334843618-6-16-2022-10-CC-SBRR-CFFVQY-20220616163906

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334843618
Report Date: 06/16/2022
Date Signed: 06/16/2022 04:39:38 PM

Document Has Been Signed on 06/16/2022 04:39 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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	ALIPIO & GLORIA FAMILY CHILD CARE HOME		FACILITY NUMBER:	334843618
ADMINISTRATOR:	ALIPIO,GLORIA/GLORIA ZAIDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 302-8802
CITY:	MURRIETA	STATE: CA	ZIP CODE:	92563
CAPACITY:	14	CENSUS: 14	DATE:	06/16/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Licensees Gloria Alipio, Zaida Gloria and Staff 1 Crisilda Wright		TIME COMPLETED:	04:50 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

On 06/16/2022 at 8:00 AM Licensing Program Analyst (LPA) Susan Brewer, arrived unannounced at the facility to conduct an annual inspection. LPA was greeted by Licensee Gloria Alipio and Staff 1 Crisilda Wright, was granted entry into facility. LPA conducted a COVID-19 pre-screening. Licensee Zaida Gloria joined the inspection. LPA toured the facility, inside and out, reviewed records, and observed and/or discussed the following: LPA took a census of 1 resident child present. Day care children began to arrive at approximately 8:30 AM, full census listed below.

Normal days and hours of operation are: Monday- Friday, 6:00 AM to 6:30 PM

OFF-LIMIT AREAS INCLUDE: 1^st Floor closet, Garage and Entire 2^nd Floor

The inspection consisted of reviews of the following domain: Physical Plant, Care and Supervision, Records, Facility Administration, Staffing Ratio and Capacity, Personal Rights. The inspection found the facility to be in compliance in these domains, except as noted on the LIC809D. Deficiencies cited this visit.

· The facility is NOT operating within the licensed capacity and appropriate ratios on 06/16/2022. Daycare children started to arrive at 8:30 AM, census was 5 children. At 9:49 AM the census was 12 with 4 infants present; at 11:06 AM the census was 13 children present. At 11:30 AM the facility was at a capacity of 14, 5 of which are infants..

· The Licensee is present in the home and has ensured that children in care are supervised.
· When temporarily absent from the home, the Licensee shall arrange for a substitute adult to care for and supervise children.
· A working telephone is present.
· Appropriate fire extinguisher not tagged (needle in the green), 1 of 2 smoke detectors was verified to be working and the 2 carbon monoxide devices present were observed to have batteries however after testing the devices during the inspection, it was determined that the carbon monoxide devices are expired/faulty and need replacement on 06/16/2022.

SUPERVISOR'S NAME: Pauline Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022

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 11

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 STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: ALIPIO & GLORIA FAMILY CHILD CARE HOME	FACILITY NUMBER: 334843618
	VISIT DATE: 06/16/2022

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
26
27
28
29
30
31
32

· All hazardous items are NOT inaccessible, this includes detergents, cleaning compounds, medications and other items which could pose a danger to children at 9:55 AM, LPA observed hair products, dietary supplements & adult beverages on counter-top, within a child’s reach. Licensees removed in LPA's presence.
· Storage of poisons is inaccessible to children and locked
· There is a properly barricaded fireplace on 06/16/2022.
· No guns, but weapons ARE present as stated by the Licensee Zaida Gloria. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 regulations. LPA Susan Brewer, verified that the weapons are decorative samurai swords made inaccessible to daycare children on 06/16/2022.
· Stairs are barricaded on 06/16/2022.
· Home is clean and orderly, with heating and ventilation for safety and comfort
· Safe and appropriate toys and equipment are present for both indoor and outdoor activities.
· Outdoor play areas are fenced and/ or appropriate supervision is present
· Verification of control of property verified by Grant Deed dated 06/19/2015, and on file.
· Pediatric CPR and 1st Aid training completed 02/26/2022; Cards expire on 02/2024 for both Co-Licensees.
· Health & Safety Certificate – Licensees Zaida Gloria and Gloria Alipio, completed on 09/13/2015.
· Mandated reporter: General: NOT ON FILE for Licensees or Staff; Child Care Expires: 01/27/2021
· Fire clearance: 05/31/2022
· Documentation of fire & earthquake drills to be conducted every six months: Last drill on 06/16/2021 at 10:30 AM, lasted 5 minutes with 12 children present and 4 adults.
· There are no bodies of water on 06/16/2022. Licensees Gloria Alipio and Zaida Gloria, understand 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.
· Children’s files are NOT complete on 06/16/2022, referenced on Confidential names list are missing: 5 Infant children #1, 2, 3, 6 and 11 present, were missing LIC6227 Infant Safe Sleep Plans and Sleep Logs; 5 of 14 children #1, 2, 7, 9 and 11 present, were missing all required enrollment documents
8 of 14 children #1, 2, 7. 9 and 11 present, were missing the LIC627 Medical Consent Forms, 3 children had the incorrect forms for Elderly Residential Facilities; 5 of 15 children #1, 2, 7, 9 and 11 present, missing the LIC700 Emergency Information form; 7 of 14 children #1, 2, 4, 7, 8, 9 and 11 present, were missing proof of immunization records; 5 of 14 children #1, 2, 7, 9 and 11 present, missing LIC995A Parents Rights forms.

