364830506-8-30-2024-09-CC-RMOD-D8MPMM-20240830112634

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364830506
Report Date: 08/30/2024
Date Signed: 08/30/2024 11:26:48 AM

Document Has Been Signed on 08/30/2024 11:26 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	PEREZ FAMILY CHILD CARE		FACILITY NUMBER:	364830506
ADMINISTRATOR:	PEREZ MICHELLE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(909) 792-8318
CITY:	REDLANDS	STATE: CA	ZIP CODE:	92374
CAPACITY:	14	CENSUS: 2	DATE:	08/30/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Elizabeth Deling, Licensee's Assistant		TIME COMPLETED:	11:30 AM

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On 08/30/2024 at 09:15 AM, Licensing Program Analyst (LPA) Raymond Moorehead arrived at the facility to conduct a required/annual inspection as part of a compliance review. Upon arrival, LPA was greeted and granted access to the facility by Licensee's Assistant Elizabeth Deling. 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: Monday through Friday from 5:00 AM to 8:00 PM

OFF-LIMIT AREAS INCLUDE: The garage, Master Bedroom, bedrooms 1, 2, and 3. The side yard on the west side of the home is also off-limits. (LPA observed that Licensee's backyard is temporarily off-limits as Licensee's spouse is re-doing the grass. Licensee's spouse is working on the grass to prevent gophers.)

The facility is operating within the licensed capacity and appropriate ratios.

· Appropriate supervision was provided during this inspection.

· A working telephone is present and is the current number on file.

· Appropriate fire extinguisher, smoke detector and carbon monoxide detector were present and tested during this inspection.

· Fireplace is properly screened to prevent access by children.

· All hazardous items are stored inaccessible to children.

· Toxins are locked.

· Weapons are present/stored in the home properly, according to Title 22 Regulations. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 Regulations

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Raymond Moorehead	TELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024

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

FACILITY NAME: PEREZ FAMILY CHILD CARE	FACILITY NUMBER: 364830506
	VISIT DATE: 08/30/2024

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· Stairs are not present in the home.

· Verification of control of property is on file.

· Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights posters are posted.

· Mandated Reporter Training Certificate expires on 03/17/2026 (Licensee) and on 05/16/2026 (Licensee's Assistant)

· Pediatric CPR and First Aid Card expires on 02/24/2025 (Licensee and Licensee's Assistant)

· Health & Safety Certificate - completed on 06/2007

· No bodies of water are present 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.

· Clean, safe and age-appropriate toys were observed at the time of the visit.

· Current roster is on file.

· Documentation of fire and disaster drills are on file – Last drill was conducted on 08/14/2024

· Children’s records are complete.

· Employee’s records are complete.

· The Licensee's Assistant was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov

· Resident and/or staff records reviewed on 08/30/2024 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

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Raymond Moorehead	TELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024

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

FACILITY NAME: PEREZ FAMILY CHILD CARE	FACILITY NUMBER: 364830506
	VISIT DATE: 08/30/2024

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- LPA discussed the safe sleep regulations with licensee's assistant 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's assistant 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: http://www.ada.gov/childqanda.htm

- Licensee's Assistant 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.

- 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

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Raymond Moorehead	TELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024

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

FACILITY NAME: PEREZ FAMILY CHILD CARE	FACILITY NUMBER: 364830506
	VISIT DATE: 08/30/2024

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The licensee confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

Exit interview conducted and report was reviewed with the licensee's assistant. Appeal rights were discussed and provided to the licensee. A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Please note that approximately around 10:15 AM to 10:40 AM, Licensee's Assistant stepped out of the home to take one child to school. At this time, LPA stepped out of the home as well, and waited until Licensee's Assistant returned to the home.

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Raymond Moorehead	TELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024

LIC809 (FAS) - (06/04)

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