304205307-7-23-2019-06-CC-STOE-BECUMF-20190723154215

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304205307
Report Date: 07/23/2019
Date Signed: 07/23/2019 03:42:26 PM

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:	MIRAMONTES, HILDA		FACILITY NUMBER:	304205307
ADMINISTRATOR:	MIRAMONTES, HILDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(714) 491-1725
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92801
CAPACITY:	14	CENSUS: 11	DATE:	07/23/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Hilda Miramontes		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	An inspection was conducted at the facility by Licensing Program Analyst (LPA) Stacy Torrence. LPA met with Hilda Miramontes who guided analyst on a tour of the facility inside and outside. Also present was Licensee’s Assistant, Jennifer Castaneda and husband Arnulfo Miramontes. Upon LPA arrival there were eight children napping in the daycare room. Three more children arrived at 2:34 p.m. Licensee has 19 children enrolled. Licensee currently have two assistants. Licensee has a current children’s roster available. Licensee states that three adults live in the home. Operation hours are 7:00 a.m. to 6:00 p.m. A review of criminal record clearances indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. This is a two-story home which consist of five bedrooms, two and a half bathrooms, kitchen, dining room, living room, attached garage, front yard (not fenced), and back yard (fenced). The licensee has designated the off-limit areas as; four bedrooms, two bathrooms, living room, kitchen, dining room, and front yard. The licensee has designated the daycare area as the following; daycare room; located in the back of the house. Daycare parents and children enter on the side of the house. The daycare area was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning supplies, medication, and hazardous items that can pose a danger to children. Per licensee there are no weapons or firearms in the facility. There are age appropriate toys, learning material and equipment for ages served. Fire/disaster drill log was reviewed. Outdoor play area is the back yard which was gated, and licensee stated that she is always present when children are outside playing. LPA observed various plastic playhouses and other appropriate toys. The required fire extinguisher (2A10BC), smoke detector, and carbon monoxide detector were in operable condition. First Aid kit was complete. Licensee had a current CPR/First Aid card with an expiration date of 01/20. Licensee’s two assistants have a current CPR/First Aid card with an expiration date of 07/21. Children's records: parents' rights and California School Immunization Record were reviewed.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 703-2823
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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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: MIRAMONTES, HILDA	FACILITY NUMBER: 304205307
	VISIT DATE: 07/23/2019

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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

Licensee and one assistant have their immunization against pertussis, measles, and influenza. Licensee’s other assistant is missing her pertussis immunization. Per Licensee, she is receiving the quarterly updates. Licensee and her assistants have completed the Mandated Reporter Training. Website provided: http://mandatedreporterca.com/. Licensee was informed how/where to access regulations and forms from CCLD website: www.ccld.ca.gov.

During this inspection, there was no deficiency cited per CA Code of Regulations Title 22. However, a Technical Violation was given because staff 2 was missing her Pertussis vaccine.

Exit interview was conducted. Report reviewed and discussed with the licensee. Notice of Site Visit was posted. Facility representative was informed that the notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. Appeal rights provided and explained. The licensee was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First level appeal is to Regional Manager, address is above on the report.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Stacy Torrence	TELEPHONE: (714) 703-2823
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019

LIC809 (FAS) - (06/04)

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