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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
334841590
Report Date:
11/28/2023
Date Signed:
11/28/2023 05:58:00 PM
Document Has Been Signed on
11/28/2023 05:58 PM
- It Cannot Be Edited
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD
,
3737 MAIN ST., SUITE 700
RIVERSIDE
,
CA
92501
FACILITY NAME:
LOPEZ FAMILY CHILD CARE
FACILITY NUMBER:
334841590
ADMINISTRATOR:
LOPEZ, ROSARIO
FACILITY TYPE:
810
ADDRESS:
TELEPHONE:
(951) 722-7920
CITY:
BANNING
STATE:
CA
ZIP CODE:
92220
CAPACITY:
14
CENSUS:
10
DATE:
11/28/2023
TYPE OF VISIT:
Required - 3 Year
UNANNOUNCED
TIME BEGAN:
12:57 PM
MET WITH:
Licensee Rosario Lopez
TIME COMPLETED:
06:15 PM
NARRATIVE
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On date and time listed, Licensing Program Analysts (LPAs) Perla Ordones and Samuel Lopez arrived at the facility to conduct a required/annual inspection as part of a compliance review. LPAs toured the facility, inside and out, records were reviewed, and the following was observed and/or discussed:
Normal days and hours of operation are: Monday – Sunday; 24 hours a day.
OFF-LIMIT AREAS INCLUDE: Garage, laundry room, and bedrooms assigned to Provider’s children.
The facility is not operating within the licensed capacity and appropriate ratios. During facility tour, LPAs observed 10 day-care children present, five of whom were infants, which is a violation of regulations.
·
During facility tour, LPAs observed a day-care child approach the propped open front door of the home and investigate the secondary front screen door. Day-care child proceeded to open the front screen door of the facility and peek outside the home. LPAs then observed day-care child close the screen door and return inside.
·
During visit, LPAs observed two day-care children in highchairs for approximately 10 minutes without food. Additionally, LPAs observed one of the two day-care children fall asleep in the high chair and was not moved for approximately 10 minutes.
·
A working telephone is present and current number on file.
·
Appropriate fire extinguisher, smoke detector and carbon monoxide detector present and were tested by the Licensee during this inspection.
·
Fireplace is properly screened to prevent access by children.
SUPERVISOR'S NAME:
Kimberly Williams
TELEPHONE:
(951) 248-0228
LICENSING EVALUATOR NAME:
Perla Ordones
TELEPHONE:
(951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE:
11/28/2023
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/28/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809
(FAS) - (06/04)
Page:
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of
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Document Has Been Signed on
11/28/2023 05:58 PM
- It Cannot Be Edited
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD
,
3737 MAIN ST., SUITE 700
RIVERSIDE
,
CA
92501
FACILITY NAME:
LOPEZ FAMILY CHILD CARE
FACILITY NUMBER:
334841590
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
11/28/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above as LPAs observed two accessible ground level citrus trees with numerous thorns in backyard of facility with daycare children playing near trees in a plastic play structure which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date:
11/29/2023
Plan of Correction
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2
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4
Licensee agrees to trim or make citrus trees inaccessible to children in care. Licensee agrees to send proof of the Plan of Correction (POC) to Community Care Licensing (CCL) by the end of the business day on the POC due date of 11/29/2023.
