304310190-7-26-2019-06-CC-STOE-BEFRT9-20190726131758

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304310190
Report Date: 07/26/2019
Date Signed: 07/26/2019 01:18:02 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:	LOPEZ, ROSA MARGARITA		FACILITY NUMBER:	304310190
ADMINISTRATOR:	LOPEZ, ROSA MARGARITA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(714) 229-8347
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92801
CAPACITY:	14	CENSUS: 3	DATE:	07/26/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Rosa Lopez		TIME COMPLETED:	01:25 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	Licensing Program Analyst (LPA) Stacy Torrence conducted an announced inspection at the above facility. LPA met with Rosa Lopez who guided analyst on a tour of the facility inside and outside. During today’s inspection, there were three children present. Per licensee, she has 11 children enrolled. 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 5:30 p.m. A review of individual records indicates that all individuals that resides in the home or who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. This is a one-story home which consist of three bedrooms, two bathrooms, two kitchens, dining room, living room, front yard(fenced), and back yard (fenced). The licensee has designated the off-limit areas as the following: two bedrooms, one bathroom, one kitchen, dining room, living room, and back yard. The licensee has designated the daycare area as the following: the side portion of the home which consist one bedroom, one bathroom, kitchen, and activity room. The daycare area was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, 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 and equipment for ages served. LPA also observed learning materials. Fire/disaster drill log was unavailable at time of visit. Outdoor play area is the front yard which was gated, and licensee stated staff are always present in the front yard when children are outside playing, there are safe and age appropriate toys for children to use. 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 09/23/19. 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: 07/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2019

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: LOPEZ, ROSA MARGARITA	FACILITY NUMBER: 304310190
	VISIT DATE: 07/26/2019

NARRATIVE

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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 has proof of immunization against pertussis, measles, and influenza. Facility was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov. Licensee have proof of completing 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, an Advisory Notes Technical Assistant was given for not able to provide a updated disaster drill log.

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: 07/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2019

LIC809 (FAS) - (06/04)

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