304313550-7-28-2021-06-CC-ECOL-C5CQZ4-20210728123606

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304313550
Report Date: 07/28/2021
Date Signed: 07/28/2021 12:36:13 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:	HURTADO, MARIA DEL CARMEN		FACILITY NUMBER:	304313550
ADMINISTRATOR:	HURTADO, MARIA DEL CARMEN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(714) 654-9485
CITY:	TUSTIN	STATE: CA	ZIP CODE:	92780
CAPACITY:	14	CENSUS: 7	DATE:	07/28/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Licensee - Maria Del Carmen Hurtado		TIME COMPLETED:	12:50 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	An Annual Random inspection was conducted at the facility by Licensing Program Analyst (LPA) Corral. LPA Corral reviewed COVID-19 Prescreening Questionnaire prior to entering the Facility. LPA Corral observed Licensee Maria and Assistant Liliana Algaranaz caring for 7 children which included 1 infant, 4 preschool age children and 2 school age children in day care area. Five of the children present in care are the licensee's grandchildren. LPA Corral observed children having lunch during inspection. Licensee was operating within the licensed capacity as specified on license. Due to COVID 19 guidelines, LPA observed staff wearing face mask, social distancing and following CDC and Dept of Public Health Guidelines.A review of the Facility Personnel Report Summary on 07/27/2021 indicates all facility residents, staff, or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. There are currently 3 adults living in the home which includes Licensee, Adult Daughter and Son in Law and 2 minor children. Facility Day care hours are 6am - 6pm, Monday through Friday. During today’s inspection, LPA Corral toured the inside and outside areas of the facility that are accessible to children in care. The home is a 3 bedroom, 2 bathroom single story home. The off limits areas of the home are the Master Bedroom and the Master Bathroom which are located down the hallway to the left and another bedroom is also off limits which is located down the hallway to the right. The rooms are made inaccessible by means of lock and key and also a children safety door knob. The living room located to the left of the main entrance is also off limits to children in care and is made inaccessible by means of a child safety gate. The child care area consist of the dining room and the kitchen which are right off the main entrance, the play room which is accessible through the kitchen and the back yard which is accessible through the play room. The children walk through the hallway to use the restroom that is located straight down the hallway. The children also have access to the first bedroom off the hallway to the right, that room is used for napping. The home has a working carbon monoxide, smoke detector, and fire extinguishers which meets Statutory and State Fire Marshall standards. Continue to Page 2.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Eileen Corral	TELEPHONE: (714) 743-8354
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2021

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: HURTADO, MARIA DEL CARMEN	FACILITY NUMBER: 304313550
	VISIT DATE: 07/28/2021

NARRATIVE

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Detergents, cleaning compounds, medicines, and other items which could pose a danger if readily available to children were stored inaccessible to children and are stored above 5 ft high in a kitchen cabinet. Licensee stated there are no firearms and/or other dangerous weapons in the facility and none were observed during today's inspections. There is a fireplace located in the living room which is screened by metal glass cover and inaccessible to children in care by the children gate located in the entrance of the living room. The home has age appropriate toys and books for the ages served. During today’s inspection LPA observed children playing in the play room and in the backyard with Assistant Liliana, children were also observed eating in the kitchen. LPA verified there is a working telephone service via home land line and Licensee's cell phone. Licensee stated they do use outdoor play area and play time was observed to be supervised by Assistant Liliana, the back yard was also gated. There were no poisons or other items observed which could pose a danger to children or if they were observed, they were locked or inaccessible. There are no bodies of water on the premises.

The licensee does have a current roster of children in care. Licensee conducted a Fire Drill on 06/25/2021. Licensee does not have infants below the age of 12 months old enrolled in care. The Licensee and Assistant Liliana Algaranaz Pediatric CPR/First Aid certification expire on 04/25/2023. 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 influenza, pertussis and measles for Licensee and Assistant were 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. Licensee and Assistant completed Mandated Reporter Training on 10/13/2020.

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
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SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Eileen Corral	TELEPHONE: (714) 743-8354
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2021

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: HURTADO, MARIA DEL CARMEN	FACILITY NUMBER: 304313550
	VISIT DATE: 07/28/2021

NARRATIVE

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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.
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 also provided 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 to review the Provider Information Notices (PIN) found on the CCLD website. The following was provided and explained to Licensee, A copy of the California Department of Social Services Lead Information Brochure. A copy of the 2016 “A Child Care Providers Guide to Safe Sleep”.

The following electronic links were also provided:
Spanish: https//www.cdph.ca.gov/programs/SIDS/Documents/ChildCareProvSleepSPAN2011.pdfhttps://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
Licensee was provided A copy of the Provider Information Notice (PIN) 20-06-CCP Social and Physical Distancing Guidance. 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.
Continue to Page 4.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Eileen Corral	TELEPHONE: (714) 743-8354
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2021

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: HURTADO, MARIA DEL CARMEN	FACILITY NUMBER: 304313550
	VISIT DATE: 07/28/2021

NARRATIVE

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An exit interview was conducted with Licensee Maria Del Carmen Hurtado in Spanish. Appeal Rights were explained. The Licensee was provided a copy of Appeal Rights and signature on this form acknowledges receipt of these rights. Licensee was informed, 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 Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Eileen Corral	TELEPHONE: (714) 743-8354
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2021

LIC809 (FAS) - (06/04)

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