198016948-8-6-2019-06-CC-STOE-BESQC4-20190806120231

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198016948
Report Date: 08/06/2019
Date Signed: 08/06/2019 12:02:36 PM

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:	LICEA FAMILY CHILD CARE		FACILITY NUMBER:	198016948
ADMINISTRATOR:	LICEA, CATHERINE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 644-0102
CITY:	LA MIRADA	STATE: CA	ZIP CODE:	90638
CAPACITY:	14	CENSUS: 6	DATE:	08/06/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Catherine Licea		TIME COMPLETED:	12:15 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	An inspection was conducted at the facility by Licensing Program Analyst (LPA) Stacy Torrence. LPA met with Catherine Licea who guided analyst on a tour of the Early Childhood Setting indoors and outdoors. During today’s inspection, there were six children present. Licensee has nine children enrolled. Licensee has a current children’s roster available. Licensee states that three adults and two children live in the home. Operation hours are 6:30 a.m. to 5:30 p.m.; Monday, Tuesday,Thursday, and Friday, and close at 5:00 p.m. on Wednesday. A review of staff records indicates that all facility individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. This is a single-story home which consist of three bedrooms, two bathrooms, kitchen, dining room, living room, family room (fireplace; gated), attached garage, front yard (not fenced), and back yard (fenced). The licensee has designated the off-limit areas as such; two bedrooms, attached garage, and front yard (not fenced). The licensee has designated the daycare area as the following; one bedroom, two bathrooms, living room, family room (which is separated by a child proof gate), kitchen, dining room, and back yard(fenced). Licensee has a dog on the premises who is kept in a gated portion of the back yard. The daycare area was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning supplies, medication, and hazardous items that can pose a danger to children. Per licensee there are no weapons or firearms in the facility. There were age appropriate toys and learning materials. Fire/disaster drill log was reviewed. Outdoor play area is the back yard and licensee stated that she is always present when children are outside playing. The required fire extinguisher (2A10BC), smoke detector, and carbon monoxide detector were in operable condition. First Aid kit was complete. Licensee had a current CPR/First Aid card with an expiration date of 04/20. Children's records: parents' rights and California School Immunization Record were reviewed.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2019

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LICEA FAMILY CHILD CARE	FACILITY NUMBER: 198016948
	VISIT DATE: 08/06/2019

NARRATIVE

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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

Licensee had proof of immunization against pertussis, measles, and influenza. Facility was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov. Licensee have completed the Mandated Reporter Training. Website provided: http://mandatedreporterca.com/. Licensee was informed how/where to access regulations and forms from CCLD website: www.ccld.ca.gov. LPA provided licensee with the Effects of Lead Exposure, the Safe Sleep Policy, and the Guide to Safe Sleep pamphlets.

During this inspection, there was no deficiency cited per CA Code of Regulations Title 22.

Exit interview was conducted. Report reviewed and discussed with the licensee. Notice of Site Visit was posted. Facility representative was informed that the notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. Appeal rights provided and explained. The licensee was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First level appeal is to Regional Manager, address is above on the report.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2019

LIC809 (FAS) - (06/04)

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