198020612-9-2-2021-33-CC-RLOZ-C6GUJH-20210902153735

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020612
Report Date: 09/02/2021
Date Signed: 09/02/2021 03:37:48 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:	MEDINA FAMILY CHILD CARE		FACILITY NUMBER:	198020612
ADMINISTRATOR:	MARIA MEDINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 392-0726
CITY:	EL MONTE	STATE: CA	ZIP CODE:	91732
CAPACITY:	14	CENSUS: 6	DATE:	09/02/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Maria Medina, Licensee		TIME COMPLETED:	04:00 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	At 1:00 pm Licensing Program Analysts (LPA) Roxana Lopez conducted an unannounced required 1 year inspection to the above facility. A risk assessment was conducted and the appropriate PPE material was used. LPA met with Zoila Villanueva Romero, Assistant. Per Assistant Licensee had just left to pick up school children. Assistant Zoila, was not letting LPA Lopez into the facility, she called Licensee Maria Medina and confirmed with her LPA’s entry. Assistant guided analysts on a tour of the area where the children were located and the outside of the facility. At 1:20 PM Licensee, Maria Medina arrived and took over inspection. LPA noticed that the front of the house is undergoing some construction. Per Licensee, a pipe burst in her kitchen area and the front of the house is being repaired. Per Licensee, there are 13 children that are currently enrolled. A current children’s roster was available for review. There were 6 children present upon arrival. The licensee states that 2 adults currently live in the home. Per Licensee, she currently has two assistants. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed child care home. Licensee states that there are no firearms stored in the home. This is a one story home which consists of 4 bedrooms (1 located in the detached garage), 3 bathrooms, kitchen, living room, dining room, front yard, backyard (fenced), and detached garage. The children have access to 1 bedroom (daycare room), 2 bathrooms, living room, dining room and back yard. Per licensee, areas off limits to children and parents include: 3 bedrooms, 1 bathroom, front yard and detached garage. The LPA toured all areas used by children during this visit. Per Licensee, due to a kitchen pipe bursting the living room, dining room and 1 bathroom is off limits at this time. LPA observed 2 construction workers in these areas and areas were observed to be inaccessible to children in care. The bedroom, bathroom and outdoor area is accessible through a side door of the house. -------------------------------------------------------- Pg. 1 of 4 ---------------------------------------------------------------------------

SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2021

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 4

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: MEDINA FAMILY CHILD CARE	FACILITY NUMBER: 198020612
	VISIT DATE: 09/02/2021

NARRATIVE

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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 cellphone that is used and the cellphone stays at the facility during operation hours. There is ventilation and heating (individual units). The following was observed and reviewed during this inspection.

Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. Poisons are locked in a cabinet in the off limits detached garage. The restroom that children use was observed to be safe and sanitary.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 03/24/2021, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable. All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill documented was conducted on 8/3/2021

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted in the bedroom(day care room)

The home is observed to be clean and orderly. LPA observed all off limit areas made inaccessible by a security knob. There are toys available for children. Appropriate sleeping arrangements in forms of cots, 1 crib and 1 playpen were observed.

Per Licensee, she provides food for children in care.

Licensee states that she is currently caring for infants. LPA advised the licensee about the sleep regulation and discussed and provided the LIC 9227 Individual Sleeping Plan. Infant sleep in the bedroom (day care room)

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.
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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2021

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: MEDINA FAMILY CHILD CARE	FACILITY NUMBER: 198020612
	VISIT DATE: 09/02/2021

NARRATIVE

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There are no pets on the premises.

The licensee is observed to be operating within the license capacity limitations.

At 2:20 PM 4 school age children arrived

At 2:27 pm children’s records were reviewed, including emergency information and were observed to be complete.

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 09/2022. There are first aid supplies available.

The licensee and her assistants do have proof of immunization against influenza, pertussis, and measles.

Licensee and assistants have the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file.

LPA issued a Confidential Names List (LIC 811) to the licensee which documents staff and children’s files reviewed during this inspection.

Incidental Medical Services (IMS):
The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS at this time. 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 advised the licensee to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov

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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2021

LIC809 (FAS) - (06/04)

Page: 4 of 4

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: MEDINA FAMILY CHILD CARE	FACILITY NUMBER: 198020612
	VISIT DATE: 09/02/2021

NARRATIVE

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The following was discussed with the Licensee:
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. Failure to obtain 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.

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 adult/infant CPR & Pediatric First Aid certification and a valid criminal record clearance associated to the facility license.

LPA Lopez consulted with applicant regarding COVID-19 health and safety guidelines on this date/ LPA observed COVID postings on this date. 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.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Maria Medina, Licensee including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role and their signature on this form acknowledges receipt of these forms.

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SUPERVISOR'S NAME: Brandi VanOosten	TELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana Lopez	TELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2021

LIC809 (FAS) - (06/04)

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