304312223-2-28-2020-06-CC-YVIA-BM8RE5-20200228115659

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304312223
Report Date: 02/28/2020
Date Signed: 02/28/2020 11:57:07 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:	QUIROZ, EDA		FACILITY NUMBER:	304312223
ADMINISTRATOR:	QUIROZ, EDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(714) 639-3055
CITY:	SANTA ANA	STATE: CA	ZIP CODE:	92705
CAPACITY:	14	CENSUS: 0	DATE:	02/28/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	07:45 AM
MET WITH:	Eda Quiroz, Licensee		TIME COMPLETED:	11:00 AM

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	An annual required inspection was conducted at the facility by Licensing Program Analyst Yesenia Villa. Upon arrival LPA Villa was greeted by Fernando Tambare licensees spouse. The licensee was in an off-limit area of the home when the LPA arrived. There were no children present during this inspection. The facility was operating within the licensed capacity as specified on the license. A review of the Facility Personnel Report Summary on this date indicates all facility residents, staff, or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Licensee states her hours of operation are 24 hours, seven days a week. The license had an updated roster available during today’s inspection. Licensee states she has seven children enrolled in her day care. Licensee states there are four adults and no minors residing in the home including the licensee. During today’s inspection, LPA and licensee toured the inside and outside areas identified in the facility sketch as accessible to childcare children. The following was observed and reviewed during this inspection.This is a one story home which consists of 4 bedrooms and 2 bathrooms. The areas used for the day care are the living room, the restroom in the hallway, the dining room and the back yard for outdoor play. The off-limit areas for the children are the 4 bedrooms and the restroom located in the master bedroom. The off-limit areas are kept closed with the doorknob locks and licensee states she maintains the off-limit areas closed during day care hours.The children use the back yard for outdoor play time. The outdoor play area was observed to be fenced, with age appropriate toys and free of hazards during this inspection. There are no bodies of water in the home.All areas identified on the facility sketch that children use, were inspected for safety, comfort, cleanliness, telephone service via home phone and mobile phone. There are working carbon monoxide, smoke detector, and fire extinguisher in the home that meet 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.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 293-9465
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2020

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: QUIROZ, EDA	FACILITY NUMBER: 304312223
	VISIT DATE: 02/28/2020

NARRATIVE

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Licensee has the Parent’s Rights poster and other appropriate forms posted. Children records were reviewed for LIC700 and Immunization cards. All records were observed to be complete. 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. The licensee has proof of immunization against pertussis, and measles, and influenza or written declaration to decline.

Staff files were reviewed for Immunizations, MMR, TDAP and Influenza and Mandated Reporter Training. 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. The licensee and her assistant are exempt from the mandated reporter training due to not being bilingual.

Licensee was reminded that the Mandated reporter training expires every two years. The licensees Pediatric CPR/First Aid certification. The last fire disaster drill was conducted on 01/08/2020 as indicated on the fire disaster drill log. Licensee stated there are no firearms or weapons in the home.

Incidental Medical Services (IMS) policy was discussed. Licensee states there are no children who require medication in her care at this time. 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 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, immunization's, Pediatric CPR/First Aid, and mandated reporter training.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 293-9465
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2020

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: QUIROZ, EDA	FACILITY NUMBER: 304312223
	VISIT DATE: 02/28/2020

NARRATIVE

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CCLD website www.ccld.ca.gov was provided to licensee to access regulations, updates, and licensing forms. Licensee was advised to register through 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. A copy of the 2016 “A Child Care Providers Guide to Safe Sleep” was provided to the licensee. The following electronic links were also provided:
Spanish: https//www.cdph.ca.gov/programs/SIDS/Documents/ChildCareProvSleepSPAN2011.pdf
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

There were no citations cited during this inspection. There were no Title 22 Regulations observed during this visit.

Appeal Rights were explained. The Licensee was provided a copy of appeal rights (LIC 9058 01/16) and their 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. Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.00. The Notice of Site Visit must be posted on or adjacent to the door.
End of Report.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Yesenia Villa	TELEPHONE: (714) 293-9465
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2020

LIC809 (FAS) - (06/04)

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