid. Expiration date is 12/17/2022 for the licensee and staff one(1) and staff two(2). Licensee and assistants do have proof of immunization against pertussis, and measles. Declination of flu vaccine from the licensee and staff one and two both received their flu vaccine. Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. Exp. Date for licensee is 06/14/2023, 06/17/2023 for staff one, and 06/14/2023 for staff two.

Incidental Medical Services (IMS):
The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS at this time. 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 ------Page 2

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Steven Rodriguez	TELEPHONE: (323) 430-3179
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2021

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: FLORES FAMILY CHILD CARE	FACILITY NUMBER: 198016656
	VISIT DATE: 08/30/2021

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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.

Health and Safety Code 1596.7996 Effective January 1, 2019, Child Care Centers and Family Child Care Homes are required to provide parents and guardians of children enrolled, enrolling or reenrolling in care with written information on the risks and effects of lead exposure, blood lead testing requirements and recommendations and options for locations of affordable blood lead tests. 2019 Lead flyer Provided.

Based on the LPA's observations and records review no deficiencies will be cited today 8/30/21.

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

Exit interview was conducted with Kenia Herrera and licensee Mayra Flores who was on the call, including, but not limited to Appeal Procedures and Appeal Rights.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Steven Rodriguez	TELEPHONE: (323) 430-3179
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2021

LIC809 (FAS) - (06/04)

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