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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
198019665
Report Date:
11/16/2022
Date Signed:
11/16/2022 05:00:45 PM
Document Has Been Signed on
11/16/2022 05:00 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
CCLD Regional Office
,
1000 CORPORATE CENTER DR 200B
MONTEREY PARK
,
CA
91754
FACILITY NAME:
SANTOS FAMILY CHILD CARE
FACILITY NUMBER:
198019665
ADMINISTRATOR:
ANDREA SANTOS
FACILITY TYPE:
810
ADDRESS:
TELEPHONE:
(562) 506-4843
CITY:
LAKEWOOD
STATE:
CA
ZIP CODE:
90713
CAPACITY:
14
CENSUS:
9
DATE:
11/16/2022
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME BEGAN:
12:40 PM
MET WITH:
Licensee, Andera Santos
TIME COMPLETED:
05:15 PM
NARRATIVE
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On November 16, 2022 at 12:40 PM, Licensing Program Analyst (LPA) Monique Ayala conducted an unannounced inspection at the facility noted above and met with Licensee, Andrea Santos. The purpose of the inspection was to conduct the Required - 1 Year inspection. The operating hours of the facility is Monday through Friday from 7:00 AM to 5:30 PM. Entrance Checklist (LIC 126) was provided to the Licensee upon arrival. Individuals residing in the home were discussed and noted. At the time of the inspection, the Licensee, Licensee's Husband, Licensee's Adult Daughter/Assistant, Assistant/Staff (S1) and 9 children were present.
All areas identified on the facility sketch were inspected. This facility is a single family home that consists of 3 bedrooms, 2 bathrooms, living room, dining room, kitchen, detached garage (converted to day care room), fenced pool area and fenced backyard.
Areas that are accessible to children include: 2 bathrooms, living room, dining room, kitchen, detached garage (day care room), and fenced backyard. Per Licensee, the children utilize the fenced backyard for outdoor activity.
Areas off-limits to children include: 3 bedrooms and fenced pool area located in the backyard. LPA observed the bedroom doors closed, making the rooms inaccessible to children in care. LPA also observed the above-ground pool fenced per licensing regulations. Per Licensee, the above-ground pool and fence were installed in 2020. Licensee confirmed that an updated Facility Sketch (LIC 999) for the above-ground pool and change to the "off-limit" bedrooms was not submitted to the Department for review. Licensee was advised that off-limit areas must be made inaccessible during operating hours or while children in care are present.
SUPERVISOR'S NAME:
Valarie Cook
TELEPHONE:
(323) 513-3858
LICENSING EVALUATOR NAME:
Monique Ayala
TELEPHONE:
(323) 246-2016
LICENSING EVALUATOR SIGNATURE:
DATE:
11/16/2022
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/16/2022
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
17
Document Has Been Signed on
11/16/2022 05:00 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
CCLD Regional Office
,
1000 CORPORATE CENTER DR 200B
MONTEREY PARK
,
CA
91754
FACILITY NAME:
SANTOS FAMILY CHILD CARE
FACILITY NUMBER:
198019665
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
11/16/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(d)
Operation of A Family Child Care Home
(d) The home shall provide safe toys, play equipment and materials.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above as LPA observed 5 infant bouncers and 1 infant rocker stored (not in use) inside the detached garage (converted day care room) which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date:
12/16/2022
Plan of Correction
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During the inspection, Licensee immediately removed the prohibited items from the garage. LPA will conduct an unannounced follow-up inspection at the facility by 12/16/2022 to ensure that the prohibited items are permanently removed and no longer in use.
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
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Based on observation, the licensee did not comply with the section cited above as the facility had the required fire extinguisher that is fully charge but did not have verification available for when the fire extinguisher was purchased or last serviced which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date:
12/16/2022
Plan of Correction
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Licensee will purchase a new fire extinguisher and submit a photograph of the fire extinguisher and proof of purchase (photograph of receipt) to LPA via e-mail by 12/16/2022.
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:
Valarie Cook
TELEPHONE:
(323) 513-3858
LICENSING EVALUATOR NAME:
Monique Ayala
TELEPHONE:
(323) 246-2016
LICENSING EVALUATOR SIGNATURE:
DATE:
11/16/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/16/2022
LIC809
(FAS) - (06/04)
Page:
2
of
17
Document Has Been Signed on
11/16/2022 05:00 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
CCLD Regional Office
,
1000 CORPORATE CENTER DR 200B
MONTEREY PARK
,
CA
91754
FACILITY NAME:
SANTOS FAMILY CHILD CARE
FACILITY NUMBER:
198019665
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
11/16/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(10)
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: (10) A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Sections 1596.846(b) and (c).
