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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019340
Report Date: 05/03/2023
Date Signed: 05/03/2023 02:06:14 PM


Document Has Been Signed on 05/03/2023 02:06 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:RAMIREZ FAMILY CHILD CAREFACILITY NUMBER:
198019340
ADMINISTRATOR:RAMIREZ, MICHELLEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 582-9197
CITY:HUNTINGTON PARKSTATE: CAZIP CODE:
90255
CAPACITY:14CENSUS: 13DATE:
05/03/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Michelle Ramirez, LicenseeTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Denise Gibbs conducted an unannounced annual required inspection at the above facility on 5/3/23 at 11:40AM. LPA met with Michelle Ramirez, Licensee who guided analysts on a tour of the facility.

There were 12 daycare children and four adults present when LPA arrived. An additional one infant (C13) was observed with visiting adult (A1). Infant is not part of the day care. 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 Monday- Friday 6AM- 6PM. This facility partners with Head Start.

This is a two-story home that consists of four bedrooms, two and a half bathrooms, living room, kitchen, dining room, attached garage front yard (not fenced) and back yard (fenced). Main care areas include living room and backyard. Per Licensee, Off limit areas include, four bedrooms and two bathrooms upstairs and attached garage.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection:

LPA reviewed required posted documentation located in the main care are, which included facility License, Publication (PUB) 394- Notification of Parent Rights, Licensing Form (LIC) 9148- Earthquake Preparedness form, and LIC 610- Facility Disaster Plan. All documents were observed.

Facility records were reviewed for LIC 9040- Facility Roster and Disaster drill log. Last drill conducted on 5/2/23. All documents were observed.
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SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 198019340
VISIT DATE: 05/03/2023
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Smoke and carbon monoxide detectors, located in the living room and dining room were tested and are operable. Fire extinguisher indicated fully charged and was serviced, 12/2022. The home maintains telephone service via landline and cell phone.

There are toys and other age appropriate material available for children in the living room and backyard. The home is observed to be clean and orderly. LPA observed that detergents, cleaning compounds and medication are stored in the attached garage, inaccessible to children. There is a fire place in the dining room that is screened. Stairs leading to the second floor are gated to prevent children's access. Isolation area for sick children waiting to be picked up is in the entrance labeled isolation area, away from the other children. Food is provided by Licensee. Licensee was reminded that all food brought from a child home must be labeled and properly stored. Per Licensee, there are no firearms or weapons stored in the home. Toys are washed once or twice a months and toys that putin a child's mouth are put in a dirty toys bucket away from other children.

The bathroom that children use is located off the hallway adjacent to the main care area. Bathroom was observed to be clean and free of hazards. Changing table for children in diapers was observed in the hallway near the bathroom.

Infant Care: Currently licensee has two infants enrolled. Older infants nap on mats in the main care area with the preschool children. Each infant has their own mat. Bedding provided by facility and washed once a week. LPA informed licensee of the Safe Sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months, and provided PIN 20-24-CCP.

Currently, children are using the back yard for outdoor play. The outdoor play area was observed to be gated. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that could be hazardous to children in care. Two storage sheds were observed in the backyard, one containing toys and equipment for the daycare and one with licensee's personal items (locked). There are no pools or spas, or other bodies of water.



Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A
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SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 198019340
VISIT DATE: 05/03/2023
NARRATIVE
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Notification of Parents’ Right, and documentation of 15-minute Infant Sleep Check (0-24 months). All documents were observed. 15-minute sleep check was discussed with licensee.

Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC-501: Personnel Record, LIC 508- Criminal Record Statement, Proof of immunization against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. All items were observed.

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. 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

Based on the LPA's observations and records review no deficiencies will be cited today 5/3/23.

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.

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 .---------------PAGE 3

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 198019340
VISIT DATE: 05/03/2023
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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 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.

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

Exit interview conducted and report was reviewed with the Licensee, Michelle Ramirez.


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SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4