304312768-5-6-2021-06-CC-KDEI-C2RQ38-20210506114820

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304312768
Report Date: 05/06/2021
Date Signed: 05/06/2021 11:48:33 AM

Document Has Been Signed on 05/06/2021 11:48 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:	RAMIREZ, FANI		FACILITY NUMBER:	304312768
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 3	DATE:	05/06/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Licensee Ms. Ramirez Fani		TIME COMPLETED:	12:00 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) Ketki Desai conducted an unannounced in-person Case Management inspection for a change in capacity to a Large Family Child Care home and met the Licensee Ms. Ramirez Fani. There were three preschool age children present at the time of the inspection. Ms. Ramirez Fani provided a tour of the home. Fire clearance from the Anaheim Fire Prevention office was received and approved for a large family childcare home. A review of the Facility Personnel Report Summary indicates adult residents, who require caregiver background check clearances exemptions is received and is cleared. Licensee stated, she is not currently registered with any Resource Foster Care agency or holds a Resource foster parent license. Applicant was reminded if changes to notify the licensing office. The Licensee is requesting a Large family childcare home license. Per Licensee, operation hours will be Monday to Friday, 6.00 AM to 6.00 PM care and supervision shall be provided to children ages Newborn to 12 years of age. On today’s inspection upon arrival LPA observed the home has been set up for Day care activities with activities and educational items arranged for the children. Licensee has set up the room with age appropriate furniture and activities. Licensee has assistants associated to the facility and shall continue to provide additional care and supervision to children. All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a single-story home with 4 bedrooms, 2 bathrooms, living room, dining room, kitchen, laundry room in the garage, Detached garage, side yard, front yard and backyard that is fenced and fully covered, there are three emergency exit doors in the back yard. (One leading into the side yard and two leading to the front yard) (1)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2021

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: RAMIREZ, FANI	FACILITY NUMBER: 304312768
	VISIT DATE: 05/06/2021

NARRATIVE

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Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service (cell phone), ventilation and heating. The home has a central Air/ Heating system, the A/C unit is in the side yard and the area is inaccessible to children,

Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible in areas designated for children. The applicant states (that there are no poisons on the premises). Applicant was advised that any poisons must be locked with a key or combination lock.

Based on the Facility Sketch submitted, areas off limits to children and parents are: Licensee has placed the three bedrooms, kitchen, side yard, garage and Master bedroom as off-limits areas. Licensee acknowledged the children may never enter the off-limit areas.
Licensee has installed a wooden safety gate in the kitchen area making it inaccessible. There is couch placed in the front of the small hallway leading to additional bedrooms of the home making the area inaccessible to children. Garage is detached and there is no door inside the home leading into the garage area. Laundry room is inside the garage. There is no stairway in the home.
There is a Fireplace in the living area, and it is made inaccessible by a safe barrier in front (a wooden bookcase and a metal barrier behind it too) It is made safe for children.
Applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary.

Areas Designated for Day care activities: The children shall enter through the main front entrance of the home into the living area. The Licensee has designated the Living area, one bedroom and bathroom, (In front of the living room), and the backyard as part of her day-care.

Upon entering Licensee shall receive the children at the main entrance of the home, no visitors are allowed beyond this point, upon entrance temperatures shall be checked, hands shall be sanitized, and the children shall be guided into the designated day care areas.

The bathroom is at the side of the bed room, it was observed to be safe and free of hazardous items. Sink cabinets has no hazardous items. It was observed to be safe and clean.

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2021

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: RAMIREZ, FANI	FACILITY NUMBER: 304312768
	VISIT DATE: 05/06/2021

NARRATIVE

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OUTDOOR PLAY AREA: Licensee have designated back-yard area for outdoor activities, it was observed to be fenced on all the sides with emergency exit doors, it also fully shaded with wooden planks installed. LPA observed age appropriate toys placed under the shaded patio area .The outdoor activity areas were observed to be safe. No hazardous were observed.

Per Licensee there is one Pets, in the home.

There are no firearms, weapons or bodies of water on the premises.

The value on the 2A10BC fire extinguisher indicates fully charged, as indicated on service tag observed. Smoke and carbon monoxide detectors were tested and are operable.

There are toys and educational items available for children.

Licensee states that food is provided to the children including lunch with snacks and Breakfast and she is associated to Children’s Home Society.

Licensee have completed the required Pediatric First Aid and CPR which expires on 3/6/23. There are first aid supplies available and is current on the required Mandated Reporter Child Abuse training.

The following was discussed with the applicant:
·Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately.
Civil Penalties will be assessed if not in compliance.
·In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR certification and a valid criminal record clearance associated to the facility license.
·Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License may be terminated.
·The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.
Applicant was also made aware of the Child Advocacy program so she could receive the updated Quarterly reports and other information in a timely manner. ChildCareAdvocatesProgram@dss.ca.gov (Page-3)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2021

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: RAMIREZ, FANI	FACILITY NUMBER: 304312768
	VISIT DATE: 05/06/2021

NARRATIVE

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Reporting Requirements: Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.
Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.
Fire and safety drills must be performed every six months and documented for review by the Department.
Children and Staff records must be maintained and updated as needed and must be available for review by the Department.
No smoking, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility.
All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.
Licensees shall reveal each facility license number in all advertisements, publications or announcements with the intent to attract clients.

UPDATE: H&S 1597.622: Commencing September 1, 2016, 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 applicant has submitted proof of immunization's.

UPDATE: Health and Safety Code 1596.7995: Beginning January 1, 2018, all licensed providers, applicants, directors and employees to complete training as specified on mandated reporter duties. Training is available at: www.mandatedreporterca.com

Infant Care: Licensee states that she will care for infants. LPA advised the Licensee to sleep infants where they can always be directly supervised and advised against sleeping infants in a separate room. The Licensee states the following as a supervision plan for infants: The infants will sleep where she will be providing supervision and they shall not be left unattended. LPA provided a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. Online copy can be downloaded at: https://www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2021

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: RAMIREZ, FANI	FACILITY NUMBER: 304312768
	VISIT DATE: 05/06/2021

NARRATIVE

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Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials
LPA reviewed with applicant the following safe sleep best practices:
· 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.

Per applicant, there are no dual licenses at this address. Applicant’s email address was obtained during this inspection. The applicant was advised that email may be public information.

Once licensed, the applicant is required to adhere to the terms and limitations stated on the license. A copy of this report and all other Licensing reports must be made available to the public for 3 years.

The facility is complying for a (Large Family Child Care Home) with Title 22 Regulations at the time of inspection, in the event additional requirements are needed, Licensee will be notified.

Appeal rights were presented and Exit interview was conducted with the Licensee Ms. Ramirez Fani

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2021

LIC809 (FAS) - (06/04)

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