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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334842510
Report Date: 07/23/2019
Date Signed: 07/23/2019 01:13:55 PM

COMPREHENSIVE INSPECTION
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:ZAMORA FAMILY CHILD CAREFACILITY NUMBER:
334842510
ADMINISTRATOR:ZAMORA, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 391-9698
CITY:COACHELLASTATE: CAZIP CODE:
92236
CAPACITY:14CENSUS: 3DATE:
07/23/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Maria ZamoraTIME COMPLETED:
01:25 PM
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On date and time listed, Licensing Program Analysts (LPAs) Ana Noble, Ericka Smith and Alaina Wilburn arrived at the facility to conduct an annual inspection. LPA toured the facility, inside and out, records were reviewed and the following was observed and/or discussed:
Normal days and hours of operation are: Sunday, Monday, and Thursday-Saturday 5:30 am-3:00 p.m.
OFF-LIMIT AREAS INCLUDE: 3 Bedroom, Masterbath, and garage. Licensee understands that visual supervision is needed when children are outside.
· The licensee is present in the home and ensures that children in care are supervised at all times
· The licensee is operating within the licensed capacity and ratios
· Fire extinguishers, smoke detectors, and carbon monoxide detectors meet State Fire Marshall standards and were tested by the applicant during this inspection.
· No Fireplaces and open face heaters are screened to prevent access by children
· Single store home
· Storage areas for poisons, detergents, cleaning compounds, medications and other items which could pose a danger to children are stored where they are inaccessible to children-In backyard there was a rotary tiller and in kitchen upper cabinet several cutting knives within reach of tallest child in care.
· All poisons are locked
· Storage areas for firearms and other dangerous weapons are inaccessible to children, and locked
· Ammunition is stored and locked separately from weapon(s) LICENSEE UNDERSTANDS ALL GUNS, WEAPONS AND AMMUNITION MUST BE KEY-LOCKED SEPARATELY AND MADE INACCESSIBLE PER TITLE 22 REGULATIONS.
· The home is kept clean and orderly, with heating and ventilation for safety and comfort
· Each child has safe, healthful, and comfortable accommodations, furnishings, and equipment
· The home provides safe toys, play equipment, and materials
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Ana NobleTELEPHONE: (951) 782-3278
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: ZAMORA FAMILY CHILD CARE
FACILITY NUMBER: 334842510
VISIT DATE: 07/23/2019
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· All pools, spas, hot tubs, fish ponds, or similar bodies of water are made inaccessible to children by covering or fencing as specified by regulation. 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 when not in use.
· The home has a current roster of children was incomplete missing dates of birth of children.
· The home conducts fire and disaster drills at least once every six months, and documents the date and time of each drill 7/1/2019
· Licensee documents immunizations and maintains and updates records for children in care
· Licensee provides the child's parent or representative with a copy of the Family Child Care Home Notification of Parents' Rights
· The licensee and other personnel, as specified, have completed training on preventive health practices which was completed; including pediatric CPR and First Aid which expires 10/2020.
· The licensee was asked to provide information in regard to having an association to any licensed community care facility. The licensee states she is not associated to any licensed facility
· Criminal record clearances are required prior to all adults living or working in a Family Child Care Home. A civil penalty of $100.00 per day the person has been present, may be assessed. Resident and/or staff records reviewed on 7/22/19 indicate that all adults who require caregiver background checks have received all required clearances or exemptions.
· The licensee understands that upon notice of the Department to remove an individual from the home, pursuant to H&S Code 1596.871(c)(2), or to exclude an individual from the home, pursuant to H&S Code 1596.8897, the licensee immediately removes the individual and prevents them from returning to the home or having contact with children in care
· Children are not left in parked vehicles and the licensee understands that this is prohibited
· The licensee understands that any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advance notice
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Ana NobleTELEPHONE: (951) 782-3278
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019
LIC809 (FAS) - (06/04)
Page: 2 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: ZAMORA FAMILY CHILD CARE
FACILITY NUMBER: 334842510
VISIT DATE: 07/23/2019
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· Facility is not currently providing IMS 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
· For more information on SIDS and Safe Sleep Environments, please visit:
California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Rick-of-SIDS-in-Early-Education-and-Child-Care
And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep
The following was reviewed with the licensee(s):
- AB 2084 - Nutritious Beverages in Child Care Facilities effective January 1, 2012
- AB 1819 – Smoking prohibition on the premises of Family Child Care Homes, effective January 1, 2015
- AB 2621 – Public information posted on the internet, effective January 1, 2015
- AB 2386 – Carbon Monoxide Detector Regulations, effective January 1, 2015
- AB 2236 – Civil Penalties, effective July 1, 2015
- SB 277 – Immunizations, Personal Beliefs Exemption, effective January 1, 2016
- AB290 – Child Nutrition, effective January 1, 2016
- SB792 – Immunization requirements for staff, volunteers, effective September 1, 2016
- AB2231 (2016) – Increased Civil Penalties, effective July 1, 2017
NOTE: Repeat violations are defined as a violation of a previously cited statutory or regulatory Section and/or subsection within 12 months prior.
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Ana NobleTELEPHONE: (951) 782-3278
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019
LIC809 (FAS) - (06/04)
Page: 3 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: ZAMORA FAMILY CHILD CARE
FACILITY NUMBER: 334842510
VISIT DATE: 07/23/2019
NARRATIVE
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- Effective January 1, 2017 – Children under 2 years of age shall ride in a rear-facing car seat unless the child weighs 40 or more pounds OR is 40 or more inches tall. For additional information regarding car seat laws see www.chp.ca.gov
- Access to forms & Regulations for Family Child Care Homes online at www.ccld.ca.gov
- Responsibility to know the regulations for anyone providing care
- Inaccessibility of hazards must be constantly reassessed depending on the children in care
- Current facility’s phone numbers must be on file at all times.
- Failure to meet the posting requirements shall result in an immediate $100 civil penalty.
- Documentation of fire & earthquake drills to be conducted every six months
- Responsibilities of being a mandated reporter
- Baby walkers, bouncy seats, exersaucers and other similar items are prohibited
- The applicant is urged to visit the U.S. Consumer Product Safety Commission webpage at www.cpsc.gov to ensure that equipment purchased for the day care has not been recalled
- Once licensed, the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809/LIC9099) must also be posted for 30 days. A civil penalty of $100 per violation will be assessed for noncompliance.
- Access to forms & Regulations for Family Child Care online at www.ccld.ca.gov.
- Please subscribe at childcareadvocatesprogram@dss.ca.gov to receive Department updates. They will be sent directly to your e-mail account once you have set up an account. This website can also be accessed through www.ccld.ca.gov
vPlease completed Mandated Reporter Training at the following link: http://mandatedreporterca.com/
- The Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).

