304310078-6-20-2019-06-CC-YVIA-BDBMQW-20190620094925

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304310078
Report Date: 06/20/2019
Date Signed: 06/20/2019 09:49:30 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:	ROJAS, MARILU		FACILITY NUMBER:	304310078
ADMINISTRATOR:	ROJAS, MARILU		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(714) 306-4470
CITY:	BUENA PARK	STATE: CA	ZIP CODE:	90620
CAPACITY:	14	CENSUS: 8	DATE:	06/20/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	07:45 AM
MET WITH:	Marilu Rojas, Licensee		TIME COMPLETED:	10:00 AM

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Licensing Program Analyst (LPA) Yesenia Villa conducted an unannounced annual random site inspection to ensure the health & safety standards as required by regulations governing family child care homes. Upon arrival, LPA met with Licensee Marilu Rojas and assistant Rebecca Barcenas. LPA toured the facility inside and outdoors. There were 5 children present in the living room and 3 other children in the playroom with assistant, a total of 8 children during today’s inspection. Per Licensee there are 2 adults and 1 child residing in the home. Licensee’s operating hours are Monday-Friday 6:00am to 6:00 p.m. All adults residing in the home are fingerprint cleared. Per Licensee she has 14 children in care an updated roster was available.

The home is a single story home with 3 bedrooms and 2 bathroom. The following areas used for daycare: is the living room and play room located in the back of the home and one restroom. The back yard is used for outdoor play time. The off-limit areas include: the two bedrooms,dinning room, other restroom and detached garage. Licensee was informed that children are not permitted in off-limit areas. Off limit areas made inaccessible with door latches.

Licensee has the Parent’s Rights poster and other appropriate forms posted on wall in the living room. Pediatric First Aid/CPR certificate are valid thru 01/20/20 for licensee and 01/08/2010 for assistant. Licensee's disaster drill log notes last drill conducted on 06/12/19. Licensee has a working telephone. The licensee has proof of the mandated reporter certificate training and immunizations required, MMR, TDAP and the Influenza shot. Mandated reporter training was completed on 02/27/2018.

Detergents and cleaning supplies were inaccessible to the children in care. Fire extinguisher was inspected and met state regulations. There is an operational smoke detector and carbon monoxide in the living room. The licensee maintains a First Aid Kit in the home. There are adequate age appropriate toys, books, and games. There are no firearms present on the premises as stated by licensee. There are no pools or spas, or other bodies of water. Page 1 of 2

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 703-2818
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2019

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: ROJAS, MARILU	FACILITY NUMBER: 304310078
	VISIT DATE: 06/20/2019

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The following were discussed: Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being in the presence of the children in care. Individuals within one month of their 18th birthday must be fingerprinted immediately. No smoking, No infant walkers, No baby bouncers, No Johnny jumpers, No exersaucers and any other item that falls into that category. LPA discussed disaster drills, posting requirements, children records requirements, mandated child abuse and injury/death reporting.

LPA reviewed SIDs, Never Shake A Baby, safe sleeping practices and Effects of Lead Exposure pamphlet. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. Safe sleep flyer was issued to licensee. She was advised also provided with the Childrens advocate information for quarterly updates ChildCareAdvocatesProgram@dss.ca.gov

Incidental Medical Services (IMS) policy was discussed. Licensee states there are no children requiring medication. 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 and regulations on line at: www.ccld.ca.gov

There were no deficiencies cited during this inspection.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 consecutive days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Licensee and Appeal rights were provided and explained. Licensee was informed that appeals must be submitted in writing within 15 days of a citation.

An exit interview was completed with licensee Marilu Rojas.

Page 2 of 2 end of report.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 703-2818
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2019

LIC809 (FAS) - (06/04)

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