304313882-10-19-2021-06-CC-KDEI-C7XRV6-20211019132101

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304313882
Report Date: 10/19/2021
Date Signed: 10/19/2021 01:21:21 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:	YANEZ, MARIA		FACILITY NUMBER:	304313882
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 4	DATE:	10/19/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Administrator Ms. Yanez Maria		TIME COMPLETED:	01:30 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 License initiated inspection for a change in capacity at the existing Family Child Care home. LPA met with Licensee Ms. Yanez, Maria present at the home, providing care and supervision to enrolled children. At the time of inspection there was 1 infant, 1 Toddler and 2 Preschool age children, they were being served home cooked lunch by the Licensee. A review of the Facility Personnel Report Summary indicates all adults, residing in the home who require caregiver background check clearances are cleared. Currently there are five adults residing in the home and they have obtained the needed clearances. Licensee is requesting a Large family childcare home license. Per Licensee, operation hours will be Monday to Friday, 6:00AM to 6.00 PM. Licensee states that she will care for children 3 months to School age children (12). All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a two-story home that consists of four bedrooms, three bathrooms, living room, family room, dining room, kitchen, attached garage, front yard(not fenced), and fenced backyard. Licensee stated she is not currently registered with any Foster Care agency or holds a foster parent license, she was informed if any changes are to occur, Department shall be notified. 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 area inaccessible to children (side yard) (Page-1)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021

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: YANEZ, MARIA	FACILITY NUMBER: 304313882
	VISIT DATE: 10/19/2021

NARRATIVE

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Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible in areas designated for children. They are locked in a drawer with safety latches. The licensee states (that there are no poisons on the premises). Licensee 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 : Licensee has designated entire second floor, (which includes three bedrooms, two bathrooms, and attic), one bedroom (located on the first floor), garage, and front yard as the off-limit areas. Licensee has placed a child safety wooden gate at the bottom stairs leading to the second floor, ensuring these areas are inaccessible to the children in care. LPA observed all the doors have child safety knobs on it and the doors were closed. Sharp knives are located in the kitchen and inaccessible by mean of placing in a cabinet above the oven. Poisons/Hazardous items are not stored on site, and none were observed.
There is a fireplace in the day care living room with proper glass safety barrier door locked manually

Licensee understands that licensing staff may have access to off-limit areas during inspection visit if necessary.

LPA also observed COVID19, precautions at the facility, with required postings, temperature checks upon arrival, social distancing and activities being held in small groups. Licensee and the older children above age 2, were wearing masks.

Areas Designated for Day care activities: Licensee has designated the family room, living room, kitchen, dining room, one bathroom, and backyard as part of her day-care. Children shall enter the home through the front entrance, they walk through the living area the designated child care room. Most of the indoor activities are held here including napping. Dining area in the kitchen is mainly utilized during dining activities, older children are served food, on the horse show shaped table in the living area, while Infants and Toddlers use the high chairs placed across the dining room. Kitchen is open, cabinets with cleaning supplies and sharp objects have child safety latches installed.

Designated children's bathroom is next to the dining room, it was observed to be clean and safe for child use. Sink cabinet has a safety latch. (Page-2)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021

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: YANEZ, MARIA	FACILITY NUMBER: 304313882
	VISIT DATE: 10/19/2021

NARRATIVE

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The designated room for Day care activities was observed to have age appropriate furniture, toys and educational materials for children in care.

Since the Licensee is providing Infant Care, she has appropriate Infant furniture including changing table/ Crib and high chairs.

All the infant needs are provided by the parents. (Diapers/Wipes/Formula, while all bedding linens for infants are provided by the Licensee and washed daily on premises. Older children nap on the mats, linens and blankets are provided by the parents , stored in their individual cubbies and are washed on premises on a weekly basis.

OUTDOOR PLAY AREA: Backyard is designated for outdoor play area, it is fenced and has concrete and grassy area, it has age appropriate outdoor toys. There is a shaded area with table and chairs where often snacks are served, There is a caged coupe at the end of the yard where pets are present.

Per applicant, there are two bunny rabbits, they were inside the coupe when children are present. They are not accessible to children during their play time.

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.

Licensee states that she provides Breakfast/ Lunch Dinner and snacks for children in care. Food brought from the children’s homes, those containers shall be labeled with child’s name and properly stored or refrigerated. Licensee is enrolled in a Food Program: Chicano Federation: San Diego.

Licensee have completed the required Pediatric First Aid and CPR which expires 2/2022. There are first aid supplies available.

Licensee has a cell phone and an additional cell phone which is used for childcare. The additional cell phone remains on the premises during hours of operation. (Page-3)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021

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: YANEZ, MARIA	FACILITY NUMBER: 304313882
	VISIT DATE: 10/19/2021

NARRATIVE

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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.
Licensee 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 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 infant walkers, 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.

Licensee provides Infant care and following was reviewed and new PIN released in September was shared. A copy of “A Child Care Providers Guild to Safe Sleep” was provided to Licensee:

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

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021

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: YANEZ, MARIA	FACILITY NUMBER: 304313882
	VISIT DATE: 10/19/2021

NARRATIVE

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A copy of “A Child Care Providers Guild to Safe Sleep” was provided to Licensee:
English: https//www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf
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

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

OTHER INFORMATION AND FORMS PROVIDED: (Posters were emailed to the Licensee)

Capacity Handout for a Small Family Child Care Home and Large Family Child Care Home was provided.

Fire inspection from Brea Fire Prevention office have granted the fire clearance

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021

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: YANEZ, MARIA	FACILITY NUMBER: 304313882
	VISIT DATE: 10/19/2021

NARRATIVE

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Licensee does have a current roster of children in care. Four children's files were reviewed and meets the requirements. LIC 9227 was reviewed in the one infant file and meets the requirements.

. LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

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

On today’s inspection each child was observed to have a safe, healthful and comfortable accommodation furnishing and equipment’s.

An exit interview conducted with licensee. 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.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021

LIC809 (FAS) - (06/04)

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