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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020609
Report Date: 12/22/2020
Date Signed: 12/23/2020 08:35:42 AM

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:FERDINANDUS FAMILY CHILD CAREFACILITY NUMBER:
198020609
ADMINISTRATOR:IONA FERDINANDUSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 231-1649
CITY:GLENDORASTATE: CAZIP CODE:
91740
CAPACITY:14CENSUS: 1DATE:
12/22/2020
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Iona FerdinandusTIME COMPLETED:
04:50 PM
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Pre-Licensing Inspection Conducted In English
Licensing Program Analysts (LPA) Cynthia Reyes conducted an announced Pre-Licensing inspection on this date for the purpose of inspecting the facility for initial license. Due to COVID- 19 precautionary measures were taken during the entire inspection and all individuals present during this inspection wore appropriate personal protective equipment. LPA met with applicant Iona Ferdinandus who confirmed the family members residing in the home, that consists of 3 adults and 1 children. The applicant is requesting a Large (14 Capacity) family child-care home license. Per Applicant, operating hours will be Monday to Friday, 6:30AM to 6:00PM. Applicant states during Covid-19, no parents are allowed inside the home and children health checks which include temperature being taken will be conducted prior to children entering the home at the front entrance door to the home.

Applicant Iona guided the analyst on a tour of the facility, indoors and out. All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. The home was inspected for safety, comfort, cleanness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children.
Per applicant there are no weapons or firearms currently in the facility. The backyard is adequately fenced and there is no * swimming pool, spa or other bodies of water observed on the premises. LPA observed there are age appropriate toys and napping equipment. Applicant owns property and a copy of the mortgage bill was given as proof of owning. During the walk threw of the interior of the home LPA observed the smoke detector and carbon monoxide to be located in Play room and LPA had the applicant test both (@3:46 PM) and LPA was able to hear the alarm and found both to be operational. LPA also observed the required fire extinguisher (2A 10BC) located mounted in the play room with a service date of 09/28/2020. Family child care on-line Orientation taken on 06/09/2020
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 12/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2020
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 5
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: FERDINANDUS FAMILY CHILD CARE
FACILITY NUMBER: 198020609
VISIT DATE: 12/22/2020
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Page 2

The areas observed by the LPA & confirmed by the applicant during the inspection, were the:

Off limits areas that include: Master Bedroom W/bath, 3 bedrooms, laundry room, garage, front yard kitchen, large dinning room **Rooms that are off-limits need to be made inaccessible during operating hours** The applicant does understand that licensing staff may have access to off-limit areas during the inspection if necessary.

The areas used by children include: (Living room Isolation area only), day-care/family room, bathroom in the hallway, the small dinning area & back yard

The applicant states that she will provide food for children in care (inquired of the food program). Licensing staff advised that if children bring food from home it should be properly labeled.

Infant Care: LPA advised the applicant to sleep infants where they can always be directly supervised and advised against sleeping infants in a separate room. LPA advised of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. A online copy can be downloaded at: https://www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

The applicant has completed the required Health and Safety Training (XX/XX/XXXX), Nutrition Training and Pediatric First Aid and CPR. (Exp. 09/12/2022 for applicant and daughter/assistant Abigail). LPA observed there are first aid supplies available on the premises.

LPA discussed: Incidental Medical Services (IMS) policy. 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 and the ADA, available at: http://www.ada.gov/childqanda.htm .
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 12/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2020
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: FERDINANDUS FAMILY CHILD CARE
FACILITY NUMBER: 198020609
VISIT DATE: 12/22/2020
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At 4:15 PM The following was discussed with the applicant: Page 3

· Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Civil Penalties will be assessed if not in compliance.

· 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, Influenza), mandated reporter training and a valid criminal record clearance associated to the facility license.

· Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License may be terminated.

· The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked and batteries replaced as needed.

· Reporting Requirements: Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.

· Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.

· Fire and safety drills must be performed each month and documented for review by the Department.

· Smoking is prohibited in a family childcare homes.

· 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.

· No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 12/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2020
LIC809 (FAS) - (06/04)
Page: 5 of 5
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: FERDINANDUS FAMILY CHILD CARE
FACILITY NUMBER: 198020609
VISIT DATE: 12/22/2020
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Page 4 Continuation The following was discussed with the applicant:

· Inspection Authority: All adults living and working in the home shall be made aware of the Department’s right to inspection of the home, which includes, but is not limited to the right to enter the home when children are being cared for, interview children and adults, review documentation and observe off limit areas if needed.

· The facility license number must be on all advertisements, publications or announcements with the intent to attract clients.

- Isolation for Ill children: When a child is ill he/she shall be separated from other children (reference 102417(e) Operation of a Family Child Care Home).

· Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information.

· Immunization Requirement: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The licensee and all adults working with children have proof of immunizations.

· Mandated Reporter Training: H&S 1596.8662: Beginning January 1, 2018, all licensed providers, applicants, directors and employees to complete training as specified on mandated reporter duties. Training is available at: www.mandatedreporterca.com (Iona has taken on 08/20/2020)

LPAs advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov

LPA reviewed the LIC 311D - Forms/Records to Keep in Your Family Child Care Home.

LPAs consulted with applicant regarding COVID-19 health and safety guidelines on this date, applicant was provided forms to post via email. Licensing staff observed COVID- 19 postings posted in the day care on this date. Parents will enter at the front door (covered porch area outside the front door to the home) & temperatures will be taken of parents and children. Hand sanitizer is available at the entrance of the day care.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 12/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2020
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: FERDINANDUS FAMILY CHILD CARE
FACILITY NUMBER: 198020609
VISIT DATE: 12/22/2020
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During this inspection LPA discussed PIN 20-06 CCP, 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. LPA reviewed with the applicant the Child Care Covid-19 Self-Assessment guide that the applicant filled out before this inspection.

The applicant’s signature on this report acknowledges that they have signed the Application for a Family Child Care Home License (LIC 279) under penalty of perjury that the statements on the application and any attachments are true and correct.

Applicant’s email address is on file. The applicant was advised that email may be public information.

Based on licensing staff observations, the following corrections need to be corrected prior to obtaining a small family childcare license. Corrections are due before or by: 01/08/2021.
(1) 8 Hours Health & Safety Training (Including lead and nutrition) For Iona & Abigail
(2) Proof of MMR for Iona. (3) Mandated certificate for Abigail

Once the pending corrections are cleared the application will be submitted for final file review and license. Once licensed, the applicant is required to adhere to the terms and limitations stated on the license. This home currently meets the description of a safe and healthy environment for children as described in Chapter 1, Division 12, Title 22 of California Code of Regulations and the facility file will be submitted for approval for a Large family childcare license. (Capacity 14)

At 04:40 AM/PM exit interview was concluded with Iona Ferdinandus, Applicant who acknowledges receipt of report. A copy of this report (LIC 809) and Appeal Rights (LIC 9058) were discussed, signed and printed and given to applicant on this date. Consultation regarding the licensing state laws and regulations, were conducted throughout this inspection

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 12/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2020
LIC809 (FAS) - (06/04)
Page: 3 of 5