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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300609303
Report Date: 06/07/2019
Date Signed: 06/07/2019 09:34:53 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:FILLIGER, LETICIAFACILITY NUMBER:
300609303
ADMINISTRATOR:FILLIGER, LETICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 970-0478
CITY:YORBA LINDASTATE: CAZIP CODE:
92887
CAPACITY:12CENSUS: 0DATE:
06/07/2019
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Leticia FilligerTIME COMPLETED:
09:40 AM
NARRATIVE
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An Informal Meeting was conducted on this day in the Orange Regional Office. Present during the meeting were Licensing Program Manager (LPM) Judy Hanson, Licensing Program Analyst (LPA) Jung Mi (Jamie) Han, and licensee Leticia Filliger.

The purpose of this informal meeting is to discuss the licensee's most recent inspections and the history of the facility.

102417(g)(9)(A)(1) - Operation of a Family Child Care Home. All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill.
- There was no verification of drills.

102419(d) - At the time of acceptance of each child into care, the licensee shall provide the child's parent with a copy of the notice Family Child Care Home Notification of Parents’ Rights, LIC 995A (8/06).
- This was missing form some children's files.

The facility representatives state that they will ensure compliance with Title 22 Operation of a Family Child Care Home 102417(g)(9)(A)(1) . The licensee stated she is conducting drill every month and document it.

The facility representatives state that they will ensure compliance with Title 22 Operation of a Family Child Care Home 102419(d). The licensee stated she added parent's right in enrollment packet.

Facility was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Jung Mi HanTELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2019
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: FILLIGER, LETICIA
FACILITY NUMBER: 300609303
VISIT DATE: 06/07/2019
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A copy of the 2016 “A Child Care Providers Guild to Safe Sleep” was provided to the facility representative.

English: https//www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

Spanish: https//www.cdph.ca.gov/programs/SIDS/Documents/ChildCareProvSleepSPAN2011.pdf

AAP: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx

NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative

Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials

· Always place infants on their backs for sleeping


· Use only a tight-fitting sheet on the crib or play yard mattress
· Do not hang any items from the crib or above the crib
· Keep all items, including blankets, out of the crib or play yard
· Pacifiers may be used as long as they do not have items attached to them
· Infants should not be swaddled or have any items covering them while sleeping
· The temperature of the room should be comfortable enough for an adult to wear a t-shirt and not be too hot or too cold

Provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org

The following was also discussed with the Licensee:


I. The licensee's will be placed on required visits for the next two years.
II. The licensee was advised that it is her responsibility to know & understand Title 22 Regulations.
III. The licensee's facility must be in compliance at all times.
IV. The licensee was advised to check the Child Care Licensing web site at www.ccld.ca.gov for quarterly updates, training, forms and regulations.

Exit interview conducted with licensee, Leticia Filliger who is in agreement with this report which documents this meeting.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Jung Mi HanTELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2019
LIC809 (FAS) - (06/04)
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