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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020538
Report Date: 04/17/2020
Date Signed: 04/17/2020 03:10:14 PM

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:DUME FAMILY CHILD CAREFACILITY NUMBER:
198020538
ADMINISTRATOR:LUCIANO & ALMA DUMEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 465-5690
CITY:ROWLAND HEIGHTSSTATE: CAZIP CODE:
91748
CAPACITY:14CENSUS: 0DATE:
04/17/2020
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Alma Ceja & Luciano DumeTIME COMPLETED:
02:42 PM
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This was a pre-licensing inspection for change of location conducted by Jennifer Hua, Licensing Program Analyst (LPA) due to COVID-19 and precautionary measures. This pre-licensing inspection was conducted with Alma Ceja & Luciano Dume, Applicants via a tele-inspection by use of (FACETIME). Per applicants, no other individuals reside in the home.

During this tele-inspection the Applicants took this LPA on a tour of the home. During this tour the following was noted:

All areas identified on the facility sketch were inspected by tele-visit. This is a one story home consists of 3 bedrooms, 2 restrooms. living room, family room, enclosed patio, kitchen, garage, front yard, and backyard (fenced).

Areas that are accessible to children are as follows: 2 bedrooms, 1 bathroom, living room, family room, enclosed patio, and backyard (fenced). Per applicants parents/children will enter the facility through the front door.

Areas off limits based on facility sketch submitted to children and parents include: 1 bedroom and 1 bathroom, kitchen, garage and front yard..

**Rooms that are off-limits need to be made inaccessible during operating hours**
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2020
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: DUME FAMILY CHILD CARE
FACILITY NUMBER: 198020538
VISIT DATE: 04/17/2020
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Areas that will be used by children were inspected by tele-inspection for safety, comfort, cleanliness, telephone service, ventilation and heating (central). Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible.

Per applicants, there are no pets, firearms, weapons, bodies of water on the premises. There are toys, books, furniture, cribs and cots available for children. The valve on the required 2A 40BC fire extinguisher indicates fully charged (purchased 02/28/2020). Smoke and carbon monoxide detectors in the day care areas were tested and is operable. Emergency supplies will be placed by the front door for easy access.

Applicants have current Pediatric CPR and First Aid training as indicated on the certificate.

The applicants have proof of immunization against influenza, pertussis, and measles.
Applicants completed required mandated reporter training on 04/2020. Mandated reporter training must be completed every 2 years. www.mandatedreporterca.com

The following was discussed with the applicants at:
Individuals who are 18 years of age or older living/working in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.

Reporting requirements, Safe Sleep were discussed. A Child Care Provider's Guide To Safe Sleep and Lead Poising Facts handout will be mailed to applicants.

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
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2020
LIC809 (FAS) - (06/04)
Page: 2 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: DUME FAMILY CHILD CARE
FACILITY NUMBER: 198020538
VISIT DATE: 04/17/2020
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Exit interview was conducted with Alma Ceja, via tele-inspection. This report will be sent to the Applicants via email with a read receipt or confirmation of receipt of email, which will act as the Applicants' signatures.
SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 513-3793
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 981-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2020
LIC809 (FAS) - (06/04)
Page: 3 of 3