304310190-2-12-2020-06-CC-ECOL-BLR42E-20200212174301

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304310190
Report Date: 02/12/2020
Date Signed: 02/12/2020 05:43:11 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: 5	DATE:	02/12/2020
TYPE OF VISIT:	Case Management - Deficiencies	UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Licensee - Rosa Margarita Lopez		TIME COMPLETED:	05:50 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) Corral and Licensing Program Manager (LPM) Lopez conducted a Case Management inspection due to deficiencies observed on 02/12/20 at 1:45 p.m. Upon arrival LPA and LPM observed an infant sleeping in their carseat. at approximately 1:45 p.m. Licensee stated child was going to be picked up early due to an appointment. LPA advised Licensee not to nap children in car seats even if parent is picking up early because car seats are not appropriate napping equipment. Licensee immediately removed infant from car seat and placed infant in play-pen, child was picked up from facility at 2:57 p.m. Based on LPA and LPM observations and interviews conducted with the licensee, the licensee failed to provide safe and comfortable accommodations by sleeping the infant in a car seat when he was not being transported. Licensee was informed infants should only be placed in car seats while being transported. During record review, the Child Care Facility Roster was found to be outdated, record review indicated 3 out of the 5 children present during today's inspection were not listed in the children's roster. Licensee failed to maintain an updated Children Roster in the facility. During interview with Licensee, Licensee informed LPA and LPM there was a child who fell and hit her lip on 02/03/2020. Licensee stated Child's lip was swollen, but not bruised or bleeding. During interview with Assistant, Assistant stated child was not distressed, child played and ate like normal and did not show signs of being in pain. Licensee stated she did not notify the child's mother because child played and ate as usual. Licensee did speak to parent the day of the incident, around 9 p.m. During the Licensee and Parent conversation, parent informed Licensee child was taken to seek medical attention. Licensee did inform parent of incident on the same business day but failed to inform the Licensing Department that an Unusual Incident had occurred within 24 hours. Continue to Page 2.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Eileen Corral	TELEPHONE: (714) 743-8354
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2020

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LOPEZ, ROSA MARGARITA	FACILITY NUMBER: 304310190
	VISIT DATE: 02/12/2020

NARRATIVE

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Page 2.
The following regulations are being cited today, refer to 809D.

California Code of Regulations, Title 22, 102423 – Personal Rights
(a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

California Code of Regulations, Title 22, 102417 – Operation of a Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: (8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

California Code of Regulations, Title 22, 102416.2 – Reporting Requirements
(b) The licensee shall report to the Department any of the events as specified in Health and Safety Code Sections 1597.467(b)(1)(A) through (b)(1)(C) that occur during the operation of the family child care home. (1) Medical treatment means treatment by a medical professional, as defined in Section 101152(m).

Exit interview was conducted with Licensee in Spanish. Notice of Site Visit was posted during the visit. Licensee 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. Licensee was provided a copy of appeal rights and signature on this form acknowledges receipt of these rights. Licensee was informed first level of appeals should be sent to the regional manager to the address listed above.

End of Report

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Eileen Corral	TELEPHONE: (714) 743-8354
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2020

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LOPEZ, ROSA MARGARITA	FACILITY NUMBER: 304310190
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/12/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 02/12/2020 Section Cited	1 2 3 4 5 6 7	102423 – Personal Rights (a) Each child receiving services from a family child care home shall have certain rights.. (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement was not met as evidenced by:
	8 9 10 11 12 13 14	Based on LPA & LPM observation infant was sleeping in a car seat upon arrival at 1:45 p.m. while not being transported. This poses an immediate risk to the personal rights of children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Eileen Corral	TELEPHONE: (714) 743-8354
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2020

LIC809 (FAS) - (06/04)

Page: 3 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LOPEZ, ROSA MARGARITA	FACILITY NUMBER: 304310190
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/12/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/21/2020 Section Cited	1 2 3 4 5 6 7	102417 - Operation of a Family Child Care Home (g) The home shall be free from defects... Safety precautions shall include but not be limited to: (8) Each family child care home shall have a current roster of children. This requirement was not met as evidenced by:
	8 9 10 11 12 13 14	Based on LPM Record Review, the Children's Roster was not current. 3 out of the 5 children present during today's inspection were not included in the Children Roster. This poses a potential risk to the safety of children in care.	8 9 10 11 12 13 14
Type B 02/19/2020 Section Cited	1 2 3 4 5 6 7	102416.2 – Reporting Requirements (b) The licensee shall report to the Department any of the events... that occur during the operation of the family child care home. (1) Medical treatment means treatment by a medical professional. This requirement was not met as evidenced by:
	8 9 10 11 12 13 14	Based on LPA & LPM interviews Licensee failed to inform Licensing Department that an Unusual Incident occurred in the facility where a child received medical attention and licensee was notified by parent. This poses a potential risk to the safety of children in care.	8 9 10 11 12 13 14

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Eileen Corral	TELEPHONE: (714) 743-8354
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2020

LIC809 (FAS) - (06/04)

Page: 4 of 4