198017557-8-27-2019-33-CC-LGOZ-BFFV9U-20190827161456

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198017557
Report Date: 08/27/2019
Date Signed: 08/27/2019 04:15:04 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:	198017557
ADMINISTRATOR:	FLORES, KARLA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(213) 220-5397
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90026
CAPACITY:	14	CENSUS: 6	DATE:	08/27/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:42 PM
MET WITH:	Karla Flores		TIME COMPLETED:	04:28 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	Licensing Program Analysts (LPA) Lissete Gonzalez conducted an unannounced annual random site inspection to ensure the health & safety standards as required by regulations governing family child care homes. Upon arrival, LPA met with Licensee, Karla Flores who provided LPA a tour of the facility indoors and outdoors. Also present was the Licensee’s spouse, Juan Bautista. There were 7 children present including 3 infants. Licensee states there are 13 children enrolled. The children’s roster was reviewed and is current. Licensee’s operating hours are from 6:30 a.m. to 7:00 p.m. from Monday through Friday. This is a one story duplex home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, 2 living rooms and outdoor side area of house (gated). The children use 2 bedrooms, a living room, one bathroom and side of house for play. Per licensee, areas off limits to children and parents include: 1 bedroom, 1 bathroom, kitchen, dining room and other living room. The LPA toured all areas used by children during this visit. LPA inspected the living room used by the children. There are adequate age appropriate toys, books, and games. No hazards or violations were observed. There is proper ventilation through the home. The bathroom was inspected for safety and cleanliness. No hazards of violations were observed. LPA inspected the 2 bedrooms used by the children. No hazards of violations were observed. There are electrical outlet covers throughout and a First Aid Kit is available. There is a child safety door located at the entrance of the kitchen that also barricades the remainder of the off limit areas of the home. Cleaning compounds and detergents are stored in a latched lower kitchen cabinet that is inaccessible to children. Knives and sharp objects are stored in a locked kitchen drawer. The outdoor play area was inspected. The outside play area is gated and there is shade. There is grass throughout the outdoor play area that provides cushioning to absorb a fall. No hazards or violations were observed. REPORT CONTINUES ON NEXT PAGE: 1 OF 3

SUPERVISOR'S NAME: Adriana Hernandez	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Lissete Gonzalez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2019

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: FLORES FAMILY CHILD CARE	FACILITY NUMBER: 198017557
	VISIT DATE: 08/27/2019

NARRATIVE

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Per California Code of Regulations Title 22, Division 12, no deficiency cited during today's visit. Exit interview conducted with Licensee, Karla Flores. A copy of this report was provided and explained.

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.

END OF REPORT: PAGE 3 OF 3

SUPERVISOR'S NAME: Adriana Hernandez	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Lissete Gonzalez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2019

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: FLORES FAMILY CHILD CARE	FACILITY NUMBER: 198017557
	VISIT DATE: 08/27/2019

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Licensee has the Parent’s Rights poster and other appropriate forms posted on a board in the living room. Licensee, Karla Flores’ First Aid/Pediatric CPR certificates are valid through 07/10/2021. Licensee completed the mandated reporter training and received the certificate on 5/15/2018. Licensee's disaster drill log notes last drill conducted on 04/23/19. Licensee has a working telephone.

LPA observed the 2A10BC fire extinguisher located in the living room was serviced on 04/02/2019 and is fully charged. There is an operational smoke detector and an operational carbon monoxide detector in the home. There are no firearms or poisons present on the premises as stated by Licensee. Currently there are no pets.

Staff files were reviewed and found to be complete. Children’s files were reviewed and found to be complete.

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. LPA discussed disaster drills, posting requirements, children records requirements, mandated child abuse and injury/death reporting.
LPA reviewed LIC 311D with licensee, reminding her of required forms. LPA reviewed SIDs, Never Shake A Baby, and safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space.

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 A qualified Assistant must be present and actively involved in caring for children whenever nine (9) or more children are present at the facility in a large family child care home.

REPORT CONTINUES ON NEXT PAGE: 2 OF 3

SUPERVISOR'S NAME: Adriana Hernandez	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Lissete Gonzalez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2019

LIC809 (FAS) - (06/04)

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