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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019437
Report Date: 10/16/2019
Date Signed: 10/16/2019 04:32:39 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:RUELAS FAMILY CHILD CAREFACILITY NUMBER:
198019437
ADMINISTRATOR:ZOILA RUELASFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 624-7074
CITY:LA PUENTESTATE: CAZIP CODE:
91744
CAPACITY:14CENSUS: 6DATE:
10/16/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:49 PM
MET WITH:Zoila RuelasTIME COMPLETED:
04:40 PM
NARRATIVE
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Annual Random inspection conducted by Licensing Program Analyst (LPA) Jennifer Hua. LPA met with licensee Zoila Ruelas, who guided the analyst on a tour of the facility. Per licensee, total 8 adults and 1 minor residing in the home. LPA observed 6 children in care supervised by Licensee and assistant. Licensee and assistant speak Spanish and some English.

Child care areas were inspected. This is a one story home which consists of 4 bedrooms, 2 bathrooms, kitchen, dining room, living room, day care area, garage, and backyard (fenced). Areas used by the children are one bathroom, kitchen, dining room, living room, day care room, and backyard. These areas were inspected for safety, comfort, cleanliness, telephone service, ventilation and heating (central). Areas off limits to children and parents include: Four bedrooms, one bathroom, and garage.

Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible. Emergency disaster plan was posted during this visit.

Per licensee, there are no firearms, weapons, bodies of water or pets on the premises. Toys were observed for children. The valve on the required 2A 10BC fire extinguisher indicates fully charged but has not been serviced annually. Smoke and carbon monoxide detectors in the home were tested and are operable.

Licensee and assistant have CPR and Pediatric First Aid training and will expire on 09/4/2021.

Child Care Roster, Disaster Plan, Emergency Disaster Drill and Children's Records were reviewed. Children records and required licensing forms were discussed as well as mandated child abuse reporting and criminal records clearance (finger prints and child abuse clearance) requirement
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019
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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: RUELAS FAMILY CHILD CARE
FACILITY NUMBER: 198019437
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/16/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/22/2019
Section Cited

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mmunizations. The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.
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This requirement includes updating each child's PM 286 (6/95) when the child is due to receive required immunizations after enrollment in the family day care home. The requirement is not met as evidenced by: Child # 1 lack record, #4 need updates. This poses a potential risk to the health and safety of children in care.
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Type B
10/22/2019
Section Cited

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Operation of a Family Child Care Home. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshal. The requirement is not met as evidenced by: Fire extinguisher is fully but has not been serviced annually. This poses a potential risk to the health and safety of children in care

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:
DATE: 10/16/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/16/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4
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: RUELAS FAMILY CHILD CARE
FACILITY NUMBER: 198019437
VISIT DATE: 10/16/2019
NARRATIVE
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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 Child Care Provider's Guide to Safe Sleep was discussed and provided to licensee. Drills conducted on 10/10/19. Affidavit Regarding Liability Insurance in files. Licensee was informed to complete the Mandated Reporter Training on department website at http://www.mandatedreporterca.com/ if training is available in her language.

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.
· 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.

Deficiencies cited on attached 809D.

Exit interview was conducted with licensee. Notice of Site Visit notice posted. And Licensee advised to keep notice posted for 30 days or a civil penalty of $100 will be assessed.
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 ChicoTELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019
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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: RUELAS FAMILY CHILD CARE
FACILITY NUMBER: 198019437
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/16/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/22/2019
Section Cited

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Admission Procedures and Parental Rights. At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parents’ Rights, LIC 995A (8/06), the Caregiver Background Check Process Process, LIC 995E (6/05), and the Family Child Care Consumer Awareness Information, LIC 9212 (10/05).
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The requrirement is not met as evidenced by: Child #1- #6 lack notice in file. This poses a potential risk to the health and safety of children in care.
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Type B
11/15/2019
Section Cited

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Immunization Requirements. Effective 9/1/16, all individuals who provide care and supervision to children are required to obtain immunizations for Pertussis, Measles and Influenza. The requirement is not met as evidenced by: Record not available for staff #1. This poses a potential risk to the health and safety of children in care.
Type B
11/15/2019
Section Cited

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Personnel Records. Personnel records shall be maintained on each employee and shall contain the following information: The requirement is not met as evidenced by: Staff #1 lack record in file. This poses a potential risk to the health and safety of children in care.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:
DATE: 10/16/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/16/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4