198018480-2-11-2020-33-CC-JHUA-BLPSLY-20200211125908

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198018480
Report Date: 02/11/2020
Date Signed: 02/11/2020 12:59:13 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:	RAMOS FAMILY CHILD CARE		FACILITY NUMBER:	198018480
ADMINISTRATOR:	RAMOS, HILDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 339-5799
CITY:	AZUSA	STATE: CA	ZIP CODE:	91702
CAPACITY:	14	CENSUS: 4	DATE:	02/11/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:52 AM
MET WITH:	Hilda Ramos		TIME COMPLETED:	01:10 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	An Annual inspection was conducted by Licensing Program Analyst Jennifer Hua LPA. Met with licensee, who guided the analyst on a tour of the facility on this date. This is a single story home. Residing in facility are 2 Adults and 0 Children. The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. sent. Also in the home on this date was the licensee, assistant Leonor Rojas and licensee's spouse. Areas used by children were inspected as follows: Kitchen, living room, dinning, 2 bedrooms, 1 bathroom back yard and back yard play room. Per licensee, there are no weapons, firearms, swimming pool or spa on the premises. The backyard is adequately fenced. There are age appropriate toys and equipment on the premises. The smoke detectors, carbon monoxide and fire extinguisher (2A 10BC) are in operable condition. Fire extinguisher was serviced on 5/29/19. Licensee is current in Pediatric CPR/First Aid Exp. 01/11/22 & Assistant's certificate will expire on 12/15/20. Areas off limits include: Garage, Front Yard, Master Bedroom w/ bath & Family room. Rooms that are off-limits need to be made inaccessible during operating hours *The Licensee does understand that licensing staff may have access to off-limit areas during inspection visit if necessary.* Child Care Roster, Disaster Plan, Emergency Disaster Drill and Children's Records were reviewed. Drills were conducted on 4/11/19. Licensee will conduct drills ASAP.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer Hua	TELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2020

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: RAMOS FAMILY CHILD CARE	FACILITY NUMBER: 198018480
	VISIT DATE: 02/11/2020

NARRATIVE

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Rooms that are off-limits need to be made inaccessible during operating hours. No smoking, No infant walkers, Johnny jumpers, exersaucers, bouncers and any other item that falls into that category, earthquake – fire, disaster drills and safety, posting requirements, children records requirements, mandated child abuse and injury/ death reporting, criminal records, child abuse clearance and criminal records transfer requirements, SIDS, Never Shake A Baby, A Provider's Guide to Safe Sleep was provided and explained. Lead Poisoning Facts hand out was provided to Licensee. Affidavit Regarding Liability Insurance form in files. Licensee completed the Mandated Reporter Training on department website at http://www.mandatedreporterca.com/ on 2/2/18. Licensee will renew training by 2/14/20.

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) 514-0388 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

· Dog(s) and or pets should be isolated from children in care. No pets
· It is recommended that a First Aid kit be available on premises.
Outdoor supervision required at all times. If outdoor area not adequately fenced provider must be with children at all times when outdoors.

No deficiencies cited.

Exit interview was conducted with licensee.
Site visit notice posted. And Licensee advised to keep notice posted for 30 days.
Web site address to order forms: http://www.dss.cahwnet.gov/cdssweb/On-lineFor_293.htm#l
INTERNET ADDRESS: http://www.ccld.ca.gov – To access licensing forms, updates and Title 22.

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer Hua	TELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2020

LIC809 (FAS) - (06/04)

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