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above as LPA observed 2 infant walkers stored (not in use) inside the detached garage (converted day care room) which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date:
12/16/2022
Plan of Correction
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During the inspection, Licensee immediately removed the prohibited items from the garage. LPA will conduct an unannounced follow-up inspection at the facility by 12/16/2022 to ensure that the prohibited items are permanently removed and no longer in use.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 2 personnel records (Licensee's Adult Daughter/Assistant and Staff (S1)) which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date:
12/16/2022
Plan of Correction
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Licensee's Adult Daughter/Assistant and Licensee's Assistant/Staff (S1) will complete the Mandated Reporter Training (AB 1207), and Licensee will submit proof of completion to LPA via e-mail by 12/16/2022.
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:
Valarie Cook
TELEPHONE:
(323) 513-3858
LICENSING EVALUATOR NAME:
Monique Ayala
TELEPHONE:
(323) 246-2016
LICENSING EVALUATOR SIGNATURE:
DATE:
11/16/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/16/2022
LIC809
(FAS) - (06/04)
Page:
3
of
17
Document Has Been Signed on
11/16/2022 05:00 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
CCLD Regional Office
,
1000 CORPORATE CENTER DR 200B
MONTEREY PARK
,
CA
91754
FACILITY NAME:
SANTOS FAMILY CHILD CARE
FACILITY NUMBER:
198019665
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
11/16/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 3 personnel records (Licensee, Licensee's Adult Daughter/Assistant and Staff (S1)) which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date:
12/16/2022
Plan of Correction
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Licensee, Licensee's Adult Daughter/Assistant, and Licensee's Assistant/Staff (S1) will complete the Pediatric First Aid and CPR Training (EMSA-approved) and Preventative Health and Safety Practices Training (EMSA-approved). Licensee will submit proof of completion to LPA via e-mail by 12/16/2022.
Section Cited
Personnel Records
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:
Valarie Cook
TELEPHONE:
(323) 513-3858
LICENSING EVALUATOR NAME:
Monique Ayala
TELEPHONE:
(323) 246-2016
LICENSING EVALUATOR SIGNATURE:
DATE:
11/16/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/16/2022
LIC809
(FAS) - (06/04)
Page:
4
of
17
Document Has Been Signed on
11/16/2022 05:00 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
CCLD Regional Office
,
1000 CORPORATE CENTER DR 200B
MONTEREY PARK
,
CA
91754
FACILITY NAME:
SANTOS FAMILY CHILD CARE
FACILITY NUMBER:
198019665
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
11/16/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.3(a)(3)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (3) Installation of in-ground or above-ground swimming pools, spas, fish ponds, decorative water feature, fountains or other bodies of water.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above as Licensee did not notify the Department about installing an above-ground pool and making changes to "off-limit" areas which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date:
12/16/2022
Plan of Correction
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Licensee will submit an updated Facility Sketch (LIC 999A) to LPA via e-mail by 12/16/2022.
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
This requirement is not met as evidenced by:
Deficient Practice Statement
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3
4
Based on record review, the licensee did not comply with the section cited above in 1 personnel record (Licensee's Assistant/Staff (S1)) which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date:
12/16/2022
Plan of Correction
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Licensee will submit the immunization record (pertussis and measles or documentation of exemption) for Licensee's Assistant/Staff (S1) to LPA via e-mail by 12/16/2022.
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:
Valarie Cook
TELEPHONE:
(323) 513-3858
LICENSING EVALUATOR NAME:
Monique Ayala
TELEPHONE:
(323) 246-2016
LICENSING EVALUATOR SIGNATURE:
DATE:
11/16/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/16/2022
LIC809
(FAS) - (06/04)
Page:
5
of
17
Document Has Been Signed on
11/16/2022 05:00 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
CCLD Regional Office
,
1000 CORPORATE CENTER DR 200B
MONTEREY PARK
,
CA
91754
FACILITY NAME:
SANTOS FAMILY CHILD CARE
FACILITY NUMBER:
198019665
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
11/16/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(7)
Operation of A Family Child Care Home
(7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in 1 child's record (C1) which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date:
12/16/2022
Plan of Correction
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Licensee will submit the completed Identification and Emergency Information (LIC 700) for child (C1) to LPA via e-mail by 12/16/2022.