See LIC809D for cited deficiency. Appeal rights discussed and a copy of this report was provided to the licensee on this date.

During the exit interview, the LICENSEE, Ms. Zamora, confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Ana NobleTELEPHONE: (951) 782-3278
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019
LIC809 (FAS) - (06/04)
Page: 4 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: ZAMORA FAMILY CHILD CARE
FACILITY NUMBER: 334842510
VISIT DATE: 07/23/2019
NARRATIVE
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As a REMINDER: when your child(ren) turn 18 years of age, you MUST SUBMIT an updated LIC279, LIC508 and TB Screen and have your child submit for LIVESCAN background clearance. This also applies to any adult PRIOR to them moving into the home or who currently lives in the home. Also, PRIOR to employment of any adult, you must submit the LIC508, TB screening and obtain a background clearance through LIVESCAN.

A NOTICE OF SITE VISIT WAS ISSUED AND IS TO BE POSTED IN A PROMINENT LOCATION AT THE FACILITY FOR THE NEXT 30 DAYS ALONG WITH A COPY OF ALL TYPE A DEFICIENCIES (LIC9099D) CITED DURING THIS INSPECTION. A COPY OF ALL TYPE A DEFICIENCIES CITED DURING THIS INSPECTION MUST ALSO BE IMMEDIATELY (WITHIN 24 HOURS OF THE CHILD’S NEXT DAY IN CARE) GIVEN TO THE PARENTS OF ALL CHILDREN ENROLLED IN THE CHILD CARE FACILITY AND ANY CHILDREN ENROLLED INTO THE CHILD CARE FACILITY OVER THE NEXT 12 MONTHS (AT THE TIME OF ENROLLMENT). A copy of this report was provided to the licensee on this date and must be made available to the public upon request for the next 3 years.
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Ana NobleTELEPHONE: (951) 782-3278
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019
LIC809 (FAS) - (06/04)
Page: 5 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ZAMORA FAMILY CHILD CARE
FACILITY NUMBER: 334842510
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/23/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/29/2019
Section Cited
CCR
102417(g)(4)
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Operation of a Family Child Care Home. 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 requirements of was met by evidence of: In the backyard there >>>>>>>>>>>>>>>>>>>>>>>>>>>
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Licensee agrees to remove all items make inaccessible and submit a picture showing items removed to the Dept. by 7/29/2019.

>>>>was a rotary tiller and in an upper kitchen cabinet were several cutting knives accessible to the tallest child in care. This is an immediate risk to children in care.
Type B
08/02/2019
Section Cited
CCR
102417(g)(8)
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Operation of a Family Child Care Home. Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement was not met by evidence of: The current roster did not have children date of birth listed during inspection. This is a potential risk.
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Licensee corrected during inspection.
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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: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Ana NobleTELEPHONE: (951) 782-3278
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019
LIC809 (FAS) - (06/04)
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