198019619-12-10-2021-33-CC-RLOZ-C9L22S-20211210160114

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019619
Report Date: 12/10/2021
Date Signed: 12/10/2021 04:01:22 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:	ACOSTA FAMILY CHILD CARE		FACILITY NUMBER:	198019619
ADMINISTRATOR:	GABRIELA M. ACOSTA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 479-1795
CITY:	PICO RIVERA	STATE: CA	ZIP CODE:	90660
CAPACITY:	14	CENSUS: 6	DATE:	12/10/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Gabriela Acosta		TIME COMPLETED:	04:30 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	At 1:10 pm Licensing Program Analyst (LPA) Roxana Lopez conducted an unannounced required 1 year inspection to the above facility. A risk assessment was conducted upon entry- appropriate PPE was used. LPA met with Gabriela Acosta, Licensee who guided analysts on a tour of the facility. Per Licensee, there are 9 children currently enrolled. A current children’s roster was available for review. There were 6 children present upon arrival- 1 being an infant. The licensee states that 1 adult and 2 children currently live in the home. Per Licensee, she currently has 1 assistant. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed child care home. Licensee states that there are no firearms stored in the home. This is a single-story home which consists of 2 bedrooms, 2 restrooms, living room, dining room, den, kitchen, laundry room, garage and backyard (fenced). The children have access to den, 1 bathroom and backyard (fenced). Per licensee, areas off limits to children and parents include, 2 bedrooms, 1 bathroom, kitchen, living room, laundry room, garage and dining room. The LPA toured all areas used by children during this visit. LPA observed a baby gate separating the front of the house and the den, bathroom and back yard that children use. 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 cellphone that stays at the facility during operation hours. There is ventilation and heating. The following was observed and reviewed during this inspection. ----------------------------------------------------- Pg. 1 of 4------------------------------------------------------------------------

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2021

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ACOSTA FAMILY CHILD CARE	FACILITY NUMBER: 198019619
	VISIT DATE: 12/10/2021

NARRATIVE

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Detergents, cleaning compounds, and medications were observed to be inaccessible to children. Poisons are locked in the laundry room. The restroom that children use was observed to be safe and sanitary.

LPA Lopez did observed a fireplace in the living room which was barricaded and a wall heater in the dining room which is disconnected and inaccessible for children in care. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 5/29/2021, as indicated on purchased receipt. Smoke and carbon monoxide detectors were tested and are operable. 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 10/21/2021

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted in the entry.

The home is observed to be clean and orderly. There are toys available for children. Appropriate sleeping arrangements and cribs were observed.

Licensee states that they are currently caring for infants. Per Licensee, the only infant in care is 1.5 years old. 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 an 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.

LPA did observe a small one person trampoline outside. LPA advised Licensee that if she chooses to keep the trampoline she needs to follow the safety guidelines on the original package- Supervising that only one child at a time is using it.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.
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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2021

LIC809 (FAS) - (06/04)

Page: 6 of 6

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: ACOSTA FAMILY CHILD CARE	FACILITY NUMBER: 198019619
	VISIT DATE: 12/10/2021

NARRATIVE

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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.

There are pets on the premises. LPA observed birds to be caged out in the backyard and two dogs inside the off limits area of the home.

The licensee is observed to be operating within the license capacity limitations.

At 2:30 pm children’s records were reviewed, including emergency information and were observed to be complete.

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 10/7/2022. There are first aid supplies available.

LPA observed that the Licensee and assistant do have proof of immunization record and the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file for Licensee. Assistant has not taken the Mandated Reporter AB 1207 compliant Child Care Training

LPA issued a copy of the LIC 857 Children’s Records Review and the LIC859 Staff Records Review to the licensee during this inspection.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2021

LIC809 (FAS) - (06/04)

Page: 5 of 6

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: ACOSTA FAMILY CHILD CARE	FACILITY NUMBER: 198019619
	VISIT DATE: 12/10/2021

NARRATIVE

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LPA advised the licensee to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov.

Licensing staff consulted with licensee regarding COVID-19 health and safety guidelines on this date, Licensing staff observed COVID- 19 postings posted in the day care on this date. A RAST inspection is on file. During this inspection LPA discussed Social and Physical Distancing Guidance And Healthy Practices For Child Care Facilities In Response To The Global Coronavirus (COVID-19) Pandemic Written In Collaboration With The California Department Of Education.

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 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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/inspection-process.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

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

Exit interview conducted and report was reviewed with Licensee, Gabriela Acosta..

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2021

LIC809 (FAS) - (06/04)

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