334845179-10-23-2019-09-CC-DHOE-BH8NBJ-20191023101912

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334845179
Report Date: 10/23/2019
Date Signed: 10/23/2019 10:19:25 AM

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:	ORTIZ FAMILY CHILD CARE		FACILITY NUMBER:	334845179
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 5	DATE:	10/23/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:52 AM
MET WITH:	Chelsey Ortiz, Licensee		TIME COMPLETED:	10:30 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	On 10/23/19 at 8:52am, Licensing Program Analyst (LPA) Destinee Hogue arrived at the facility to conduct an unannounced inspection. Licensee Chelsey Ortiz has applied to increase her capacity to a Large Family Child Care Home. Present during this inspection were LPA Hogue, Licensee Chelsey Ortiz, Spouse Orlando Ortiz and five daycare children. LPA toured the facility inside and out, reviewed records and observed the following: · Normal days and hours of operation are: Monday-Friday, 6:30am to 5:30pm · OFF-LIMIT AREAS INCLUDE: Second floor, laundry, garage, and dog run (side of backyard) · Fire extinguisher, smoke detector and carbon monoxide detector are present and were tested by the Licensee during this inspection. · All hazardous items are inaccessible to daycare children. · Toxins and poisons are locked. · No guns or weapons present as of this date. LICENSEE UNDERSTANDS ALL GUNS, WEAPONS AND AMMUNITION MUST BE KEY-LOCKED SEPARATELY AND MADE INACCESSIBLE PER TITLE 22 REGULATIONS. · Stairs are properly barricaded · Fireplace is screened · Verification of control of property on file (Tax bill) · Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights forms are posted · Pediatric CPR and First Aid Card expires 1/6/2020 · Health & Safety Certificate completed 7/22/18 · AB1207 Mandated Child Abuse Reporter training completed 1/20/18 · There are no bodies of water as of this date. Licensee understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2019

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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ORTIZ FAMILY CHILD CARE	FACILITY NUMBER: 334845179
	VISIT DATE: 10/23/2019

NARRATIVE

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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.
· Clean, safe and age appropriate toys are present at the facility.
· There are no toxic plants observed at this time.
· Current roster on file
· Documentation of fire drills on file. Last emergency drill conducted 9/27/19
· Children’s records are complete
· There are no employees currently working at the facility.
· 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.
· 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 10/23/19 indicate that all adults who require caregiver
background checks have received all required clearances or exemptions.
· 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.
· 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 provided Licensee with Provider Information Notice (PIN) 19-12-CCP U.S. Consumer Product

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2019

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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ORTIZ FAMILY CHILD CARE	FACILITY NUMBER: 334845179
	VISIT DATE: 10/23/2019

NARRATIVE

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Safety Commission Infant Sleeper Recall
· 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-Risk-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):
- Effective July 1, 2017 – AB2231 (2016) – Increased Civil Penalties - For failing to correct a violation the civil penalty is increased to $100 per day for EACH violation until corrected; For failing to correct a repeated violation the civil penalty is increased to $250 immediately assessed , and $100 per day afterwards for EACH repeated violation until corrected; For an Immediate Risk violation the civil penalty is increased to $500 immediately assess, and $100 per day for EACH violation after that until corrected; For any repeated Immediate Risk violations the civil penalty is increased to $1,000 immediately assess, and $100 per day afterwards for EACH repeated violation until corrected. NOTE: Repeat violations are defined as a violation of a previously cited statutory or regulatory Section and/or subsection within 12 months prior.
- Effective January 1, 2019 - AB2370 - Lead Poisoning – providers are required to provide a lead toxicity prevention handout to parents/guardians of newly enrolled and newly reenrolled children with information on risks and effects of lead poisoning; blood lead testing recommendations and requirements; and options for obtaining blood lead testing, including free and/or discounted testing. There will be a training component of this added to the Preventative Health Training beginning July 1, 2020.
- Effective January 1, 2016 - SB 277 – Immunizations, Personal Beliefs Exemption. Definition of SB277 on LIC809 Facility Evaluation Report dated 9/4/18.
- Effective January 1, 2016 - AB290 – Child Nutrition - Definition of AB290 on LIC809 Facility

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2019

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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ORTIZ FAMILY CHILD CARE	FACILITY NUMBER: 334845179
	VISIT DATE: 10/23/2019

NARRATIVE

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Evaluation Report dated 9/4/18.
- Effective September 1, 2016 - SB792 – Immunization requirements for staff & volunteers. Definition of SB792 on LIC809 Facility Evaluation Report dated 9/4/18.
- Effective January 1, 2018 - AB1207 – Mandated Child Abuse Reporting: Child Day Care Personnel Training. Definition of AB1207 on LIC809 Facility Evaluation Report dated 9/4/18.
- 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

Responsibilities of a Licensee:
- Know the regulations for anyone providing care
- Inaccessibility of hazards must be constantly reassessed
- Current facility’s phone numbers must be on file at all times.
- Failure to meet posting requirements shall result in an immediate $100 civil penalty.
- Document and conduct fire & earthquake drills every six months
- Responsible for being a mandated reporter and updating AB1207 certificate every two years
- Baby walkers, bouncy seats, exersaucers and other similar items are prohibited
- The applicant is urged 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
- Access to forms & Regulations for Family Child Care online at www.ccld.ca.gov.
- Licensee stated she is signed up to receive quarterly updates from the Child Care Advocate Program
- Duty Officer is available to answer questions Monday – Friday (8:00am-5:00pm) at 1-844-LET-US-NO (1-844-538-8766) or (951)782-4200.

During the exit interview, the Licensee Chelsey Ortiz 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: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2019

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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ORTIZ FAMILY CHILD CARE	FACILITY NUMBER: 334845179
	VISIT DATE: 10/23/2019

NARRATIVE

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A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS.

The application for a Large Family Child Care Home will be submitted for approval with a maximum capacity of 12, or 14 with parent notification.

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: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2019

LIC809 (FAS) - (06/04)

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