198020101-2-7-2023-54-CC-MAYA-CNTR98-20230207114906

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020101
Report Date: 02/07/2023
Date Signed: 02/07/2023 11:49:25 AM

Document Has Been Signed on 02/07/2023 11:49 AM - 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:	ARAYA FAMILY CHILD CARE		FACILITY NUMBER:	198020101
ADMINISTRATOR:	ANGELA ARAYA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 212-8601
CITY:	LAKEWOOD	STATE: CA	ZIP CODE:	90713
CAPACITY:	14	CENSUS: 9	DATE:	02/07/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Licensee, Angela Araya		TIME COMPLETED:	12:00 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 February 7, 2023 at 9:00 AM, Licensing Program Analyst (LPA) Monique Ayala conducted an unannounced inspection at the facility noted above and met with Licensee, Angela Araya. 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 5:00 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/Assistant (S1), and nine (9) children were present. All adults present have obtained a criminal record clearance or exemption. LPA conducted a tour of the inside and outside of the facility accompanied by Licensee, Angela Araya. This facility is a single family home that consists of three (3) bedrooms, one (1) bathroom, living room, dining room, kitchen, enclosed patio (located in backyard), detached garage, and fenced backyard. Areas that are accessible to children include: two (2) bedrooms, 1 bathroom, living room, dining room, kitchen, enclosed patio, and fenced backyard. Per Licensee, the children utilize the fenced backyard and front yard for outdoor activity. Licensee was advised that direct visual supervision must be provided at all times while using the front yard for outdoor activity. Areas off-limits to children include: 1 bedroom, and detached garage. LPA observed the door to the off-limit bedroom closed and locked, making the area inaccessible to children in care. LPA also observed the inside of the garage inaccessible to children in care. 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: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ARAYA FAMILY CHILD CARE	FACILITY NUMBER: 198020101
	VISIT DATE: 02/07/2023

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The following documents were posted in a prominent, publicly accessible area: Facility License, Notification of Parents' Rights (PUB 394), Earthquake Preparedness (LIC 9148), Emergency Disaster Plan (LIC 610A), and Facility Roster (LIC 9040). Licensee also had verification of Disaster and Fire Drills posted. However, the last documented drill was conducted on December 7, 2021.

Areas used by children were inspected for safety, comfort, heating, cleanliness and telephone service. The home does not have any wall heaters or fireplaces. The home is equipped with central air and heating. Detergents, cleaning compounds, and medicines were made inaccessible to children. 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.

Per Licensee, the home has birds, a tortoise, 1 cat, and 1 dog. LPA advised the Licensee that best practice is to keep pets isolated from children in care. Per Licensee, there are no bodies of water, firearms and/or weapons on the premises. LPA observed age appropriate toys and napping equipment for children. LPA also observed electrical outlet covers installed in the child care areas. Per Licensee, snacks and meals are provided to the children by the facility. Licensee was reminded that any food that is brought from the child's home shall be labeled with the child’s name and properly stored or refrigerated.

LPA observed the required fire extinguisher (2-A:10-B:C) that is fully charged. Licensee did not have proof of purchase or verification of the last service date for the fire extinguisher available for review. Licensee was reminded to have the fire extinguisher serviced yearly. Smoke detector and carbon monoxide detector was tested and is operable. First Aid kit and emergency supplies are available and kept in the bathroom and inside a locker in the backyard.

LPA conducted a record review of five (5) children's records, and 2 personnel records. Based on the children's record review, the children's records had all of the required documents per licensing regulations. Based on the personnel record review, Licensee's husband/Assistant (S1) did not have proof of immunization for measles and pertussis (or documentation of exemption), and a TB clearance (or risk assessment) available for review.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Monique Ayala	TELEPHONE: (323) 246-2016
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ARAYA FAMILY CHILD CARE	FACILITY NUMBER: 198020101
	VISIT DATE: 02/07/2023

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Based on Licensee's record review, Licensee has proof of immunization against measles, pertussis, and a TB clearance. Licensee has a decline declaration statement for influenza. Licensee has a current Pediatric First Aid and CPR certification (expires October 2024). Licensee completed the Preventative Health and Safety Practices through a course at Long Beach City College. Licensee completed the Mandated Reporter Training (AB 1207) on April 14, 2022. Licensee was advised that the Mandated Reporter training (AB 1207) must be completed every 2 years and is available at www.mandatedreporterca.com.

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

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.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Monique Ayala	TELEPHONE: (323) 246-2016
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ARAYA FAMILY CHILD CARE	FACILITY NUMBER: 198020101
	VISIT DATE: 02/07/2023

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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.

Deficiencies were cited during today's inspection (refer to deficiency pages).

LPA informed the Licensee that she is not current with her annual licensing fees, and currently owes $140.00. LPA advised Licensee that failure to pay outstanding fees may result in the closure of the facility file, and the Family Child Care Home license in result would be invalid.

During the inspection, LPA requested the following documents be submitted to LPA via e-mail by Friday, February 10th: updated Current Children in your Home (LIC 279B) and updated Facility Sketch (LIC 999A).

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, Angela Araya.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Monique Ayala	TELEPHONE: (323) 246-2016
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/07/2023 11:49 AM - 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: ARAYA FAMILY CHILD CARE	FACILITY NUMBER: 198020101
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/07/2023

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 on observation, the licensee did not comply with the section cited above as the Licensee did not have proof of purchase or verification of the last service date for the fire extinguisher which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/07/2023
	Plan of Correction
1 2 3 4	Licensee will either purchase a new fire extinguisher or have the fully charged extinguisher serviced, and submit proof of correction to LPA via e-mail by 03/07/2023.

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: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/07/2023 11:49 AM - 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: ARAYA FAMILY CHILD CARE	FACILITY NUMBER: 198020101
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(9)(A)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: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. 1. The licensee shall document the drills, including the date and time of each drill. This documentation shall kept at the family child care home. 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 last documented drill was conducted on December 7, 2021 which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/07/2023
	Plan of Correction
1 2 3 4	Licensee will conduct a fire drill and disaster drill, and submit proof of completion to LPA via e-mail by 03/07/2023.

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: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/07/2023 11:49 AM - 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: ARAYA FAMILY CHILD CARE	FACILITY NUMBER: 198020101
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(c)

Administration of Child Day Care Licensing

(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home. 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 Licensee's husband/Assistant (S1) did not have proof of immunization for measles, pertussis, and a TB clearance available for review which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/07/2023
	Plan of Correction
1 2 3 4	Licensee's husband/Assistant (S1) will obtain the required documents, and Licensee will submit proof of completion to LPA via e-mail by 03/07/2023.

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: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC809 (FAS) - (06/04)

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