304310480-7-10-2019-06-CC-YVIA-BDY5WN-20190710201924

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304310480
Report Date: 07/10/2019
Date Signed: 07/10/2019 08:19:31 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:	HERNANDEZ, IRMA		FACILITY NUMBER:	304310480
ADMINISTRATOR:	HERNANDEZ, IRMA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 691-1348
CITY:	LAHABRA	STATE: CA	ZIP CODE:	90631
CAPACITY:	14	CENSUS: 9	DATE:	07/10/2019
TYPE OF VISIT:	Case Management - Annual Continuation	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Irma Hernandez, Licensee		TIME COMPLETED:	03:00 PM

NARRATIVE

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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 are met. Upon arrival, the licensee was not present. Per assistant’s licensee was at the doctors office. Licensee arrived about an hour and a half after LPAs arrival.

LPA Villa was greeted by assistant Yurixi Estrada who was in the living room with 2 infants and 2 toddlers. Present in the home was also assistant Magali Dimas, who was not associated to this facility nor had fingerprint clearance. Census was obtained during todays visit, there were a total of 9 children present, two of which were infants. The facility was observed to be within ratio during todays visit. All personnel present have not obtained criminal background/fingerprint clearance prior to residing in the home. This will result in a civil penalty citation that will be cited in the 809D page attached. Per Licensee Magali Dimas has been employed with her for about two to three weeks.

During todays inspection LPA toured the facility inside and outdoors. Per assistant Yurixi Estrada there are 2 adults residing in the home. Licensee’s operating hours are Monday to Friday 6:00 am-6:00pm. Per assistant they have 9 children enrolled in the day care. An updated roster was available during the inspection. The home is a single-story home with 1 bedroom and 1 bathroom, living room, kitchen and large play room located in the back of the home. The following areas are used for day-care: the living room the backroom/play room, kitchen, bedroom and restroom located near the bedroom. The garage is a detached garage that is kept locked per licensee as it is also an off-limit area to the children. Page 1 of 3

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 703-2818
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2019

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: HERNANDEZ, IRMA	FACILITY NUMBER: 304310480
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/10/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/11/2019 Section Cited CCR 102370.2(1)(b)	1 2 3 4 5 6 7	102370.2 (1)(b) Child Abuse Central Index The applicant shall submit the Child Abuse Central Index checks (LIC 198A [3/99] for state licensed facilities and LIC 198 [4/99] for county licensed facilities) for all individuals required to be checked directly to the California Department of Justice at the same time that the individual's fingerprints are submitted for a	1 2 3 4 5 6 7	Per Licensee Adult #2. will not be present with the children and will not work with her without her clearance. She will submit transfer and fingerprint clerance paperwork and will verify she is associated before placing her back to work.
	8 9 10 11 12 13 14	criminal background check as required by Section 102369(b)(8)... This requirement was not met as evidence by Adult#2 Magali Dimas. was not associated and did not have proof of finger print clearance during this inspection. This poses an immediate risk to the health and safety of the children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	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: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 703-2818
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2019

LIC809 (FAS) - (06/04)

Page: 4 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: HERNANDEZ, IRMA	FACILITY NUMBER: 304310480
	VISIT DATE: 07/10/2019

NARRATIVE

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The Licensee was reminded that full supervision is required at all times to ensure children do not have access to the off-limit areas. The children use the back yard for outdoor play time. There were no hazards observed in the outdoor area during today’s inspection. There are no bodies of water on the premises. Licensee has the Parent’s Rights poster and other appropriate forms posted on wall in the play room. Pediatric First Aid/CPR certificates are valid thru 09/15/19 for assistant present. Licensee Pediatric/F.A./CPR expires 10/05/2020. Licensees disaster drill log notes last drill was conducted on 07/08/19.

Licensee has a working telephone via cell phone and home phone. The licensee has completed her mandated reporter training certificate dated 03/25/2018. Her assistant Yurixi had proof of mandated reporter certificate completed on 03/25/2018. Immunization's required, MMR, TDAP and the Influenza shot were verified for assistant and Licensee.

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. There are adequate age appropriate toys, books, and games. There are no firearms present on the premises as stated by licensee. Nine children’s files were reviewed for LIC700 and Immunization card. All files were complete. Licensee and assistant files were reviewed during todays inspection and were found to be complete.

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 is to be in the home. LPA discussed disaster drills, posting requirements, children records requirements, mandated child abuse and injury/death reporting. Page 2 of 3

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 703-2818
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2019

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: HERNANDEZ, IRMA	FACILITY NUMBER: 304310480
	VISIT DATE: 07/10/2019

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LPAs reviewed SIDs, Never Shake A Baby, safe sleeping practices pamphlet. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. Safe sleep guidelines flyer was provided during todays visit.

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, Licensee was advised where to access the quarterly updates and LPA Villa provided Licensee with the following email childcareadvocatesprogram@dss.ca.gov.The following deficiencies will be cited on the 809D page attached. In accordance with title 22 regulation 102370.2 child abuse central index, you are hereby notified that an immediate $500 civil penalty per violation, followed by $100 per day per violation will be assessed until corrected.

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 Irma Hernandez. Page 3 of 3 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: 07/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2019

LIC809 (FAS) - (06/04)

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