Type A
Section Cited
CCR
102416.5(d)(1)
Staffing Ratio and Capacity
(d) For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either: (1) Twelve children, no more than four of whom may be infants; or
This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
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Based on observation and record review, the licensee did not comply with the section cited above as LPAs observed 10 daycare children present, five of whom were infants, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date:
11/29/2023
Plan of Correction
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Licensee agrees to submit plan to ensure only four infants are cared for at once per regulations and agrees to send proof of the Plan of Correction (POC) to Community Care Licensing (CCL) by the end of the business day on the POC due date of 11/29/2023.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:
Kimberly Williams
TELEPHONE:
(951) 248-0228
LICENSING EVALUATOR NAME:
Perla Ordones
TELEPHONE:
(951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE:
11/28/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/28/2023
LIC809
(FAS) - (06/04)
Page:
2
of
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Document Has Been Signed on
11/28/2023 05:58 PM
- It Cannot Be Edited
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD
,
3737 MAIN ST., SUITE 700
RIVERSIDE
,
CA
92501
FACILITY NAME:
LOPEZ FAMILY CHILD CARE
FACILITY NUMBER:
334841590
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
11/28/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102423(a)(2)
Personal Rights
(a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above as LPAs observed two daycare children in highchairs for approximately 10 minutes without food and LPAs observed one of the two daycare children fall asleep in the high chair for approximately 10 minutes which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date:
11/29/2023
Plan of Correction
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Licensee agrees to submit a statement of agreement to ensure proper usage of high chairs and agrees to send proof of the Plan of Correction (POC) to Community Care Licensing (CCL) by the end of the business day on the POC due date of 11/29/2023.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:
Kimberly Williams
TELEPHONE:
(951) 248-0228
LICENSING EVALUATOR NAME:
Perla Ordones
TELEPHONE:
(951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE:
11/28/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/28/2023
LIC809
(FAS) - (06/04)
Page:
3
of
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Document Has Been Signed on
11/28/2023 05:58 PM
- It Cannot Be Edited
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD
,
3737 MAIN ST., SUITE 700
RIVERSIDE
,
CA
92501
FACILITY NAME:
LOPEZ FAMILY CHILD CARE
FACILITY NUMBER:
334841590
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
11/28/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on interview and record review, the licensee did not comply with the section cited above as S2 was missing proof of the Mandated Reporter Child Care Providers Training (AB1207) which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
12/12/2023
Plan of Correction
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Licensee agrees to have S2 complete the Mandated Reporter Child Care Providers Training (AB1207). Licensee agrees to send proof of S2's AB1207 certificate to Community Care Licensing (CCL) by the end of the business day on the Plan of Correction (POC) due date of 12/12/2023.
Type B
Section Cited
CCR
102416.2(a)
Reporting Requirements
(a) The licensee shall report the following information the Department by telephone or fax within the Department's next business day and during normal working hours (8am to 5pm).
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above as LPAs observed flood damage to the daycare children's bathroom which was never reported to the department which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
12/12/2023
Plan of Correction
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Licensee agrees to complete an Unsual Incident Report (UIR) in regards to the flooding incident mentioned above. Licensee agrees to submit the UIR to Community Care Licensing (CCL) by the end of the business day on the Plan of Correction (POC) due date of 12/12/2023.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:
Kimberly Williams
TELEPHONE:
(951) 248-0228
LICENSING EVALUATOR NAME:
Perla Ordones
TELEPHONE:
(951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE:
11/28/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/28/2023
LIC809
(FAS) - (06/04)
Page:
4
of
13
Document Has Been Signed on
11/28/2023 05:58 PM
- It Cannot Be Edited
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD
,
3737 MAIN ST., SUITE 700
RIVERSIDE
,
CA
92501
FACILITY NAME:
LOPEZ FAMILY CHILD CARE
FACILITY NUMBER:
334841590
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
11/28/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) 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. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above as LPAs observed that S2 was missing proof of the MMR and Pertussis immunizations which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
12/12/2023
Plan of Correction
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Licensee agrees to obtain proof of S2's MMR and Pertusiss immunzations. Licensee agrees to send proof of S2's immunizations to Community Care Licensing (CCL) by the end of the business day on the Plan of Correction (POC) due date of 12/12/2023.
