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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017185
Report Date: 10/04/2019
Date Signed: 10/04/2019 09:11:24 AM

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:ORTEGA FAMILY CHILD CAREFACILITY NUMBER:
198017185
ADMINISTRATOR:ORTEGA, MARGARITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 881-0641
CITY:LOS ANGELESSTATE: CAZIP CODE:
90033
CAPACITY:14CENSUS: 6DATE:
10/04/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Margarita Ortega TIME COMPLETED:
09:20 AM
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Licensing Program Analyst (LPA) Judy Mora conducted an unannounced random inspection. LPA met with licensee, Margarita Ortega, who guided analyst on a tour of the facility. The licensee's assistant, Fatima Juarez, was also present. There were 5 children present. Licensee states that there are currently 13 children enrolled, children's roster was reviewed and is current. Disaster drill log was available, last drill documented was 09/2019.

This is a one story home which consists of 2 bedrooms, 1 bathroom, kitchen, dining room, living room, and front yard (fenced). The children use the bathroom, living room, dining room and front yard area. Per licensee, areas off limits to children and parents include: 2 bedrooms and kitchen. There is a kiddie gate blocking entrance to the kitchen. Family members residing in the home are 3 adults (criminal record clearances on file). The LPA toured all areas used by children during this visit.

Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for safety and comfort (wall heater which is inaccessible & wall ac). There is a working telephone service maintained in the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible in all areas of the home. The licensee states that there are no poisons in the home. The licensee does understand that poison must be locked with a key or combination lock.
Per licensee, there are no weapons, firearms or bodies of water on the premises. There were safe toys, play equipment and materials observed for children. Emergency Disaster Plan was observed to be posted at the time of visit. Children’s records were reviewed to ensure that each file is complete. The valve on the required 2A 10BC fire extinguisher indicates fully charged (serviced 10/25/18). Smoke detector and carbon monoxide detector in the dining & living rooms were tested, and are in operable condition. The licensee has current Pediatric First Aid and CPR, which will expire 02/2020. The Licensee's assistant also has current Pediatric First Aid & CPR which expires 07/2021.

*REPORT CONTINUES ON THE NEXT PAGE
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2019
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 3
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: ORTEGA FAMILY CHILD CARE
FACILITY NUMBER: 198017185
VISIT DATE: 10/04/2019
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LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov

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.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

Exit interview was conducted with Licensee. The Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

*END OF REPORT
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: ORTEGA FAMILY CHILD CARE
FACILITY NUMBER: 198017185
VISIT DATE: 10/04/2019
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Incidental Medical Services (IMS) policy was discussed. Per Licensee, there are no children on medication. 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

SB792 (Immunization Requirements for Staff and Employees) was discussed with the Licensee. The Licensee and her assistant have immunization documentation on file.

AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: https://www.mandatedreporterca.com/training/child-care-providers. Licensee has completed the training, certificate is on file dated 07/2019. Licensee's assistant has also completed the training, certificate dated 03/2020.

The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed.

LPA provided Licensee with PIN 19-02-CCP, Safe Sleep Awareness Campaign (Spanish Version).

LPA provided a copy of the Winter 2019 Quarterly Update (Spanish Version).

The following was discussed: Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.

No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility. Effective January 1, 2010, licensees of family child care homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.

*REPORT CONTINUES ON NEXT PAGE
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Judy MoraTELEPHONE: (323) 981-3371
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3