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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018877
Report Date: 02/08/2023
Date Signed: 02/08/2023 03:40:53 PM


Document Has Been Signed on 02/08/2023 03:40 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:RUIZ FAMILY CHILD CAREFACILITY NUMBER:
198018877
ADMINISTRATOR:RUIZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 225-4093
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY:14CENSUS: 12DATE:
02/08/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Licensee Maria Ruiz TIME COMPLETED:
03:50 PM
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On 2/8/23 Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced annual required inspection at the above facility. LPA met with Licensee Maria Ruiz who guided analyst on a tour of the facility. There were 12 children and 2 additional staff present when LPA arrived. Individuals residing in the home have been discussed and noted. All adults present in the home have obtained a criminal record clearance or exemption. Facility capacity is in compliance for a Large Family Child Care Home.Hours of operation are Mon to Sun 12AM to 11:59PM and care is provided to children ages 0 to 13 years old. Licensee was advised care cannot be provided for more than 24 hours.
This is a one story home which consists of 4 bedrooms, 2 bathrooms, kitchen, living room, garage and backyard (fenced).
Areas on limits to children are living room, one bathroom in the hallway, one bathroom in the day care napping room, two day care rooms and the back yard.
Areas off limits to children include: 2 front bedrooms, kitchen and garage and one storage structure in the backyard. The LPA toured all areas used by children during this visit.
Food is provided by Licensee. Licensee was reminded if children bring food from home it must be labeled with the child’s name and properly stored or refrigerated.
All areas that are accessible for children to use were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection:
LPA observed required posted documentation for Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. Facility records were reviewed for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster drill log, last drill conducted on 1/25/2023. Licensee had a copy of the Roster available during the inspection.
Smoke and carbon monoxide detectors were tested and are operable. Fire extinguisher indicated fully charged and was serviced on 01/2023. The home maintains telephone service. The home is observed to be clean and orderly. There are toys and other age appropriate materials available for children.
There is an A/C/ heater unit available in the playroom.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette EstradaTELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:
DATE: 02/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/08/2023
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: RUIZ FAMILY CHILD CARE
FACILITY NUMBER: 198018877
VISIT DATE: 02/08/2023
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knives, sharp objects, detergents, cleaning compounds and medication are stored in the off limits kitchen, inaccessible to children. Per Licensee, at the moment there are no children enrolled who require medications. LPA inspected the on limits bathrooms. LPA observed latched cabinets under the sink which contained household items. LPA did not observe any hazardous cleaning compounds accessible to children in the bathrooms. Children use the enclosed backyard for outdoor play. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with.
Per Licensee, there are no poisons in the home. Licensee understands that all poisons must be locked, not only inaccessible to children. Isolation area for sick children waiting to be picked up is in the living room, supervised by an adult and away from the other children. Per Licensee, there are no firearms or weapons stored in the home. There are no pools or spas, or other bodies of water. There are no pets in the home.
Infant Care: Currently licensee cares for 4 infants over 12 months. LPA observed 2 play yards and 1 crib in the napping room. Napping equipment does not block entrances or exits. Infant mattresses were observed to be firm with tightly fitted sheets. LPA did not observe loose object, bumpers, objects hanging, or objects attached to the cribs. There are currently no infants who use pacifiers while napping. Each infant has their own crib/ napping mat and bedding. LPA discussed with license the Safe sleep regulation and reviewed LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months.
Overnight Care: There is no overnight care provided at the moment. LPA discussed the following: Licensee is aware that they must remain awake while children are awake. If children sleep in separate area from licensee, the door must remain open. If licensee cannot hear children when they wake up, video or audio device can be used.
Children’s records contained (LIC) 282- Affidavit Regarding Liability Insurance, Immunization Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, infant children's records did not contain the 15 minute sleep log.
Staff records were reviewed. Licensee, Staff 1 and Staff 2 have a current certification issued by the American Red Cross for Pediatric First Aid/ CPR which expires on 2/2024. Licensee, Staff 1 and Staff 2 have completed Mandated Reporter Training which expires on 6/29/2024. Staff had proof of required immunization records for measles, pertussis and flu (written declinations). Staff 1 and Staff 2 files contained signed LIC 9052 employee rights .
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette EstradaTELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:

DATE: 02/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023
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: RUIZ FAMILY CHILD CARE
FACILITY NUMBER: 198018877
VISIT DATE: 02/08/2023
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During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.
Incidental Medical Services (IMS):
Incidental Medical Services (IMS) policy was discussed. At the moment, no children enrolled require medication. 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm
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.
LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleephttps://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.
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/process.
Based on the LPA's observations and records review no deficiencies will be cited today 2/8/23.
Exit interview conducted and report was reviewed with the Licensee, Maria Ruiz . A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette EstradaTELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:

DATE: 02/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023
LIC809 (FAS) - (06/04)
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