198019447-5-17-2023-54-CC-KCHE-CRWTJ8-20230517144554

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019447
Report Date: 05/17/2023
Date Signed: 05/17/2023 02:46:08 PM

Document Has Been Signed on 05/17/2023 02:46 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:	RODRIGUEZ FAMILY CHILD CARE		FACILITY NUMBER:	198019447
ADMINISTRATOR:	RODRIGUEZ,REBECA & MARIANA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 842-1659
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90023
CAPACITY:	14	CENSUS: 11	DATE:	05/17/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Mariana Rodriguez, Co-Licensee		TIME COMPLETED:	03:20 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	On 05/17/2023 at 1:15 PM, Licensing Program Analyst (LPA)Katrina Chicote conducted an Unannounced Required – 1 Year inspection to the above facility. Upon arrival, LPA disclosed the purpose of the inspection and met with Co-Licensee, Mariana Rodriguez, who granted entry to facility and provided guided tour of the home both indoors and outdoors. Adults in the home were discussed and all have criminal record clearance. Also present was Licensee’s Assistant (A1) and Co-Licensee, Rebeca Rodriguez. There were 11 (3 infants) children napping during today’s inspection. LPA observed children sleeping on standard blue cots and one infant, under 12 months, in a crib. Licensee states that there are currently 11 children enrolled. The children's roster was reviewed and is current. At 1:15 PM, LPA observed required postings posted outside and upon entry to facility. Disaster drill log was also available during today’s inspection, last disaster drill conducted on 04/2023. This is a single-story home which consists of two bedrooms and one bathroom, Kitchen, and Day Care Space. There is a fireplace in the home that is barricaded by heavy wooden play kitchen equipment. Areas used by the children include the Day Care Space (located upon entry of the home) and Bathroom 1 (located down hallway through the rear of the home). Per Licensee, areas off limits to children and parents include kitchen and all bedrooms. At 1:17 PM, LPA observed that there are operable baby gates separating areas used by children and off-limits areas. All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. LPA observed ceiling fans through out Day Care Space operating during inspection. There is a working telephone maintained in the home. At 1:16 PM, LPA observed child size tables and chairs available well maintained, cubbies for children's belongings, infant feeding chairs, shelves with art materials, books, puzzles, dramatic play toys, and other age appropriate toys free of loose and sharp parts available for children at time of inspection. At 1:18 PM, LPA observed Bathroom to have operable toilet and sink, locks on medicine cabinet and under sink Report Continues - Page 1 of 3

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023

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 5

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: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198019447
	VISIT DATE: 05/17/2023

NARRATIVE

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cabinet, and general area safety and sanitation at time of inspection. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. Licensee states these items are stored in off limits Kitchen area. The Licensee states any other hazardous cleaning solutions and poisons are stored in off limits garage. The Licensee does understand that poison must be locked with a key or combination lock. The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

Per Licensee, the children will have access to backyard area for out door play which LPA observed is accessible down hallway and through door in Bedroom. Per Licensee, Bedroom is off limits and only used as a walkway to access backyard. LPA advised Licensee that there needs to be supervision of children when walking to outdoor play area. At 1:23 PM, LPA observed backyard has concrete and adequate perimeter fencing through-out the yard. LPA observed garage units in the back that Licensee states is vacant and off limits. LPA observed picket fencing making this area off limits to children. LPA observed play house, ride along toys, and other age appropriate toys free of loose and sharp parts available for the children in the backyard and all trees, shrubs, and plants observed to be maintained and some plants to be stored behind fencing making plans off limits to children. Per Licensee, she has four dogs that are kept separate from daycare children during operation hours. At 1:26 PM, LPA observed two dogs in a dog run on side yard that is fenced and two additional dogs in another dog run that is behind multiple fences making them off limits to children.

Per Licensee, they provide food for children in care and use Day Care Space to eat. Per Licensee, isolation area for sick children is dependent on what area is not being used. Licensee states she has taken sick child outside and sat with them while children are inside playing supervised.

At 1:23 PM, LPA observed the valve on the required 2A 10BC fire extinguisher indicates fully charged with service tag dated 01/10/2022. LPA discussed the requirement of fire extinguishers having to be serviced annually or purchasing a new one. LPA observed smoke detectors present that is part of ADT system. At 1:27 PM, LPA tested carbon monoxide detector and observed to be in operable condition. LPA observed First Aid kit is kept by the entrance and was inventoried for necessary supplies. The Co-Licensees have current Pediatric First Aid and CPR expiring on 08/20/2024. Proof of immunization against influenza, pertussis, and measles was readily available during today’s inspection. The Co-Licensees have taken the AB1207 Mandated Reporter on 12/06/2022.
Report Continues - Page 2 of 3

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198019447
	VISIT DATE: 05/17/2023

NARRATIVE

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Per Licensee, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPA observation did not see any bodies of water around the premises.

The following were discussed:
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

Licensee (or facility representative) 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.

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 incline sleepers and any other item that falls into that category are permitted in the facility.

LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] 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.

Based on this information, the following deficiencies on the attached LIC 809D are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted and report was reviewed with the Licensee, Mariana Rodriguez.
Report Ends - Page 3 of 3

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023

LIC809 (FAS) - (06/04)

Page: 3 of 5

Document Has Been Signed on 05/17/2023 02:46 PM - It Cannot Be Edited

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: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 198019447
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/17/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(1)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based o n LPA observation and interview, Licensee did not have a fire extinguisher serviced within the year. LPA observed service tag dated 01/10/2022, per Licensee she has not yet had it serviced. This poses a potential health, safety, and personal rights risk to children in care.
	POC Due Date: 06/16/2023
	Plan of Correction
1 2 3 4	Licensee states she will get the fire extinguisher serviced and provide photo proof of service tag via email/text by POC date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023

LIC809 (FAS) - (06/04)

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