198018370-6-9-2021-33-CC-MGAA-C3TTNQ-20210609145307

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198018370
Report Date: 06/09/2021
Date Signed: 06/09/2021 02:54:01 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:	LOPEZ FAMILY CHILD CARE		FACILITY NUMBER:	198018370
ADMINISTRATOR:	SONIA STEPHANIE LOPEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 819-3566
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90038
CAPACITY:	14	CENSUS: 5	DATE:	06/09/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:17 PM
MET WITH:	Arelis Orellana, Assistant		TIME COMPLETED:	03:00 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) Mireya García conducted an unannounced random inspection. LPA met with Assistant, Arelis Orellana who guided analyst on a tour of the facility. Licensee was not present during this inspection. The licensee's assistant’s Arelis Orellana and Dinora Cabrera were present providing care and supervision. There were 5 children present. Assistant Arelis states that there are currently 6 children enrolled. Family members residing in the home are 2 adults (criminal record clearances on file), 1 child and 4 dogs (dogs are kept away from day care areas). This is a two-story home which consists of 4 bedrooms, 4 bathrooms, kitchen, dining room, laundry room, living room (upstairs), and backyard (fenced). The following areas are used for day-care: Main day care is provided in one of the homes bedrooms (first room on the right when entering home). Children use the bathroom located in the main day care area and back yard (fenced). Per Assistant, Arelis, areas off limits to children and parents include: 3 bedrooms, 3 bathrooms, living room (second floor) dining room, laundry room and kitchen. At 12:41 p.m.,The LPA began 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 central air for safety and comfort. There were safe toys, play equipment and materials observed for children. The second floor stairs are barricaded with a safety gate. 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. Per Assistant, Arelis there are no poisons in the home. The Assistant, Arelis does understand that poisons must be locked with a key or combination lock. REPORT CONTINUES ON NEXT PAGE 1 OF 4.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2021

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 4

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: LOPEZ FAMILY CHILD CARE	FACILITY NUMBER: 198018370
	VISIT DATE: 06/09/2021

NARRATIVE

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LPA observed and inspected sleeping equipment for infants. LPA observed play yards readily available for infant use. Per Assistant, Arelis there are currently no infants in care/enrolled. LPA observed that play yards are free from loose articles and objects. There are no objects hanging above or attached to the side of the play yards. LPA observed that play yards do not hinder the entrance or exit to and from the space they are sleeping in. Mattresses were observed to be firm and covered with a fitted sheet that is appropriate to the mattress size. Assistant, Arelis was advised that infants shall not be swaddled while in care and all infants up to 12 months should be placed on their back for sleeping.

LIC 9227 (Individual Sleeping Plan) for infants up to 12 months was explained and issued to the Assistant, Arelis. Title 22 Regulation Section 102425(j) Infant Safe Sleep was discussed with the Assistant, Arelis including but not limited to documentation that shall be maintained.

Per licensee, there are no weapons, firearms. The home has a pool on the premises, LPA observed that the pool met all requirements per Title 22 regulations. Children’s records were reviewed to ensure that each child has an Identification and Emergency form. The valve on the required 2A 10BC fire extinguisher indicates fully charged with a service date of 09/30/2020. At 12:53 p.m., Smoke and carbon monoxide alarm in the kitchen was tested and is in operable condition. The Licensee and Assistant's have current Pediatric First Aid and CPR, which will expire 12/2022.

Incidental Medical Services (IMS) policy was discussed. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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

REPORT CONTINUES ON NEXT PAGE 2 OF 4.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2021

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: LOPEZ FAMILY CHILD CARE	FACILITY NUMBER: 198018370
	VISIT DATE: 06/09/2021

NARRATIVE

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SB792 (Immunization Requirements for Staff and Employees) was discussed with the Assistant, Arelis. Licensee and assistants have immunization documentation on file.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018 any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers
Licensee completed training on 06/04/2021.

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.
· The Licensee shall be present in the home and shall ensure that children are supervised at all times.
· Children shall not be left in park vehicles.
· The capacity specified on the license shall be the maximum number of children for whom care can be provided.
· Car seats shall only be used for transportation purposes and shall not be used for sleeping.
· All children in care have the right to receive safe, healthful, and comfortable accommodations, furnishings and equipment.
· When a child shows signs off illness, they will be separated from other children until the nature if the illness is determined.

LPA reviewed and issued the LIC 311 - Forms/Records to Keep in Your Family Child Care Home.
CHILDREN’S FORMS/RECORDS, FACILITY FORMS/RECORDS and INFORMATION TO BE POSTED, Disaster drills, posting requirements, children records requirements, mandated child abuse and injury/death reporting, and criminal record transfer requirements were discussed.

REPORT CONTINUES ON NEXT PAGE 3 OF 4.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2021

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: LOPEZ FAMILY CHILD CARE	FACILITY NUMBER: 198018370
	VISIT DATE: 06/09/2021

NARRATIVE

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LPA advised the Assistant, Arelis 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 Assistant, Arelis Orellana. The Assistant was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

REPORT ENDS HERE PAGE 4 OF 4.

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 981-3390
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2021

LIC809 (FAS) - (06/04)

Page: 4 of 4