198019145-7-30-2021-54-CC-ECHZ-C5ERSY-20210730131731

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019145
Report Date: 07/30/2021
Date Signed: 07/30/2021 01:17:47 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	RODRIGUEZ FAMILY CHILD CARE		FACILITY NUMBER:	198019145
ADMINISTRATOR:	ROXANA R. & JACQUELINE G.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 281-9027
CITY:	BELLFLOWER	STATE: CA	ZIP CODE:	90706
CAPACITY:	14	CENSUS: 6	DATE:	07/30/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Roxana Rodriguez & Jacqueline Gonzalez		TIME COMPLETED:	01:30 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) Elka Chavez conducted an unannounced annual inspection in Spanish to the above facility on 07/30/2021. LPA arrived at the facility at 10:40 AM and met with Licensee, Roxana Rodriguez, Licensee who guided analyst on a tour of the facility. Also present during this inspection, was, Co-Licensee Jacqueline Gonzalez. Per Licensee, there are 13 children that are currently enrolled. A current children’s roster was available for review. There were 6 children present upon arrival. This is a single-story home which consists of 3 bedrooms, 1 bathroom, kitchen, laundry room, living room, front yard, backyard (fenced), and 2 detached garages. The children use the living room, bedroom (located next to the kitchen), bathroom and back yard (fenced). LPA observed that there is a fireplace in the living room. LPA observed cubbies have been placed in front of the fire place making it inaccessible to children in care. Per Licensee, areas off limits to children and parents include: 2 bedrooms (next to the bathroom), kitchen, laundry room, 2 detached garages and front yard. Individuals who reside in the home were noted and discussed. Per Licensee, they currently have one assistant. All adults present in the home have obtained a criminal record clearance. Licensee states that there are no firearms stored in the home. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a landline and cell phone. There is ventilation and heating. LPA observed a window air conditioner. Safe toys play equipment and materials were observed. Detergents, cleaning compounds, medications, and other items which could pose a danger to children we observed to be inaccessible to children in the off-limit laundry room. LPA observed a child safety gate located in the kitchen making the area inaccessible to children in care. The licensee states that there are no poisons

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka Chavez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2021

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: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198019145
	VISIT DATE: 07/30/2021

NARRATIVE

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in the home and understands that storage areas for poisons must be locked with a key or combination lock. The restroom that children use was observed to be safe and sanitary. LPA observed child safety locks in the bathroom cabinets.

The valve on the required 2A10BC fire extinguisher indicates fully charged and was serviced on 03/11/21, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable. LPA observed them in the living room, kitchen and bedroom used by children in care.

Licensee states that she is currently caring for infants and there are infants enrolled. Licensee states that the infant will sleep in the bedroom next to the kitchen where they are constantly supervised. Appropriate sleeping arrangements and cots were observed. Licensee was advised that cribs or play yards cannot hinder the entrance or exit from the sleeping space, mattresses shall be firm and covered with a fitted sheet that overlaps the underside, so it cannot be dislodged. Cribs and play yards must be free of loose articles and objects. No objects can be hung above or attached to the side of the crib. LPA advised the Licensee that infants cannot be swaddled, shall be placed on their backs for sleeping and shall be supervised. Infants shall be checked on every 15 minutes and the time of each 15-minute check shall be documented with child’s name and date. The LIC 9227 Individual Infant Sleeping Plan shall be completed for each infant up to 12 months of age.

Currently, children are using the back yard for outdoor play time. 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. LPA did not observe any objects that can pose a danger to children on the outdoor yard. The licensee states that supervision is always provided.

The licensee is observed to be operating within the license capacity limitations. LPA did not observe any children left in parked vehicles. Car seats shall only be used for transportation. LPA did not observe any children sleeping in car seats.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 11/2022. There are first aid supplies

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka Chavez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2021

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: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198019145
	VISIT DATE: 07/30/2021

NARRATIVE

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available. LPA observed them to be kept in the living room on top of a book shelf. LPA advised that if a child shows signs of illness he/she/they shall be separated from other children.

Children’s records were reviewed, including emergency information and were observed to be complete. The licensee has proof of immunization against influenza, pertussis, and measles.

LPA observed that the Licensee and assistant do not have a current Mandated Reporter AB 1207 Compliant Child Care Training Certificate on file. LPA issued a technical violation. LPA issued a Confidential Names List (LIC 811) to the licensee which documents staff and children’s files reviewed during this inspection.

All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. Last drill documented was conducted on 7/17/21.

There is a German Shepard dog on the premises. LPA observed a cage in the back yard behind the detached garage for the dog. LPA also observed a gate that extends from one garage to the other garage. Per Licensee the gate is used to keep the dog in the other side of the backyard. LPA did not observe any pools, spas, hot tubs, fish ponds, or similar bodies of water during the inspection. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Incidental Medical Services (IMS):
The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS at this time. 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

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka Chavez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2021

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: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198019145
	VISIT DATE: 07/30/2021

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LPA advised the licensee to access forms, regulations and quarterly updates online at: www.cdss.ca.gov. LPA also discussed the Provider Information Notices (PINS) on Safe Sleep Awareness: PIN 19-02-CCP, COVID FAQ - PIN 20-11-CCP and Guardian User Account Access - PIN 20-20-CCLD. LPA provided Licensee with a copy of the Children's Records form (LIC 311D).

No deficiencies cited during today’s visit. Technical violations must be corrected in order to ensure the health and safety of children in care.

Exit interview was conducted with Licensee, Roxana Rodriguez, including, but not limited to Appeal Procedures, Site Visit and Initial Appeal Rights.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Elka Chavez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2021

LIC809 (FAS) - (06/04)

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