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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304311966
Report Date: 04/29/2022
Date Signed: 04/29/2022 11:49:23 AM


Document Has Been Signed on 04/29/2022 11:49 AM - It Cannot Be Edited

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:PAPURT, KARENFACILITY NUMBER:
304311966
ADMINISTRATOR:PAPURT, KARENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 551-0768
CITY:IRVINESTATE: CAZIP CODE:
92604
CAPACITY:14CENSUS: 3DATE:
04/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Karen PapurtTIME COMPLETED:
12:00 PM
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An Annual Random inspection was conducted at the facility by Licensing Program Analyst (LPA), Alanna Gontarek. LPA met with Licensee, Karen Papurt. LPA observed licensee caring for (3) children; which included (1) infant and (2) preschool age children. Licensee was operating within the licensed capacity as specified on license.

This is a one story home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, living room, den/Infant nap room, 3 bedrooms, garage and backyard (fenced). Daycare areas include: Kitchen, dining room, den/infant nap room, one bathroom, and backyard. Per Licensee, areas off limits to children and parents include: Garage and one master bathroom. Garage is made inaccessible via lock. Master bathroom is made inaccessible via top latch above door. LPA observed that there is a fireplace in the daycare room and is barricaded by a screen and safety gate. Per licensee, children's authorized representatives provide food for children in care. LPA advised licensee all children's food brought from home must be labeled with child's name and date. There were no pets observed on the premises..

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. The licensee states that there are no additional adults or children residing in the home. Per licensee, lives alone. Licensee states that there are no firearms stored in the home.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a cellphone and land line that is used and the cellphone stays at the facility during operation hours. There is ventilation and heating (central).



The following was observed and reviewed during this inspection: Poisons, detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children via latches. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked
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SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/29/2022
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: PAPURT, KAREN
FACILITY NUMBER: 304311966
VISIT DATE: 04/29/2022
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with a key or combination lock. The restroom that children use was observed to be safe and sanitary.

The home is observed to be clean and orderly. There are toys available for children. Appropriate sleeping arrangements were observed. Per licensee, there are a total of 6 play yards. There were 4 Pack N' Plays (play yards) observed in the den/infant nap room, and 2 Pack N' Plays (play yards) observed in two of the bedrooms. Per licensee, she checks on the infant every 10 to 15 minutes and infant sleeps in a separate room. LPA advised licensee to keep door open while infant sleeps in separate room, and continue to provide 15-minute checks, documenting those checks on a Sleep Log/chart. LPA inspected the kitchen. LPA observed knives to be stored in an upper cabinet. Cleaning compounds were observed to be latched in a cabinet beneath the sink. LPA observed 3 highchairs in the kitchen. Per Licensee, other cleaning compounds are stored in the key-locked garage. LPA observed all electrical outlets to have covers. Fireplaces and open face heaters are inaccessible to children. The valve on the required 2A 10BC fire extinguisher indicates fully charged. Smoke and carbon monoxide detectors were tested and are operable.

Currently, children are using the backyard for outdoor play time. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that can pose a danger to children on the outdoor yard. The licensee states that supervision is always provided when children are outdoors. LPA observed no bodies of water on the premises.

The licensee does have a current roster of children in care. Children’s records for children present during today's inspection were reviewed for a copy of the emergency information card that contains all the information specified by regulation (LIC 700) and found to be in compliance. The licensee's CPR/First Aid certification expires on 06/2023

Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, measles, and Influenza for licensee was reviewed and within compliance.

Beginning March 31, 2018, H&S Code 1596.8662 requires all licensed providers and employees to complete mandated reporting training, and to renew the training every two years. LPA observed that the Licensee does have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file expiring 7/2023. Training is available at: www.mandatedreporterca.com.

All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill conducted was on 12/2021 .
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2022
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: PAPURT, KAREN
FACILITY NUMBER: 304311966
VISIT DATE: 04/29/2022
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Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories. These items are not permitted in a family child care facility.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.
The licensee understands she must be present in the facility, must ensure children in care are supervised at all times, and children are not to be left 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 while absent. The substitute adult must have the required criminal record, child abuse index clearances, immunizations, Pediatric CPR/First Aid, and mandated reporter training.

CCLD website was provided to licensee to access regulations, updates, and licensing forms. Per Licensee, is signed up on childcareadvocatesprogram@dss.ca.gov in order to receive quarterly updates. Licensee was advised of their responsibility to review the Provider Information Notices (PIN) found on the CCLD website.

A copy of the California Department of Social Services Lead Information Brochure was explained and provided to the licensee. LPA issued a Confidential Names List (LIC 811) to the licensee which documents staff and children’s files reviewed during this inspection.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

A copy of the 2016 “A Child Care Providers Guild to Safe Sleep” was provided to the licensee.

English: https//www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

AAP: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx

SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2022
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: PAPURT, KAREN
FACILITY NUMBER: 304311966
VISIT DATE: 04/29/2022
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NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative
Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials
· Always place infants on their backs for sleeping
· Use only a tight-fitting sheet on the crib or play yard mattress
· Do not hang any items from the crib or above the crib
· Keep all items, including blankets, out of the crib or play yard
· Pacifiers may be used as long as 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 enough for an adult to wear a t-shirt and not be too hot or too cold

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
LPA advised the licensee to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov.

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.

Exit interview conducted and report was reviewed with the licensee, Karen Papurt. This report (LIC 809) and Appeal Rights (LIC 9058) were discussed and provided to the licensee. The licensee's 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.
A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2022
LIC809 (FAS) - (06/04)
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