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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020309
Report Date: 08/07/2024
Date Signed: 08/07/2024 12:45:43 PM

Document Has Been Signed on 08/07/2024 12:45 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:LOPEZ FAMILY CHILD CAREFACILITY NUMBER:
198020309
ADMINISTRATOR/
DIRECTOR:		ADRIANA LOPEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 604-9664
CITY:LOS ANGELESSTATE: CAZIP CODE:
90023
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
08/07/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:50 AM
MET WITH:Adriana Lopez, LicenseeTIME VISIT/
INSPECTION COMPLETED:
01:05 PM
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 THIS INSPECTION WAS CONDUCTED IN SPANISH
Licensing Program Analyst (LPA) Joshua Ortega and Susann Sanchez conducted an unannounced 3 year annual inspection to the above facility. LPA arrived at the facility at 09:50AM and met with Adriana Lopez, Licensee who guided analyst on a tour of the facility. Per Licensee, there are 10 children that are currently enrolled. A current children’s roster was available for review. There were 5 children and 1 infant present upon arrival with an assistant and Licensee. Hours of operation are Monday - Friday 6am-5pm 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 states that there are no firearms stored in the home. Tour began outside at 10:05am and tour of the inside of the home began 10:15am.

This is a one-story home which consists of 3 bedrooms, 3 bathrooms, kitchen, dining room, living room, front yard (fenced) and backyard . Areas accessible to children are: Living Room, Dining room, Room 1, the restroom in Room 1 and the fenced front yard. Areas off limits: Backyard, Room 2 and Room 3, the kitchen and the other 2 bathrooms located in Room 2 and next to the kitchen. LPA observed child safety knobs on doors of the off limits bedrooms and a child safety gate preventing access to the kitchen.

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 landline and a cellphone that is used and the cellphone stays at the facility during operation hours. There is ventilation and heating. LPA observed A/C unit installed in the wall in the living room. Safe toys play equipment and materials were observed. Per the Licensee, the children play and eat in the living room and sleep throughout the dining room, living room and Room #1. Per Licensee, Room #1 is used as needed. The on limits bathroom is in Room #1 and Licensee guides children to the bathroom. The Restroom was observed to be safe and sanitary. LPA advised Licensee to keep all cords from the window blinds inaccessible to children when Room #1 is in use. LPA observed two cribs in the dining room.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/07/2024
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 198020309
VISIT DATE: 08/07/2024
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LPA observed the first aid kits. Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children; detergents and cleaning compounds are stored in the kitchen which is off limits. At 10:20 AM LPA inspected the fire extinguisher: The valve on the required 2A10BC fire extinguisher indicates fully charged, as indicated on service tag. Licensee tested the smoke detector in the living room and the carbon monoxide detector in the dining room at 10:18AM. LPA observed them to be operable. The Licensee states she provides food for children in care and uses a food program. Last drill documented was conducted on 08/07/24. There are no pets on the premises.

Currently, children are using the front 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. The licensee states that supervision is always provided. Per Licensee, there are no bodies of water.

Licensee states that she is not currently caring for infants under 12 months of age. Licensee states that infants under 24 months sleep in the dining room in a crib. Appropriate sleeping arrangements and cribs were observed. Two cribs were observed. Cribs and play yards were observed to be free of loose articles and objects. No objects were observed to be hanging above or attached to the side of the crib. LPA did not observe any infants swaddled while in care. LPA advised the Licensee that infants shall be placed on their backs for sleeping and shall be supervised. Infants are checked on every 15 minutes and the time of each 15-minute check is documented with child’s name and date. 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.

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 4/22/25. Mandated Reporter expires on 05/11/2025. Children's records were reviewed, including emergency information and were observed to be complete.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 198020309
VISIT DATE: 08/07/2024
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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 atwww.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm

Licensee was informed of the MyChildCare.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resources and Referral Agencies (R&Rs) throughout California.
During the exit interview Licensee Lopez, 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, Lopez

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024
LIC809 (FAS) - (06/04)
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