198017665-5-17-2019-33-CC-CGOZ-BC9VHS-20190517162738

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198017665
Report Date: 05/17/2019
Date Signed: 05/17/2019 04:27:51 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:	ESQUEDA FAMILY CHILD CARE		FACILITY NUMBER:	198017665
ADMINISTRATOR:	ESQUEDA, MICHELLE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 332-3270
CITY:	WEST COVINA	STATE: CA	ZIP CODE:	91791
CAPACITY:	14	CENSUS: 13	DATE:	05/17/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Michelle Esqueda, Licensee		TIME COMPLETED:	04:45 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 Analyst (LPA) Carlos Gonzalez conducted an Annual Random inspection to the above facility. LPA met with Michelle Esqueda, Licensee, who guided Analyst on a tour of the facility. LPA observed thirteen (13) children in care at the time of inspection. Also present was Licensee's Assistant, Fabiola Ortega. Per Licensee, there are currently twelve (12) children enrolled in care, as two (2) children will no longer be attending the facility as of today. Licensee provided LPA with a facility roster, reflecting the departure of two children and dated 05/17/19. This is a single story home which consists of 3 bedrooms, 1 bathroom, 1 master bathroom, dining room area, living room, kitchen, and rear family room (children's activity area). Children have access to the kitchen, living room, bathroom, and rear family room. Off-limits to children in care are all three bedrooms and master bathroom. The fireplace located in the family room is properly screened. Children use the back yard for outdoor play. Licensee was advised that 100% supervision is required at all times when children are playing outdoors. Currently residing in the home are Licensee, her spouse Jaime Esqueda, and two minor children. All individuals must obtain a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. Detergents, cleaning compounds, medications, and other items which could pose a danger, were determined to be inaccessible to children in care. LPA observed a fully charged 2-A:10:B-C fire extinguisher on the premises and the attached service tag indicates that it was last serviced on 01/21/2019. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. The combination smoke and carbon monoxide detector was tested and is working properly. There are age appropriate toys available for children. Per licensee, there are no weapons, firearms, or pets on the premises. LPA did not observe any bodies of water on the premises. Report continues on next page 1 of 3

SUPERVISOR'S NAME: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Carlos Gonzalez	TELEPHONE: (323) 981-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2019

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: ESQUEDA FAMILY CHILD CARE	FACILITY NUMBER: 198017665
	VISIT DATE: 05/17/2019

NARRATIVE

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The Licensee was observed to be operating within the licensed capacity limitations during this inspection. The Licensee and Assistant, have completed training on preventive health practices including Pediatric First Aid and CPR, which expires on 11/17/2020. There are first aid supplies available.

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. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
Children’s records were reviewed, including but not limited to, a copy of the emergency information card that contains all of the information required by regulation.

The following items were also discussed with licensee during this inspection:

· All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. LPA determined that Licensee last conducted a fire/earthquake drill on 05/08/2019, per the log provided.
· POSTING REQUIREMENTS: Parent’s Rights Poster and the Facility License were observed to be posted in the family room,, however LPA did not observe the Emergency Disaster Plan to be posted.
· Infant Walkers, Johnny Jumpers, Saucer Chairs, or any other item that falls into these categories are not permitted in a family child care facility. SMOKING IS PROHIBITED IN A LICENSED FAMILY CHILD CARE HOME.

Infant Care: Licensee does care for infants at this time. LPA advised the applicant to sleep infants where they can be directly supervised at all times and advised against sleeping infants in a separate room. Licensee states that infants are placed in the family room (children's activity area) where they can be directly supervised at all times.

Report continues on next page 2 of 3

SUPERVISOR'S NAME: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Carlos Gonzalez	TELEPHONE: (323) 981-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2019

LIC809 (FAS) - (06/04)

Page: 2 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: ESQUEDA FAMILY CHILD CARE	FACILITY NUMBER: 198017665
	VISIT DATE: 05/17/2019

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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. 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.

LPA advised the licensee how to access forms and regulations on line at: www.ccld.ca.gov.

LPA also advised Licensee on how to obtain the Department's Quarterly Updates via the following website address: www.childcareadvocatesprogram@dss.ca.gov

Beginning January 1, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors, and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Effective January 1, 2018: Existing licensees must meet requirements by March 30, 2018. Preventive (OCAP) online training modules are free of cost and available at http://www.mandatedreporterca.com/.

LPA determine that Licensee and Assistant have completed the Mandated Reporter training requirement.

Based on LPA’s observations and records review, there are no deficiencies being cited at this time. Licensee is in compliance with California Code of Regulations Title 22.

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 Michelle Esqueda, Licensee, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

Report ends page 3 of 3

SUPERVISOR'S NAME: Katherine Harewood	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Carlos Gonzalez	TELEPHONE: (323) 981-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2019

LIC809 (FAS) - (06/04)

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