Type B
Section Cited
CCR
102418(a)
Immunizations
(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the licensee did not comply with the section cited above as C5 was missing proof of immunizations which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
12/12/2023
Plan of Correction
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Licensee agrees to obtain proof of C5's required immunizations. Licensee agrees to send proof of C5's immunizations to Community Care Licensing (CCL) by the end of the business day on the Plan of Correction (POC) due date of 12/12/2023.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:
Kimberly Williams
TELEPHONE:
(951) 248-0228
LICENSING EVALUATOR NAME:
Perla Ordones
TELEPHONE:
(951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE:
11/28/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/28/2023
LIC809
(FAS) - (06/04)
Page:
5
of
13
Document Has Been Signed on
11/28/2023 05:58 PM
- It Cannot Be Edited
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD
,
3737 MAIN ST., SUITE 700
RIVERSIDE
,
CA
92501
FACILITY NAME:
LOPEZ FAMILY CHILD CARE
FACILITY NUMBER:
334841590
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
11/28/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the licensee did not comply with the section cited above as LPAs observed that C2 was missing from the roster which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
12/12/2023
Plan of Correction
1
2
3
4
Licensee agrees to update the facility roster and send proof of the updated roster to Community Care Licensing (CCL) by the end of the business day on the Plan of Correction (POC) due date of 12/12/2023.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:
Kimberly Williams
TELEPHONE:
(951) 248-0228
LICENSING EVALUATOR NAME:
Perla Ordones
TELEPHONE:
(951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE:
11/28/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/28/2023
LIC809
(FAS) - (06/04)
Page:
6
of
13
Document Has Been Signed on
11/28/2023 05:58 PM
- It Cannot Be Edited
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD
,
3737 MAIN ST., SUITE 700
RIVERSIDE
,
CA
92501
FACILITY NAME:
LOPEZ FAMILY CHILD CARE
FACILITY NUMBER:
334841590
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
11/28/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102419(d)(1)
Admission Procedures and Authorized Representatives Rights
(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). (1) The licensee shall request the child's parent or authorized representative to sign and date the bottom portion of the notice form LIC 995A (8/06), which acknowledges that the parent or
authorized representative has received and read the LIC 995A. The bottom portion of this form
must be kept in the child’s file as proof that the parent or authorized representative has been
notified of his or her rights and received a copy of the Caregiver background Check Process, LIC
995E (6/05), and the Family Child Care Consumer Awareness Information, LIC 9212 (10/05).
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above as C5 is missing proof of the completed Family Child Care Home Notification of Parent's Rights (LIC995A) which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
12/12/2023
Plan of Correction
1
2
3
4
Licensee agrees to obtain a completed LIC995A for C5 and send proof of the LIC995A to Community Care Licensing (CCL) by the end of the business day on the Plan of Correction (POC) due date of 12/12/2023.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:
Kimberly Williams
TELEPHONE:
(951) 248-0228
LICENSING EVALUATOR NAME:
Perla Ordones
TELEPHONE:
(951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE:
11/28/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/28/2023
LIC809
(FAS) - (06/04)
Page:
7
of
13
Document Has Been Signed on
11/28/2023 05:58 PM
- It Cannot Be Edited
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD
,
3737 MAIN ST., SUITE 700
RIVERSIDE
,
CA
92501
FACILITY NAME:
LOPEZ FAMILY CHILD CARE
FACILITY NUMBER:
334841590
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
11/28/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the licensee did not comply with the section cited above as C2, an infant under the age of one year old, was missing proof of the Individual Infant Sleeping Plan (LIC 9227) which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
12/12/2023
Plan of Correction
1
2
3
4
Licensee agrees to obtain a completed LIC9227 for C2 and send proof of the LIC9227 to Community Care Licensing (CCL) by the end of the business day on the Plan of Correction (POC) due date of 12/12/2023.
Type B
Section Cited
CCR
102425(j)(2)(D)(c)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the licensee did not comply with the section cited above as all infants present were missing proof of the 15 minute sleep checks which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
12/12/2023
Plan of Correction
1
2
3
4
Licensee agrees to document 15 minute sleep checks for all infants enrolled in care. Licensee agrees to send proof of the 15 minute sleep checks for all infants present during the visit to Community Care Licensing (CCL) by the end of the business day on the Plan of Correction (POC) due date of 12/12/2023.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:
Kimberly Williams
TELEPHONE:
(951) 248-0228
LICENSING EVALUATOR NAME:
Perla Ordones
TELEPHONE:
(951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE:
11/28/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/28/2023
LIC809
(FAS) - (06/04)
Page:
8
of
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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
INLAND EMPIRE CHILD
,
3737 MAIN ST., SUITE 700
RIVERSIDE
,
CA
92501
FACILITY NAME:
LOPEZ FAMILY CHILD CARE
FACILITY NUMBER:
334841590
VISIT DATE:
11/28/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
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20
21
22
23
24
25
26
27
28
29
30
31
32
· All hazardous items are stored inaccessible to children.
· Toxins are locked.
· Weapons are not present. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 Regulations
· Verification of control of property on file. (Mortgage statement)
· Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights poster are posted.
· Mandated Reporter Training completed on 11/05/2023.
