198018389-4-27-2023-54-CC-AMOY-CRB2MA-20230427173048

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198018389
Report Date: 04/27/2023
Date Signed: 04/27/2023 05:31:03 PM

Document Has Been Signed on 04/27/2023 05:31 PM - It Cannot Be Edited

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:	CONTRERAS FAMILY CHILD CARE		FACILITY NUMBER:	198018389
ADMINISTRATOR:	CONTRERAS, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 982-3522
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90059
CAPACITY:	14	CENSUS: 3	DATE:	04/27/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:20 PM
MET WITH:	Maria Contreras, Licensee		TIME COMPLETED:	05:45 PM

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Licensing Program Analyst (LPA) Alicia Mooberry conducted a Required Annual Inspection on this date. LPA met with Maria Lorena Contreras, who provided tour of the facility. LPA explained the purpose of the inspection and provided the inspection Entrance Checklist, LIC 126. LPA inspected rooms/areas on the facility sketch in which child-care services are provided and to which children have access. Per licensee the hours of operation are Monday-Friday 6:00am-8:00pm. LPA discussed overnight care regulations. There were three (3) children present upon arrival. Individual identified by licensee residing in the home were discussed and noted and have obtained a fingerprint clearance.

This a two-story home consisting of 3 bedrooms and 2 bathrooms. Areas accessible to children in care are the living room, dining room (main daycare area), bathroom (by the living room) and backyard.

Off limit areas, per Licensee and facility sketch are: Entire upstairs, attached garage, kitchen and laundry room on the first floor. LPA observed safety gate at the base of stairs and a mesh divider in the kitchen making off limit areas inaccessible by children in care. The laundry room is located off the kitchen and was observed to be locked. The garage is accessible via door in the living room, was observed to be closed and locked. LPA reminded licensee to ensure off limit areas are kept inaccessible to children in care.

LPA observed required posted documentation on the wall by the daycare area including: Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPA observed facility records including; LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan.

The facility roster is missing the address and or doctor/clinic information for 4 out of 7 children enrolled, this poses a potential risk for the safety of children in care.

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SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CONTRERAS FAMILY CHILD CARE	FACILITY NUMBER: 198018389
	VISIT DATE: 04/27/2023

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The home is observed to be clean and orderly. There are toys and other age appropriate material available for children.
Smoke and carbon monoxide detectors were tested and are operable. The required 2A10BC fire extinguisher was observed in the kitchen, with a service tag dated 11/09/22, Licensee was reminded that the fire extinguisher needs to be serviced yearly.

LPA observed that detergents, cleaning compounds are in locked cabinets in the kitchen inaccessible to children.

Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, not only inaccessible to children. Per Licensee there are no firearms or weapons stored in the home.
Isolation area for sick children waiting to be picked up is in living room, away from the other children.
The bathroom that children use is located in the hallway was observed to be clean and free of hazards.

Per licensee and record review here is one (1) infant in care. LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Currently, children are using the back yard for outdoor play. LPA observed that the outdoor yard has toys and other materials for children to play with. The outdoor play area was observed to be fenced and free of hazardous on this date.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization's Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, and documentation of 15-minute Infant Sleep Check (0-24 months).

Licensee's documents were reviewed. The licensee's Pediatric First Aid and CPR certification is current completed on 02/11/23, Proof of immunizations against measles, pertussis and influenza. Receord review shows that the licensee's Mandated Reporter Training Certificate AB1270 last completion date: 01/14/2022.

-------------------Page 2 – Report Continues

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CONTRERAS FAMILY CHILD CARE	FACILITY NUMBER: 198018389
	VISIT DATE: 04/27/2023

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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. 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

Licensee administers medication to child #4. LPA observed that the child's medication is in cabinet inaccessible to children in care, the Consent for Medication and log (LIC 9221) is complete and on file. The prescription medication was observed to be in its original package, expiration date 08/2024, stored inside kitchen wall cabinet, inaccessible to children in care

LPA discussed COVID-19 precautions and procedures and advised Licensee to stay aware of the guidance from the Public Health Department.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Based on the LPA's observations and records review no deficiencies will be cited as a result of this inspection.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Maria Lorena Contreras

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/27/2023 05:31 PM - It Cannot Be Edited

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: CONTRERAS FAMILY CHILD CARE	FACILITY NUMBER: 198018389
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/27/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited

Administration of Child Day Care Licensing


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Type B

Section Cited

CCR

102417(g)(8)

Operation of A Family Child Care Home

(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above due to facility roster is missing the address and or doctor/clinic information for 4 out of 7 children enrolled, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/05/2023
	Plan of Correction
1 2 3 4	Per licensee, proof of correction will be sent LPA via email by POC due date

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: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 04/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023

LIC809 (FAS) - (06/04)

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