198017382-7-11-2019-54-CC-DCHS-BDYPKJ-20190711112312

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198017382
Report Date: 07/11/2019
Date Signed: 07/11/2019 11:23:30 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	NOE FAMILY CHILD CARE		FACILITY NUMBER:	198017382
ADMINISTRATOR:	NOE, YVETTE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 232-1461
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90011
CAPACITY:	14	CENSUS: 4	DATE:	07/11/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:	Licensee, Yvette Noe		TIME COMPLETED:	11:40 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 (LPAs), Dayna Chambers and LPA Rita Ramos, conducted an unannounced annual random inspection to ensure the health and safety of children in care according to the regulations of the Department and Health and Safety codes. LPAs met with Licensee, Yvette Noe. LPAs were guided on a tour, inside and outside of the family child care home by licensee, Yvette Noe. There are no changes to the home or to the off-limit areas of the family child care home. LPAs observed 3 children in care and licensees daughter (12 yrs old) was present during the time of the inspection, there were no infants present. Licensee's mother, Carolina Noe, was present during the inspection and she is associated to the facility. There is one cat in the home. The home is a one story, 2-bedroom, 2 -bathroom home with a main play area, dining room, kitchen, front and backyard. The children are allowed to access only the main playroom and bathroom. The main playroom is in the front of the house. The licensee escorts the children to the bathroom which is located in a bedroom by the dining room. The other areas of the house and yard are off limits. Per licensee, she takes the children on field trips sometimes with consent of parents. Licensee's hours of operation are 6am to 6pm Monday through Friday. All adults residing, working, and present in the home are fingerprint cleared and associated to the facility. Physical Plant During the inspection, LPAs observed the home neat and orderly. The home is clean, sanitary, and in good repair, no obvious hazards. Cooling source used is a standing air condition and ceiling fans. Home has a working telephone. LPAs viewed safe age appropriate toys and play equipment in main playroom. Licensee states that there are no baby-walkers, bouncers, jumpers, saucers and similar items will not be used for children in care. There is appropriate napping/sleeping equipment within the napping area located in main play area. IMS Services: Licensee states they do not provide IMS services currently. -------------Page 1 of 5

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Dayna Chambers	TELEPHONE: (323) 558-2962
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2019

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 7

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: NOE FAMILY CHILD CARE	FACILITY NUMBER: 198017382
	VISIT DATE: 07/11/2019

NARRATIVE

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Following Items were Discussed with Licensee:
Incidental Medical Services: 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

All adults living and working in the home must be fingerprinted and cleared prior to entering the facility. 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. Civil Penalties will be assessed if not in compliance. The licensee was informed that the presence of adults in the home without Criminal Record Clearance or Exemption will be cited and civil penalty assessed for $100 per day. The licensee may find additional information and forms on the DSS website at www.ccld.ca.gov including information on the Live Scan application (LIC 9163). Appointments can be made for Live Scan at 1-800-315-4507.

Licensee was reminded it is the licensee’s responsibility to know the regulations as well as anyone who assists in providing care. Licensee was advised on how to access quarterly reports, forms, and regulations for Child Care online at www.ccld.ca.gov. Licensee was also encouraged to read the Child Care quarterly updates every season as the come out to stay informed of any changes or updates to the regulations.

In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR certification and a valid criminal record clearance associated to the facility license.

Annual fees must be paid promptly and by the due date or a late fee shall be assessed, and/or the License may be terminated.

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SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Dayna Chambers	TELEPHONE: (323) 558-2962
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2019

LIC809 (FAS) - (06/04)

Page: 5 of 7

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: NOE FAMILY CHILD CARE	FACILITY NUMBER: 198017382
	VISIT DATE: 07/11/2019

NARRATIVE

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Reporting Requirements: Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.

Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.

Smoking is prohibited in a family child care home.

Children and Staff records must be maintained and updated as needed and must be available for review by the Department.

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.

INSPECTION AUTHORITY: All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults, and review documentation.

Licensees shall reveal each facility license number in all advertisements, publications or announcements with the intent to attract clients.

UPDATE: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The licensee and all adults working with children have to have proof of immunizations.

