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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304310840
Report Date: 07/21/2021
Date Signed: 07/21/2021 10:39:32 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:LANDAVERDE, MARIAFACILITY NUMBER:
304310840
ADMINISTRATOR:LANDAVERDE, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 708-3610
CITY:SANTA ANASTATE: CAZIP CODE:
92704
CAPACITY:14CENSUS: 7DATE:
07/21/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Licensee - Maria LandaverdeTIME COMPLETED:
11:00 AM
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An Annual inspection was conducted in the facility by Licensing Program Analysts (LPA) Corral and LPA Tran. LPA Tran reviewed COVID-19 Prescreening Questionnaire with Licensee Maria Landaverde prior to entering the Facility. LPA Corral and Tran observed Licensee Maria caring for 7 children which included 1 infant, I school age and 5 preschool age children. Upon entrance to the Facility the children were having breakfast in the dining room. Licensee was observed to be operating within the licensed capacity as specified on license. Due to COVID 19 guidelines, LPA observed Licensee and children wearing face masks, social distancing and following CDC and Dept of Public Health Guidelines. A review of the Facility Personnel Report Summary conducted on 07/19/2021 indicates all facility residents, staff, or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Currently there are 4 adults living in the home which includes the Licensee, her Husband and her 2 adult children. Facility operating hours are 6am - 6pm, Monday through Friday.

During today’s inspection, LPA Corral and Tran toured the inside and outside of the Facility with Licensee, the areas identified in the facility sketch as accessible to child care children were toured. Off limits areas are all bedrooms and the Master Bathroom, which are made inaccessible by means of child safety door knobs. The child care area consist of the living room, the kitchen, the dining room and the backyard. The living room is to the left of the main entrance, the kitchen is accessible through the living room and the hallway. There is also a child gate located in the living room to prevent dining room access when the dining room is not being used. The bathroom available to children in care is located down the small hallway to the right of the kitchen. Licensee stated the children's primary area is the living room which was turned into the play room.

The home has a working carbon monoxide, smoke detector, and fire extinguisher which meets Statutory and State Fire Marshall standards. Detergents, cleaning compounds, medicines, and other items which could pose a danger if readily available to children were stored inaccessible to children, which are located above 5 ft. high. There is a fireplace in the living room screened by a glass cover and inaccessible to children in care.
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SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Eileen CorralTELEPHONE: (714) 743-8354
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2021
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 3
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: LANDAVERDE, MARIA
FACILITY NUMBER: 304310840
VISIT DATE: 07/21/2021
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The home was observed to have age appropriate toys for the ages served. During today’s inspection LPA observed books and games to be present in the living room. Licensee stated Facility does use outdoor play area. The outdoor play area was observed to be safe, the side entrances were fenced. The outdoor play area was observed to have play houses, books, tables and chairs along with cushioned play mats. Licensee was reminded outdoor play area should be visually supervised. There were no poisons or other items observed which could pose a danger to children. There are no bodies of water on the premises. LPA verified there is a working telephone service, which is the Licensee's cell phone.

All children files were reviewed by LPA Tran and found to be within compliance. The licensee does have a current roster of children in care. LPA observed 1 infant in care which was 17 months old. Licensee has an Infant Sleeping Log for the infant in care which contains the Child's Name, Date and the time of each 15 minute check. Licensee Maria's file was reviewed. The licensee completed her Pediatric CPR/First Aid certification on 01/18/2020. Beginning September 1, 2016, Health and Safety 1597.622 states, a person shall not be employed or volunteer at a family day care home if he/she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, measles and influenza for Licensee was reviewed by LPA Tran and found to be within compliance. Beginning March 31, 2018, H&S Code 1596.8662 requires licensed providers and employees to complete mandated reporting training and to renew every two years. Licensee completed Mandated Reporter Training on 03/04/2020. 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

The licensee understands she must be present in the facility and must ensure children in care are always supervised. Children are not to be left alone in parked vehicles. When the licensee is temporarily absent from the facility, arrangements must be made for a qualified substitute adult to care and supervise children. The substitute adult must have the required criminal record, child abuse index clearances, immunizations, Pediatric CPR/First Aid, and mandated reporter training.
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SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Eileen CorralTELEPHONE: (714) 743-8354
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: LANDAVERDE, MARIA
FACILITY NUMBER: 304310840
VISIT DATE: 07/21/2021
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LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian. CCLD website www.ccld.ca.gov was provided to licensee to access regulations, updates, and licensing forms. Licensee was advised to register on childcareadvocatesprogram@dss.ca.gov in order to receive quarterly updates. Licensee was advised to review the Provider Information Notices (PIN) found on the CCLD website. The following information was explained and provided to Licensee, A copy of the California Department of Social Services Lead Information Brochure and "A Child Care Providers Guide to Safe Sleep”. The following electronic links were also provided:
https//www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf. A copy of the (PIN) 20-06-CCP Social and Physical Distancing Guidance was provided to the Licensee. AAP:https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx
NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative
Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials
LPA reviewed with licensee the following safe sleep best practices:
- Always place infants on their backs for sleeping, only a tight-fitting sheet on the crib/play yard
- Do not hang items from the crib or above the crib, keep all items, including blankets out of the crib/play yard
- Pacifiers may be used if they do not have items attached to them
- Infants should not be swaddled or have any items covering them while sleeping
- The temperature of the room should be comfortable, not too hot or too cold

In the areas that were evaluated, No deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.

An exit interview was conducted with Licensee Maria Landaverde. Appeal Rights were provided and explained to the Licensee and signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above. The Notice of Site Visit was posted and discussed as required by H&S Code Sec. 1596.817. Licensee was informed Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.00.
End of Report.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Eileen CorralTELEPHONE: (714) 743-8354
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2021
LIC809 (FAS) - (06/04)
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