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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018212
Report Date: 12/11/2019
Date Signed: 12/11/2019 01:31:04 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:NARVAEZ FAMILY CHILD CAREFACILITY NUMBER:
198018212
ADMINISTRATOR:NARVAEZ, BEATRIZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 513-3492
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY:14CENSUS: 2DATE:
12/11/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Beatriz NarvaezTIME COMPLETED:
01:40 PM
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ANNUAL/RANDOM INSPECTION CONDUCTED IN SPANISH AND ENGLISH

Licensing Program Analysts(LPAs) Mayra Rivera and Warren Birks conducted an unannounced random inspection to the above facility. LPAs met with licensee Beatriz Narvaez, who guided analyst on a tour of the facility. LPAs also observed a third party individual who did not need to be associated to the facility. The licensee states that she currently has 16 children enrolled. A current children’s roster was available and is current. During this inspection there were 2 children present in the facility, 2 being preschool children present.

This is a ,duplex home which consists of 3 bedrooms, 2 bathrooms, 1 kitchen, 1 living room, dining area (no FIREPLACE):, garage, front yard, and backyard (fenced). The children use the bathroom in the hallway, living room, dining area, and gated front and side yard). Per licensee, areas off limits to children and parents include: 1 bathroom, 2 bedrooms, backyard, back unit and garage. The licensee provides food for children in care. Family members residing in the home are 4 adults who have clearances on file and 0 children.

All areas used by children were inspected for safety, comfort, cleanliness, telephone, ventilation and heating (central). During a walk thought of the outdoor play area, LPA's observed glass cleaner, antifreeze solution, and a bag of nails that were accesible to children who will play in the side yard. LPAs also observe in the bathroom under the sink shampoo and conditioner, in the kitchen counter medicine and under sink cleaning solutions. LPAs informed licensee that any poisons must be inaccessible to children and locked. LPA also informed licensee that all detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are to be inaccessible in all areas in the home.
REPORT CONTINUES ON NEXT PAGE 1 of 3


SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019
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 5
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: NARVAEZ FAMILY CHILD CARE
FACILITY NUMBER: 198018212
VISIT DATE: 12/11/2019
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REPORT CONTINUES ON NEXT PAGE 2 of 3

Per licensee, she has 4 dogs that remain in an inaccessible area of the backyard. LPA indicated there are no weapons, firearms or bodies of water on the premises. There were toys observed for children. Posting requirements were observed to be posted at the time of inspection. Children’s records were reviewed.


The valve on the required 2A 10BC fire extinguisher indicates fully charged and is due for service on 4/25/2020. Smoke and carbon monoxide detectors in the living room were tested, and are in operable condition. There are emergency supplies on the premises. The licensee was observed to be operating within the licensed capacity and is not exceeding the required limitations. All adults residing in the home have obtained a criminal record clearance. The licensee and her two assistants have proof of current pediatric first aid and CPR (expire: 2020 and 2021). LPAs presented information for the Licensee to attempt to complete the mandated reporter training. .

The following was discussed:


INFANT CARE: Licensee states that she does care for infants. LPAs discussed the licensee’s plan for supervising sleeping infants. Licensee states the following: Any infants in care will stay in the area where the licensee or assistant are. LPA advised the licensee to sleep infants where the infant can be directly supervised and advised against sleeping infants in a separate room. The licensee states that she will not sleep infants in a separate room. 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. Safe sleep concepts were provided.

Medication: 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

No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into this category are not permitted in a family child care facility.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: NARVAEZ FAMILY CHILD CARE
FACILITY NUMBER: 198018212
VISIT DATE: 12/11/2019
NARRATIVE
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LPAs explained to licensee that car seat and stroller are only and only for transportation, high chair is only and only for feeding and stated items cannot be misused.

LPAs explained LIC 311 - Forms/Records to Keep in Your Family Child Care Home.
LPAs advised the licensee how to access forms, regulations and quarterly updates , and Providers Information Notices (PIN) on line at: www.ccld.ca.gov

LPAs consulted and explained Child Abuse Reporting, Effects of Lead Exposure flyer, Updated Patent’s Rights Poster with Complaint Hotline information, Capacity Handout (Small & Large) was provided during this inspection. Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. (use LIC624B for written report). Licensees shall reveal each facility license number in all advertisements, publications, or announcements made with the intent to attract clients. Mandated reporter training must be completed every 2 years. www.mandatedreporterca.com

LPAs issued the Confidential Names List (LIC 811) to the licensee during this inspection. The Confidential Names List documents the children’s files that were reviewed during this inspection.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 daysduring 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. A copy of the report must be provided to the parents of children in care and the Acknowledgement form (LIC 9224) must be maintained in each child’s file immediately upon receipt from parent for the next 12 months. A copy of the parent Acknowledgement of Receipt of Licensing Reports Form was provided during this inspection. Exit interview conducted with Licensee Narvaez. Appeal rights explained & provided. A copy of this report and all other Licensing reports must be made available to the public for 3 years.
REPORT END 3 of 3
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2019
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: NARVAEZ FAMILY CHILD CARE
FACILITY NUMBER: 198018212
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/11/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/11/2019
Section Cited

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Personal Rights : Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative.
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These rights include, but are not limited to, the following: To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement was not met as evidenced by: LPAs observed antifreeze, glass cleaner, cleaners and medicine in accessible areas of the daycare (indoor and outdoor).
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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: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:
DATE: 12/11/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/11/2019
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: NARVAEZ FAMILY CHILD CARE
FACILITY NUMBER: 198018212
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/11/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/13/2020
Section Cited

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The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.
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(1) This requirement includes updating each child's PM 286 (6/95) when the child is due to receive required immunizations after enrollment in the family day care home. This requirement was not met as evidenced by: Licensee is missing the PM 286 blue form for child #1 and #2.
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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: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:
DATE: 12/11/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/11/2019
LIC809 (FAS) - (06/04)
Page: 5 of 5