304313723-6-5-2020-06-CC-KDEI-BQAQ2M-20200605114721

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304313723
Report Date: 06/05/2020
Date Signed: 06/05/2020 11:47:36 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:	GALVAN-SANCHEZ, OMAR & PEREZ, MARIA		FACILITY NUMBER:	304313723
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 6	DATE:	06/05/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Licensee Maria Perez		TIME COMPLETED:	10:45 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	Licensing Program Analyst (LPA) Ketki Desai conducted an unannounced Case Management - Licensee Initiated, Tele inspection via Face time, due to Pandemic situation, following the increase in capacity as requested by the Licensee. Fire clearance was approved and remains on file. LPA conducted the tele inspection with the Licensee Ms. Maria Perez who gave a tour of the home via Face time. Also present during this inspection, was Licensee’s Assistant, Mr. Galvan Omar who was providing care and supervision to six children. 1 school age and five preschool age children were present. Two of them were Licensee's children, age 10 and age 6 A current children’s roster is available and is current. A review of criminal clearance records on this date indicates adults who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. There were only 2 adult resident, 2 minor children living in the home at the time of the visit. The licensee states that 2 adults and 2 children currently live in the home. This is a single-story home with 3 bedrooms, 2 bathrooms, 2 living rooms, dining room, kitchen, patio, front and backyard. Day care activities are held in the designated living area, covered patio area where children engage indoor daily activities and backyard is utilized for outdoor activities. There is a restroom for the children which was observed to be clean. Licensee has placed child proof gates and door handles to prevent the children from entering the off-limit areas during operation hours. There are age appropriate toys and educational items available for children. Children enter through the front door, due to Covid 19, parents do not enter the facility, there is a table at the door where hand sanitizer is kept and additional posters are posted including the Visitation policy. The licensee provides food for children in care. The operating hours are from Monday to Sunday 6.00 am to 10.00 PM. Licensee also provides transportation to School age children. Care is provided to After school children.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2020

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: GALVAN-SANCHEZ, OMAR & PEREZ, MARIA	FACILITY NUMBER: 304313723
	VISIT DATE: 06/05/2020

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All areas identified on the facility sketch that children use, were inspected for safety, comfort, cleanliness, telephone service, ventilation and heating (central). The following was observed and reviewed during this inspection.

PHYSICAL PLANT
Detergents, cleaning compounds, medications, and other items which could pose a danger are inaccessible to children. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock.

Older children nap in the living area, while the younger children nap in the Play pens. Children use cots for napping, cot sheets are provided by the Licensee and linens are brought from home.
Infants napping in the play pens also have appropriate covering and linens, which are brought from home and are washed weekly by the parents.
Play room was observed to have educational, arts and crafts items along with age appropriate toys in arranged cubbies , which were accessible to children.

There is a fire place in the living area, which is secured by a locked zip tie and remains inaccessible to children. Per Licensee, it is not in use.

Out door activities are held in the backyard, which is fenced from all the sides and is free of hazards. The covered patio area is also used for table top activities and if weather is permissible children do lunch activities on the tables. Out door area was observed to clean with age appropriate toys and equipment's which were clean and free of any sharp objects.

No bodies of water was observed on the premises.

Licensee stated there are no firearms on the premises. LPA advised anytime when firearms are present, they must be locked and stored separately from the ammunition

The valve on the required 2A 10BC fire extinguisher indicates fully charged .Per State Fire Marshall standards, fire extinguishers shall be serviced annually. Smoke and carbon monoxide detectors were tested and are operable.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2020

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: GALVAN-SANCHEZ, OMAR & PEREZ, MARIA	FACILITY NUMBER: 304313723
	VISIT DATE: 06/05/2020

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The home is observed to be clean and orderly. There is heating and ventilation for safety and comfort.

The licensee states the current cell phone is used as the main contact number for the facility.

The licensee is observed to be operating within the license capacity limitations.

Licensee serves all the three meals and snacks to the children enrolled. The meals are served according to the child's presence in the facility, operating hours are from 6.00 am to 10.00 pm. Licensee stated the enrolled children have a varying schedule each day.

Children’s records were not reviewed, during this Tele inspection , per Licensee they are storied in a filing cabinet with the required documents including but not limited to, a copy of the emergency information card that contains all the information specified by regulation.

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 licensee does/does not have proof of immunization against influenza, pertussis, and measles.

The following items were also discussed with licensee during this inspection.

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 documented was conducted on January 2020.

PETS: There are no pets in the home.
POSTING REQUIREMENTS: Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are observed to be posted.
PROHIBITED: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that falls into these categories are not permitted in a family child care facility. SMOKING IS PROHIBITED IN A LICENSED FAMILY CHILD CARE HOME.

Infant Care: Licensee states that currently there are no infants enrolled.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2020

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: GALVAN-SANCHEZ, OMAR & PEREZ, MARIA	FACILITY NUMBER: 304313723
	VISIT DATE: 06/05/2020

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Incidental Medical Services (IMS):
The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS at this time. 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 how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov.

LPA consulted and explained Child Abuse Reporting, Updated Patent’s Rights Poster with Complaint Hotline information, Never Shake a Baby, Sudden Infant Death Syndrome (SIDS), and Safe Sleeping practices.

Capacity Handout (Small & Large) was emailed to the Licensee.

Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. (use LIC624B for written report). Licensees shall reveal each facility license number in all advertisements, publications, or announcements made with the intent to attract clients.

At this time, the licensee is in compliance with California Code of Regulations Title 22 for operating a Family Child Care home.
A new license for operating a Large Family Child Care Home shall be issued upon approval.

The report is being emailed to the Licensee, due to Covid 19 pandemic and LPA has requested a written acknowledgement of the report being read.
Appeal Rights were also emailed to the Licensee.
No deficiency cited during today's tele-inspection

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2020

LIC809 (FAS) - (06/04)

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