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in 1 child's record (C6) which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date:
12/16/2022
Plan of Correction
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2
3
4
Licensee will submit the completed Individual Infant Sleeping Plan (LIC 9227) for child (C6) to LPA via e-mail by 12/16/2022.
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:
Valarie Cook
TELEPHONE:
(323) 513-3858
LICENSING EVALUATOR NAME:
Monique Ayala
TELEPHONE:
(323) 246-2016
LICENSING EVALUATOR SIGNATURE:
DATE:
11/16/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/16/2022
LIC809
(FAS) - (06/04)
Page:
6
of
17
Document Has Been Signed on
11/16/2022 05:00 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
CCLD Regional Office
,
1000 CORPORATE CENTER DR 200B
MONTEREY PARK
,
CA
91754
FACILITY NAME:
SANTOS FAMILY CHILD CARE
FACILITY NUMBER:
198019665
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
11/16/2022
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)(D)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above as the Licensee did not have verification of the 15-minute physical checks for napping children that are 24-months and younger which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date:
12/16/2022
Plan of Correction
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2
3
4
Licensee will submit at least one week's worth of documentation for the 15-minute physical checks for napping children (24-months and younger) to LPA via e-mail by 12/16/2022.
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:
Valarie Cook
TELEPHONE:
(323) 513-3858
LICENSING EVALUATOR NAME:
Monique Ayala
TELEPHONE:
(323) 246-2016
LICENSING EVALUATOR SIGNATURE:
DATE:
11/16/2022
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/16/2022
LIC809
(FAS) - (06/04)
Page:
7
of
17
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 CENTER DR 200B
MONTEREY PARK
,
CA
91754
FACILITY NAME:
SANTOS FAMILY CHILD CARE
FACILITY NUMBER:
198019665
VISIT DATE:
11/16/2022
NARRATIVE
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The following documents were posted in a prominent, publicly accessible area: Facility License and Emergency Disaster Plan (LIC 610A). At the time of the inspection, Licensee made the Notification of Parents' Rights (PUB 394) and Earthquake Preparedness (LIC 9148) viewable on the parent board located in the garage. Licensee has a Facility Roster (LIC 9040) available for review. Licensee has verification of Disaster and Fire Drills available for review. The last drill was conducted on December 10, 2021.
Areas used by children were inspected for safety, comfort, heating, cleanliness and telephone service. The home does not have any fireplaces or wall heaters. The home has 1 dog that was kept on the side of the house during the inspection. Licensee was advised that best practice is to keep pets isolated from children in care. At 12:45 pm, LPA observed cleaning products under the sink inside the restroom that is located by the bedrooms. During the inspection, Licensee removed the cleaning products and placed them in an area that is inaccessible to children in care. Per Licensee, there are no poisons kept in the home. Licensee was advised that if any poisons are purchased, it is required to be locked with a key or combination lock.
At 1:00 pm, LPA observed cots stored inside the detached garage that was converted to a day care room. Per Licensee, the children sometimes nap inside the detached garage while staff are present. LPA will follow-up with the Fire Department as the fire clearance does not have any notes regarding children being allowed to nap inside the detached garage. LPA also observed 5 infant bouncers, 1 infant rocker, 1 infant swing, and 2 infant walkers stored inside the garage (not in use). Per Licensee, the infant swing was gifted and has not been used. Licensee stated that the infants use the walkers during outdoor play. LPA reminded the Licensee that
baby walkers, excersaucers, bouncers or any similar items are prohibited.
LPA advised the Licensee that swings are allowed but can not be used for napping.
LPA observed the required fire extinguishers (2-A:10-B:C) that were fully charged however, LPA was unable to verify when the fire extinguishers were purchased or last serviced. Licensee was reminded to have the fire extinguisher serviced yearly. Smoke detector and carbon monoxide detector were tested and are operable. First Aid kit and emergency supplies are available and kept in the detached garage. Licensee was reminded that food that is brought from the child's home shall be labeled with the child’s name and properly stored or refrigerated.
