198020517-10-22-2021-33-CC-RLOZ-C82V63-20211022160853

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020517
Report Date: 10/22/2021
Date Signed: 10/22/2021 04:08:58 PM

Document Has Been Signed on 10/22/2021 04:08 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:	FLORES FAMILY CHILD CARE		FACILITY NUMBER:	198020517
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 2	DATE:	10/22/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Cynthia Flores, Licensee		TIME COMPLETED:	04:15 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 1:30 pm Licensing Program Analyst (LPA) Roxana Lopez conducted an unannounced case management initiated inspection to the above facility on 10/22/2021. A risk assessment was conducted upon entry- appropriate PPE was used. LPA met with Cynthia Flores, Licensee, who guided analyst on a tour of the facility. The purpose of this inspection is due to licensee’s request for a capacity increase on 9/15/2021. Currently, the licensee’s capacity is eight. Licensee wishes to increase to a capacity of fourteen. Per Licensee, family members residing in the home are 2 adults and 2 children. Per licensee, operation hours will be Monday to Friday 6:00AM to 6:30PM. There was two children present upon arrival- one being an infant. A current children’s roster was available for review. All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a one-story home which consists of 3 bedrooms, 2 restrooms, dining room, living room, kitchen, laundry room, garage, front yard and backyard fenced. Per Licensee, main care areas include: 1 restroom located in the hallway, living room, dining room and back yard (fenced). Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service (cell phone), ventilation and heating (central). LPA did observed a fireplace in the living room which was barricaded. Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible in areas designated for children. Based on the Facility Sketch submitted, areas off limits to children and parents are: 3 bedrooms, 1 bathroom, kitchen, laundry room, garage and front yard. Licensee states that the rooms will stay locked during the hours of operation. The Licensee understands that licensing staff may have access to off-limit areas during inspection visit if necessary. ---------------------------------------------------- Pg. 1 of 3-------------------------------------------------------------------------------

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2021

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 3

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: FLORES FAMILY CHILD CARE	FACILITY NUMBER: 198020517
	VISIT DATE: 10/22/2021

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
26
27
28
29
30
31
32

The Licensee states that there are no poisons at the facility. The Licensee was advised that any poisons must be locked with a key or combination lock. The valve on the 2A10BC fire extinguisher indicates fully charged, and was last serviced on 9/13/2021 as indicated on the service tag observed. Smoke and carbon monoxide detectors were tested and are operable. Fire/disaster drill log was also current, last drill conducted on 08/20/21

The children will use the back yard for outdoor play, which was observed to be fenced. Outdoor area was observed to be safe and free of hazards. LPA observed that there are 2 chickens in a chicken coup - Per Licensee she also has birds in an off- limits bedroom. The Licensee states that there are no firearms, weapons or bodies of water on the premises. LPA did not observe any bodies of water.

There are toys available for children. The Licensee provides food for children in care. Licensee was advised that if food is brought from home containers shall be labeled with child’s name and properly stored or refrigerated. All required postings were observed to be posted in the living room.

Children’s records were reviewed and are complete. LPA provided licensee with the LIC 857 which documents children’s files reviewed during this inspection.

For assistance licensee currently has 1 assistant. Licensee and assistant have completed required Pediatric First Aid and CPR which training which expires, 8/30/2023 and the Mandated Reporter Training is on file. Licensee and assistants also have required immunization's. There are first aid supplies available.

LPA observed cots and a play pen- per Licensee children nap in the main care area.

Infant Care: Licensee states that she is currently caring for infants. LPA discussed the safe sleep regulations with licensee [or facility representative] 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 [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. LPA provided the LIC 9227 Individual Sleeping Plan to licensee.

------------------------------------------------------- Pg. 2 of 3 ---------------------------------------------------------------------------

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2021

LIC809 (FAS) - (06/04)

Page: 3 of 3

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: FLORES FAMILY CHILD CARE	FACILITY NUMBER: 198020517
	VISIT DATE: 10/22/2021

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
26
27
28
29
30
31
32

Incidental Medical Services (IMS): This facility currently does not have any children on medication. 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

LPA consulted with licensing 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- LPA Lopez observed that Licensee and child over two years old were not wearing masks. Licensee, put a mask on when LPA came into the facility and Licensee, had mask available for the child over two. LPA informed Licensee, that the usage of mask is a mandate and that every adult and child over the age of two should be wearing a mask. Per Licensee she will inform the parents during pick up- so they can bring mask for the children. 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 is seeking to provide care for 14 children 0-12 years old. A fire clearance has been granted as of 9/28/2021.

Based on today’s observation a capacity increase will be granted upon Licensing Program Manager (LPM) approval.

At this time, the facility is in compliance with California Title 22 Regulations. Therefore, there are no deficiencies being issued today.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative.

Exit interview was conducted with Cynthia Flores, Licensee.
--------------------------------------------------------- Pg. 3 of 3 --------------------------------------------------------------------------

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2021

LIC809 (FAS) - (06/04)

Page: 2 of 3