· Pediatric CPR and First Aid Card expires on 09/2025.
· Health & Safety Certificate - completed on 02/25/2007.
· No bodies of water at this time. Licensee understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 Regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.
· During facility tour, LPAs observed there were two ground level citrus trees with numerous thorns in backyard of facility. Citrus trees were accessible and day-care children were playing near trees in a plastic play structure next to citrus trees.
· Clean, safe and age appropriate toys.
· Current roster not on file. During record review, LPAs observed that C2 was missing from the roster entirely.
· Documentation of fire and disaster drills on file – Last drill conducted on 10/19/2023.
· Children’s records are not complete. During record review LPAs observed that C5 was missing proof of immunizations and a completed LIC995A, C2 who is an infant under the age of one year was missing the Individual Infant Sleeping Plan (LIC9227), and all infants present were missing proof of the 15 minute sleep checks.
· Employee’s records are not complete. During record review, LPAs observed that S2 was missing proof of the Mandated Reporter Child Care Providers Training (AB1207) as well as required immunizations.
· During visit, LPAs observed flood damage to the daycare children's bathroom which was never reported to the department. LPAs were informed the incident occurred sometime in November of 2023. The Licensee was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox:
UnusualIncidentReportsDO09@dss.ca.gov
SUPERVISOR'S NAME:
Kimberly Williams
TELEPHONE:
(951) 248-0228
LICENSING EVALUATOR NAME:
Perla Ordones
TELEPHONE:
(951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE:
11/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/28/2023
LIC809
(FAS) - (06/04)
Page:
10
of
13
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD
,
3737 MAIN ST., SUITE 700
RIVERSIDE
,
CA
92501
FACILITY NAME:
LOPEZ FAMILY CHILD CARE
FACILITY NUMBER:
334841590
VISIT DATE:
11/28/2023
NARRATIVE
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· Resident and/or staff records reviewed on 11/28/2023 indicate that all adults who require caregiver background checks have received all required clearances or exemptions.
· The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at:
Associations_Disassociations862@dss.ca.gov
LPAs discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep
as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at
https://www.cpsc.gov/
and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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:
https://www.ada.gov/resources/child-care-centers/
Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.
Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
SUPERVISOR'S NAME:
Kimberly Williams
TELEPHONE:
(951) 248-0228
LICENSING EVALUATOR NAME:
Perla Ordones
TELEPHONE:
(951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE:
11/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/28/2023
LIC809
(FAS) - (06/04)
Page:
11
of
13
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD
,
3737 MAIN ST., SUITE 700
RIVERSIDE
,
CA
92501
FACILITY NAME:
LOPEZ FAMILY CHILD CARE
FACILITY NUMBER:
334841590
VISIT DATE:
11/28/2023
NARRATIVE
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at
www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process
.
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at:
https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe
and select the Child Care option to receive email communication.
The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at:
1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200
See LIC809-D for cited deficiencies.
LPAs
Perla Ordones
and
Samuel Lopez
informed licensee
Rosario Lopez
that this report dated
11/28/2023
document(s)
three
Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.
Also, LPAs
Perla Ordones
and
Samuel Lopez
informed the licensee
Rosario Lopez
to provide a copy of this licensing report dated
11/28/2023
that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME:
Kimberly Williams
TELEPHONE:
(951) 248-0228
LICENSING EVALUATOR NAME:
Perla Ordones
TELEPHONE:
(951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE:
11/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/28/2023
LIC809
(FAS) - (06/04)
Page:
12
of
13
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
INLAND EMPIRE CHILD
,
3737 MAIN ST., SUITE 700
RIVERSIDE
,
CA
92501
FACILITY NAME:
LOPEZ FAMILY CHILD CARE
FACILITY NUMBER:
334841590
VISIT DATE:
11/28/2023
NARRATIVE
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Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
During the exit interview, the LICENSEE Rosario Lopez, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
Exit interview conducted and report was reviewed with the licensee Rosario Lopez.
SUPERVISOR'S NAME:
Kimberly Williams
TELEPHONE:
(951) 248-0228
LICENSING EVALUATOR NAME:
Perla Ordones
TELEPHONE:
(951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE:
11/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/28/2023
LIC809
(FAS) - (06/04)
Page:
13
of
13