SUPERVISOR'S NAME:
Valarie Cook
TELEPHONE:
(323) 513-3858
LICENSING EVALUATOR NAME:
Monique Ayala
TELEPHONE:
(323) 246-2016
LICENSING EVALUATOR SIGNATURE:
DATE:
11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/16/2022
LIC809
(FAS) - (06/04)
Page:
14
of
17
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 CENTER DR 200B
MONTEREY PARK
,
CA
91754
FACILITY NAME:
SANTOS FAMILY CHILD CARE
FACILITY NUMBER:
198019665
VISIT DATE:
11/16/2022
NARRATIVE
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2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
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20
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23
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26
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29
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31
32
LPA conducted a record review of 6 children's record, Licensee's record, Licensee's Adult Daughter/Assistant's record, and Licensee's Assistant/Staff's (S1) record. Based on the children's record reviews, child (C1) did not have the Identification and Emergency Information (LIC 700) completed with all of the required fields, and C6 did not have the Individual Infant Sleeping Plan (LIC 9227) available for review. Licensee did not have verification of the 15-minute physical checks available for review for napping children 24-months and younger. LPA also noticed that the children's records have the Notification of Parents' Rights (LIC 995) for Child Care Centers completed and on file. LPA advised Licensee that the LIC 995A for Family Child Care Homes needs to be completed and on file for children enrolled in care.
Based on the personnel record reviews, Licensee and personnel did not have the Criminal Record Statement (LIC 508), Statement Acknowledging Requirement to Report Child Abuse (LIC 9108), and Employee Rights (LIC 9052) available for review. During the inspection, the forms were completed and filed. LPA found that the Assistant/Staff (S1) did not have immunization records for measles and pertussis (or documentation of exemption), and TB clearance or risk assessment available for review. Licensee's Adult Daughter/Assistant and S1 did not have the Mandated Reporter Training Certificate (AB 1207) available for review.
Licensee and Licensee's Adult Daughter/Assistant completed the Pediatric First Aid and CPR training on January 5, 2021, and S1 on January 10, 2021 with the National Health and Safety Association. Per Licensee, the training's were completed online. LPA advised Licensee that the Pediatric First Aid and CPR certification must be EMSA-approved and cannot be completed online. LPA confirmed that the certifications are not EMSA-approved. Licensee, Licensee's Adult Daughter/Assistant, and S1 did not have a certificate of completion for Preventative Health and Safety Practices available for review.
Licensee has proof of immunization against measles and pertussis. Licensee has a TB clearance and decline declaration statement for influenza. Licensee completed the Mandated Reporter Training (AB 1207) on November 4, 2021. Licensee was advised that the Mandated Reporter training (AB 1207) must be completed every 2 years and is available at
www.mandatedreporterca.com
.
SUPERVISOR'S NAME:
Valarie Cook
TELEPHONE:
(323) 513-3858
LICENSING EVALUATOR NAME:
Monique Ayala
TELEPHONE:
(323) 246-2016
LICENSING EVALUATOR SIGNATURE:
DATE:
11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/16/2022
LIC809
(FAS) - (06/04)
Page:
15
of
17
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 CENTER DR 200B
MONTEREY PARK
,
CA
91754
FACILITY NAME:
SANTOS FAMILY CHILD CARE
FACILITY NUMBER:
198019665
VISIT DATE:
11/16/2022
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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 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.
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
All individuals present have obtained a criminal record clearance or criminal record exemption. Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PINs), Program Quarterly Update Newsletters and other important information communication platforms.
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
.
SUPERVISOR'S NAME:
Valarie Cook
TELEPHONE:
(323) 513-3858
LICENSING EVALUATOR NAME:
Monique Ayala
TELEPHONE:
(323) 246-2016
LICENSING EVALUATOR SIGNATURE:
DATE:
11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/16/2022
LIC809
(FAS) - (06/04)
Page:
16
of
17
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 CENTER DR 200B
MONTEREY PARK
,
CA
91754
FACILITY NAME:
SANTOS FAMILY CHILD CARE
FACILITY NUMBER:
198019665
VISIT DATE:
11/16/2022
NARRATIVE
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Deficiencies were cited during today's inspection per licensing regulations (refer to deficiency pages).
LPA discussed the Technical Support Program (TSP) with the Licensee, who stated that she will determine an agreement to participate at a later time.
A Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with Licensee, Andrea Santos.
SUPERVISOR'S NAME:
Valarie Cook
TELEPHONE:
(323) 513-3858
LICENSING EVALUATOR NAME:
Monique Ayala
TELEPHONE:
(323) 246-2016
LICENSING EVALUATOR SIGNATURE:
DATE:
11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/16/2022
LIC809
(FAS) - (06/04)
Page:
17
of
17