UPDATE: Health and Safety Code 1596.7995: Beginning January 1, 2018, all licensed providers, applicants, directors and employees to complete training as specified on mandated reporter duties. Training is available at: www.mandatedreporterca.com Spanish is exempt.
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SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Dayna Chambers	TELEPHONE: (323) 558-2962
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2019

LIC809 (FAS) - (06/04)

Page: 6 of 7

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: NOE FAMILY CHILD CARE	FACILITY NUMBER: 198017382
	VISIT DATE: 07/11/2019

NARRATIVE

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Infant Care: When Licensee states that they will care for infants. LPAs advised licensee to sleep infants where they can always be directly supervised and advised against sleeping infants in a separate room.
LPA provided the Licensee with a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. Online copy can be downloaded at: https://www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

LPA advised the Licensee how to access forms, regulations, and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.
LPA reviewed and issued the Forms/Records to Keep in Your Family Child Care Home (LIC 311D)

CHILD CARE Advocate:
You may contact the Child Care Advocate Program directly:
Phone number: (916) 654-1541
Email address: childcareadvocatesprogram@dss.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 an LPA (Licensing Program Analyst). Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit Interview was conducted with Licensee. Appeal Rights discussed and explained.

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SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Dayna Chambers	TELEPHONE: (323) 558-2962
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2019

LIC809 (FAS) - (06/04)

Page: 7 of 7

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: NOE FAMILY CHILD CARE	FACILITY NUMBER: 198017382
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/11/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/25/2019 Section Cited HSC 1596.7995H&S	1 2 3 4 5 6 7	Employees or volunteers at day care center; immunization requirements; records; exemptions. (a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles.	1 2 3 4 5 6 7	Per Licensee will get all of her immunizations by 07/25/2019. A picture of immunization records will be submitted.
	8 9 10 11 12 13 14	Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement has not been met as evidenced and observed by LPAs as the licensee did not have immunization records available. These requirements were not met and this poses a potential health risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Dayna Chambers	TELEPHONE: (323) 558-2962
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2019

LIC809 (FAS) - (06/04)

Page: 3 of 7

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: NOE FAMILY CHILD CARE	FACILITY NUMBER: 198017382
	VISIT DATE: 07/11/2019

NARRATIVE

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Fire extinguisher and smoke detector are in operational condition. The home is equipped with a fully charged fire extinguisher model 2A:10BC, last serviced 03/20/2019 according to service tag. LPAs and licensee tested the smoke detector and carbon monoxide detector which is working. The fire extinguisher must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked, batteries replaced as needed. Per licensee, she does conduct fire and safety drills that must be performed every six months and documented for review by the Department.

There is a first aid kit located in the main playroom. Per licensee, there are no firearms or weapons in the home, no bodies of water, and none were observed by LPAs.

Per Licensee, she provides transportation services to pick up children from school.

Kitchen Area is off limits.
LPAs observed no sharp utensils, matches, lighters, cleaning compounds, poisons, in kitchen area whic are inaccessible.
BATHROOM
LPAs observed no shampoos, soaps, medications, perfumes, razors, cleaning compounds, air fresheners, are not accessible and cabinets are locked.
Records
The Licensee completed the required Health and Safety Training, Nutrition Training, however, upon reviewing Pediatric First Aid including CPR, LPAs observed that it was expired. Expiration date indicated was on 09/2018. In addition, Licensee and Assistant did not have proof against immunization for measles, pertussis, and influenza.

Children’s Forms/Records: Children's records were observed by LPAs. Licensee did not have a file for Child #3.

LPAs observed required documents posted in the play area.

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SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Dayna Chambers	TELEPHONE: (323) 558-2962
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2019

LIC809 (FAS) - (06/04)

Page: 4 of 7

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: NOE FAMILY CHILD CARE	FACILITY NUMBER: 198017382
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/11/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/31/2019 Section Cited HSC 102416(b)	1 2 3 4 5 6 7	Personnel Requirements (b) a licensee of a large family day care home shall ensure that at least one person who has a current certificate in pediatric first aid and pediatric cardiopulmonary resuscitation shall be available at all times	1 2 3 4 5 6 7	Per Licensee, training will be taken and a copy of the certificate will be submitted by POC due date of 07/31/2019
	8 9 10 11 12 13 14	when children are present at the facility, or when children are off-site of the facility for facility activities. This requirement is not met as evidenced and observed by LPAs because the CPR First Aid was expired on 09/2018 and this poses a potential health and safety risk for the care of children.	8 9 10 11 12 13 14
Type B 07/25/2019 Section Cited CCR 102421	1 2 3 4 5 6 7	Child's Records 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 evidenced and observed by LPAs, Child #3 did not	1 2 3 4 5 6 7	Per Licensee, will create a file for all new children in care with all required documents. Licensee will create a file by 07/25/2019 and provide LPA wiith a copy of the required forms.
	8 9 10 11 12 13 14	have a file available for review and this poses a potential health and safety risk for the care of children.	8 9 10 11 12 13 14

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: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Dayna Chambers	TELEPHONE: (323) 558-2962
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2019

LIC809 (FAS) - (06/04)

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