198019948-1-18-2024-33-CC-CTUA-CZM2N8-20240118163221

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019948
Report Date: 01/18/2024
Date Signed: 01/18/2024 04:32:27 PM

Document Has Been Signed on 01/18/2024 04:32 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	LOPEZ FAMILY CHILD CARE		FACILITY NUMBER:	198019948
ADMINISTRATOR:	MAURA LOPEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 201-1853
CITY:	LA PUENTE	STATE: CA	ZIP CODE:	91744
CAPACITY:	14	CENSUS: 6	DATE:	01/18/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Maura Lopez		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	On 01/18/2024, Licensing Program Analyst (LPA), Carolyn Tuba conducted an unannounced annual inspection for the above facility. This is a large family childcare home. Covid risk assessment was conducted. LPA met with Licensee, Maura Lopez and assistant Samantha Briseno. LPA observed 6 children in care. A children’s facility roster was available. Per Licensee, operating hours are from Monday - Friday 6:00 am – 6:00 pm and cares for children ages birth to 14 1/2 years of age. The licensee provides breakfast, AM/PM snack, lunch and dinner to the children in care and is part of a food program. This is a one-story home which consists of a living room, kitchen, family room/daycare, breakfast nook, 3 bedrooms, 2 bathrooms, back yard, side yard, front yard, and a detached garage. Child Care areas were inspected as follows: family room converted into a daycare room, back yard, side yard which is a covered area for the children, 1 bathroom, and hallway. LPA took photos of the area. The licensee states that she and another adult currently live in the home. Per Licensee, they currently have 1 adult who assist as they operate as a large facility, as well as subs. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing, or volunteering in the licensed childcare home. 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. Licensee states that there are no firearms stored in the home. LPA observed a baby gate between the kitchen, and living room and hallway of the family childcare. Page 1 of 4

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn Tuba	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2024

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: LOPEZ FAMILY CHILD CARE	FACILITY NUMBER: 198019948
	VISIT DATE: 01/18/2024

NARRATIVE

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The home was inspected for safety, comfort, cleanliness, ventilation, and telephone service.
Fire and safety drills must be performed every 6 months and documented for review by the Department. Licensee conducted an Emergency Drill in December 2023. No one smokes in the at family childcare home.

In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR training, Immunization's (TDAP, MMR, TB, Influenza), mandated reporter training and a valid criminal record clearance associated to the facility license.

Detergents, cleaning compounds, medications, and other items, which could pose a danger, were determined to be inaccessible to children in care during this inspection.

LPA observed the required 2:A-10:B-C fire extinguisher and tag stated the last time it was inspected was January 11, 2023. LPA advised that per State Fire Marshall standards, fire extinguishers shall be service annually. Licensee states that she will be taking it in to be serviced and send LPA a picture of the new tag. The smoke detector and carbon monoxide detector were working properly. Per Licensee, there are no weapons, firearms, or bodies of water on the premises. Per Licensee there are no pets, and none were observed.

LPA advised the Licensee with regards to safe sleep and that infants under 24 months shall be checked on every 15 minutes and the time of each 15-minute check shall be documented with child’s name, date and initials of the person who checked on the child. LPA provided Licensee a booklet on Safe Sleep. The LIC 9227 Individual Infant Sleeping Plan shall be completed for each infant up to 12 months of age. LPA advised Licensee the Provider Information Notice (PIN) 20-24 CCP: Recently Approved Safe Sleep Regulations in Effect. Per Licensee children are checked and LPA observed documentation.

The licensee is observed to be operating within the license capacity limitations. LPA did not observe any children left in parked vehicles. Car seats shall only be used for transportation. LPA did not observe any children sleeping in car seats. The Licensee was reminded to utilize play yards, cribs and highchairs for what they are intended for and not leave children in them for any other reason.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee, and her assistant currently have Pediatric First Aid and CPR which expires

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SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn Tuba	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2024

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: LOPEZ FAMILY CHILD CARE	FACILITY NUMBER: 198019948
	VISIT DATE: 01/18/2024

NARRATIVE

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on 4/2024 & 9/2024, which includes the EMSA sticker. There are first aid supplies available. Licensee and assistant currently have the mandated reporting training certificate AB 1207, which expires January 2024 and August 2024 LPA advised that Mandated Reporting training needs to be conducted every 2 years. Per Licensee she will taking mandated reporter training and will send a copy of the certificate, since it will be expiring this month.

Currently, children are using the back yard for outdoor play time. The outdoor play area was observed to be enclosed with concrete wall and iron fencing. LPA observed that the outdoor yard has toys, bikes, play equipment and plastic cars, as well as other materials for children to play with.

Children and Staff records must be maintained and updated as needed and must be available for review by the Department. If Children and Staff leave the day care all records must be maintained for 3 years after leaving. LPA discussed with Licensee about Infant Sleep Plan for children under 12 months of age. LPA observed “Infant Sleep Plan” for one of the children.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

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 [or 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.
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SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn Tuba	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2024

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: LOPEZ FAMILY CHILD CARE	FACILITY NUMBER: 198019948
	VISIT DATE: 01/18/2024

NARRATIVE

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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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

Exit interview conducted and report was reviewed with the Licensee, Maura Lopez

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SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn Tuba	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2024

LIC809 (FAS) - (06/04)

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