SUPERVISOR'S NAME: Pauline Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022

LIC809 (FAS) - (06/04)

Page: 2 of 11

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 STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: ALIPIO & GLORIA FAMILY CHILD CARE HOME	FACILITY NUMBER: 334843618
	VISIT DATE: 06/16/2022

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
26
27
28
29
30
31
32

Staff files are NOT complete: LPA Susan Brewer’s review of staff records revealed that S1 failed to complete the Mandated Reporter Training, which was due by 09/22/2021 as documented on 09/08/2021 Facility Evaluation Report.

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.

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

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA Susan Brewer, discussed the safe sleep regulations with licensee Zaida Gloria, and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/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.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

SUPERVISOR'S NAME: Pauline Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022

LIC809 (FAS) - (06/04)

Page: 3 of 11

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 STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: ALIPIO & GLORIA FAMILY CHILD CARE HOME	FACILITY NUMBER: 334843618
	VISIT DATE: 06/16/2022

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
26
27
28
29
30
31
32

See LIC809D for cited deficiencies: 1 Type A citation and 2 Type B citations.

LPA Susan Brewer, informed licensee Zaida Gloria and Gloria Alipio, that this report dated 06/16/2022 document(s) 1 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, LPA Susan Brewer, informed the licensee Zaida Gloria and Gloria Alipio, to provide a copy of this licensing report dated 06/16/2021 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.

No Civil Penalty has been assessed during this inspection.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted, report was reviewed and a copy was left with the licensees Zaida Gloria and Gloria Alipio.

SUPERVISOR'S NAME: Pauline Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022

LIC809 (FAS) - (06/04)

Page: 4 of 11

Document Has Been Signed on 06/16/2022 04:39 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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: ALIPIO & GLORIA FAMILY CHILD CARE HOME	FACILITY NUMBER: 334843618
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/16/2022

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
1 2 3 4	Based on LPA Susan Brewer, review of facility and staff records, the licensees Gloria Alipio and Zaida Gloria, did not comply with the section cited above in the licensees failed to renew the Mandated Reporter Training which expired on 01/27/2021 and Staff 1 Crisila Wright, failed complete the Mandated Reporter Training, a repeat the violation issued on 09/08/2021 facility evaluation report, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/30/2022
	Plan of Correction
1 2 3 4	The licensees Gloria Alipio, Zaida Gloria, agree to complete the required training Child Abuse Mandated Reporter training and ensure that hired staff complete the training on or before 06/30/2022 and submit the certificates of completion for the General and AB1207 Child Care Provider trainings, to community care licensing on or before 06/30/2022, by fax, mail or e-mail.

Type B

Section Cited

CCR

102417(g)(7)

Operation of A Family Child Care Home

(7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA Susan Brewer's, review of children's records on 06/16/2022 the licensees Glorea Alipio and Zaida Gloria, did not comply with the section cited above, where 5 of 15 children #1, 2, 7, 9 and 11 present, were missing the LIC700 Emergency Information form which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/20/2022
	Plan of Correction
1 2 3 4	The licensee Zaida Gloria, agrees to obtain the missing LIC700 Emergency Information forms, and ensure the completion of the LIC700 for the referenced 5 of 15 children #1, 2, 7, 9 and 11 present, and will submit a written statement of understanding the regulation, with a plan to ensure the all children's files are maintained for completion and submit proof to community care licensing by provided by fax, mail or e-mail on, or before 06/20/2022

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: Pauline Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022

LIC809 (FAS) - (06/04)

Page: 5 of 11

Document Has Been Signed on 06/16/2022 04:39 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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: ALIPIO & GLORIA FAMILY CHILD CARE HOME	FACILITY NUMBER: 334843618
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/16/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102416.5(d)(2)

102416.5 (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 (2) More than twelve and up to fourteen children only if the criteria in Section 1597.465 of the Health and Safety Code are met. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA Susan Brewer observation during the annual inspection, a census conducted and review of children's records, the licensees Gloria Alipio and Zaida Gloria did not comply with the section cited above in 5 of 14 day care children present C1, C2, C3, C6 and C11 on confidential names list are infants under age 24 months, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 06/17/2022
	Plan of Correction
1 2 3 4	The licensee Zaida Gloria and Gloria Alipio, stated that a lot of the children are drop ins and will not be present on 06/17/2022, with only 8 children over 2 years old and 4 infants. The licensee agrees to submit a written statement of understanding the Title 22 regulation 102416.5(d)(2)for ratio and capacity and will submit the statement and plan of how to remain in compliance by the close of business day 06/17/2022, by mail, e-mail or fax to community care licensing.

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: Pauline Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Susan Brewer	TELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022

LIC809 (FAS) - (06/04)

Page: 11 of 11