198018605-10-29-2019-33-CC-CGRN-BHEPZ2-20191029114450

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198018605
Report Date: 10/29/2019
Date Signed: 10/29/2019 11:44:57 AM

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:	LI & RUIZ FAMILY CHILD CARE		FACILITY NUMBER:	198018605
ADMINISTRATOR:	ANGELA LI & STEPHANIE RUIZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 817-9509
CITY:	ALTADENA	STATE: CA	ZIP CODE:	91001
CAPACITY:	14	CENSUS: 6	DATE:	10/29/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Brianna Robles		TIME COMPLETED:	11:55 AM

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) Crystal Green conducted an unannounced annual inspection. LPA met with Licensees Assistant, Brianna Robles, also present during this inspection was Licensees Assistants Megan Ayon and Zara Ciccotelli. Licensee Angela Li arrived later during this inspection. There were 6 children present during this inspection. Per Licensee, there are 17 children enrolled. A current children roster was available. This is a one-story home which consists of 3 bedrooms, 1 1/2 restrooms, kitchen, dining room, living room (FIREPLACE: which is inaccessible), front yard and backyard (fenced). The children use the living room, dining room, napping room and use the restroom that is located in the laundry room. Children also has access to the kitchen area. Per licensee, areas off limits to children and parents include: both of the licensee's bedrooms and the front yard. The licensees provide snacks and lunches are provided by parents. Per Licensee Assistant, Zara Ciccotelli, only (2) adults (both licensee’s) live in the home. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for safety and comfort. 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. The licensee assistant states that there are no poisons in the home. Per licensee assistant, there are no pets, weapons, firearms or bodies of water on the premises. There were safe toys, play equipment, and materials observed for children. Emergency Disaster Plan, Parent’s Rights Poster, and the Facility License are observed to be posted. Children’s records were reviewed to ensure that each child has an Identification and Emergency form, Consent for Medical Treatment, and Immunizations records on file.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019

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: LI & RUIZ FAMILY CHILD CARE	FACILITY NUMBER: 198018605
	VISIT DATE: 10/29/2019

NARRATIVE

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The exit interview was conducted with Licensee, Angela Li. The Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

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.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2019

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: LI & RUIZ FAMILY CHILD CARE	FACILITY NUMBER: 198018605
	VISIT DATE: 10/29/2019

NARRATIVE

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Smoke detector and carbon monoxide detector were tested and are in operable condition. The valve on the required 2A10BC fire extinguisher indicates fully charged, last service date of 03/2019. All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. LPAs observed last drill documented was conducted on 05/29/2019. Both Licensee and Licensees Assistants were able to provide proof of current Pediatric First Aid and CPR during this inspection.

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. The licensee does have proof of immunization against influenza, pertussis, and measles.

AB1207 Mandated Child Abuse Reporting – Both licensees have completed the required mandated training.

This facility provides Incidental Medical Services – IMS. Per Licensee, there are currently no children enrolled requiring IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

PROHIBITED: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that falls into these categories are not permitted in a family childcare facility. SMOKING IS PROHIBITED IN A LICENSED FAMILY CHILD CARE HOME.

Infant Care: Licensee states that she is currently caring for infants. LPA advised the licensee to sleep infants where they can be directly supervised. The licensee stated the following as a supervision plan for infants: Licensee states that infants always sleep in the napping room with the door open and staff conduct periodic checks. LPA provided Licensee with “A Caregiver Provider’s Guide to Safe Sleep” and “Tips for prevent heat related illness”.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 854-8930
LICENSING EVALUATOR NAME: Crystal Green	TELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2019

LIC809 (FAS) - (06/04)

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