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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019437
Report Date: 08/17/2021
Date Signed: 08/17/2021 12:38:25 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: 4DATE:
08/17/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Licensee, Zoila RuelasTIME COMPLETED:
12:45 PM
NARRATIVE
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On 08/17/2021 at 11:10 am, Licensing Program Analyst (LPA) Jose Guzman conducted an unannounced required inspection. A risk assessment was conducted prior to entering. LPA met with Licensee, Zoila Ruelas, during today’s inspection. There were 4 children present. Licensee states that there are currently 17 children enrolled. The children's roster was reviewed and is current. Disaster drill log was also available during today’s inspection.
This is a one-story home which consists of four bedrooms and two bathrooms. Areas used by the children are one bathroom, kitchen, dining room, living room, day care room, and backyard. Per Licensee, areas off limits to children and parents include four bedrooms, one bathroom, and garage.

Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. Family members residing in the home are three adults (criminal record clearances on file) and one child. There is a working telephone maintained in the home. There is a pet in the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children were inaccessible. Per Licensee, there are no poisons in the home. The Licensee does understand that poison must be locked with a key or combination lock.
Per Licensee, there are no weapons, firearms or bodies of water on the premises. Children’s records were reviewed to ensure that each child has an Identification and Emergency form. At 11:55am LPA reviewed records and observed one of four children missing the Identification and Emergency form. The backyard is adequately fenced. There are safe toys, play equipment and materials observed for children. Emergency Disaster Plan was posted at the time of inspection. The valve on the required 2A 10BC fire extinguisher indicates fully charged with a service tag of 10/2019. Licensee understands that fire extinguishers need to be serviced yearly or a new fire extinguisher can be purchased. Smoke detector and carbon monoxide detector were tested and are functional. The Licensee and assistant have a current Pediatric First Aid and CPR, which will expire on 9/2021.
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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jose GuzmanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2021
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
VISIT DATE: 08/17/2021
NARRATIVE
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Proof of immunization against influenza, pertussis, and measles for the Licensee were readily available during today’s inspection. The Licensee and assistant have not completed the Mandated Reporter Training.

Rooms that are off-limits need to be made inaccessible during operating hours. No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility. Effective January 1, 2010, licensees of family child care homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.

Mandatory Forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. The Licensee was advised how to access forms and Regulations online at www.ccld.ca.gov. Licensee was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care.

The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensee states that if an infant is enrolled, the infant will sleep in the living room. LPA advised against sleeping infants in separate rooms. Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed. 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. A hard copy of A Child Care Provider’s Guide to Safe Sleep was provided. LIC 9227 (Individual Sleeping Plan) for infants up to 12 months was explained and issued to the Licensee. Title 22 Regulation Section 102425(j) Infant Safe Sleep was discussed with the Licensee, including but not limited to documentation that shall be maintained. Licensee was advised that infants shall not be swaddled while in care and all infants up to 12 months should be placed on their back for sleeping.
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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jose GuzmanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2021
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
VISIT DATE: 08/17/2021
NARRATIVE
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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

The following was discussed:
· Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.
· The Licensee shall be present in the home and shall ensure that children are supervised at all times.
· Children shall not be left in park vehicles.
· The capacity specified on the license shall be the maximum number of children for whom care can be provided. · Car seats shall only be used for transportation purposes and shall not be used for sleeping.
· All children in care have the right to receive safe, healthful, and comfortable accommodations, furnishings and equipment.
· When a child shows signs off illness, they will be separated from other children until the nature if the illness is determined.

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.

The deficiencies listed on the following page were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809-D. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

Exit interview was conducted with Licensee. Inspection was conducted in Spanish.


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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jose GuzmanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2021
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
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: 08/17/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/31/2021
Section Cited

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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider...shall complete the mandated reporter training...and shall complete renewal...every two years following the date...initial mandated reporter training. This requirement is not met as evidenced by
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Based on observation, interview, and record review, the Licensee did not ensure Licensee and assistant completed the Mandated Reporter Training which posses a potential health & safety risk to children in care.
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Type B
08/31/2021
Section Cited

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Child's Records- The licensee shall maintain, in each child's record, a copy of the emergency information card as required This requirement is not met as evidenced by
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Based on observation, interview, and record review, the Licensee did not ensure one of four children had a completed Identification and Emergency form which posses a potential health & safety risk to 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) 981-3374
LICENSING EVALUATOR NAME: Jose GuzmanTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2021
LIC809 (FAS) - (06/04)
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