364830506-5-16-2023-09-CC-RMOD-CRVRD3-20230516125516

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364830506
Report Date: 05/16/2023
Date Signed: 05/16/2023 12:55:35 PM

Document Has Been Signed on 05/16/2023 12:55 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:	PEREZ FAMILY CHILD CARE		FACILITY NUMBER:	364830506
ADMINISTRATOR:	PEREZ EDITH MICHELLE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(909) 792-8318
CITY:	REDLANDS	STATE: CA	ZIP CODE:	92374
CAPACITY:	14	CENSUS: 1	DATE:	05/16/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Edith Perez, Licensee		TIME COMPLETED:	01:00 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 05/16/2023 at 09:25 AM Licensing Program Analysts (LPAs) Raymond Moorehead and Susan Brewer arrived at the facility to conduct an annual inspection. LPAs were greeted by Licensee Edith Michelle Perez and granted entry to tour the facility inside and out. LPAs reviewed records and observed and/or discussed the following: Days and hours have changed, forms to be updated are: LIC 200A, LIC 610A, and LIC 999A (home and yard sketch. These forms are to be updated on or before June 16^th, 2023. Normal days and hours of operation are Monday- Friday, 5:00 AM to 8:00 PM OFF-LIMIT AREAS INCLUDE: The garage, Master Bed/Back, bedrooms 1, 2, and 3. The side yard on the west side of the home is also off-limits. 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. Deficiencies were not cited this visit. · The facility is operating within the licensed capacity and appropriate ratios · 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 type 2A:10BC, smoke detector and carbon monoxide detector are present and were tested by the Licensee during this inspection. · All hazardous items are inaccessible, this includes detergents, cleaning compounds, medications and other items which could pose a danger to children.

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Raymond Moorehead	TELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2023

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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: PEREZ FAMILY CHILD CARE	FACILITY NUMBER: 364830506
	VISIT DATE: 05/16/2023

NARRATIVE

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·Storage of poisons is inaccessible to children and locked
· There is a properly barricaded fire place
· A gun is present as stated by the Edith Michelle Perez. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 regulations. LPAs inspected the weapon and ammunition to be in compliance per Title 22 regulations.
· The home has no stairs
· Home is clean and orderly, with heating and ventilation for safety and comfort
· Clean, Safe and age-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 on file
· Property owner/landlord notification and consent on file (if renting or leasing home)
· Pediatric CPR and First Aid Card expires on 02/2025
· Health & Safety Certificate - completed on 06/2007 Lead & Nutrition (not on file)
· Mandated reporter General: 02/2022 AB 1207 Child Care Expires: 02/2024
· Fire clearance: 05/19/2009
· Documentation of fire & earthquake drills to be conducted every six months: Last drill on 03/30/2023.
· There are 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.
· Children’s files are complete 05/16/2023
· Staff’s files are complete 05/16/2023

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.

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Raymond Moorehead	TELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2023

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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: PEREZ FAMILY CHILD CARE	FACILITY NUMBER: 364830506
	VISIT DATE: 05/16/2023

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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 Edith Michelle Perez 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.

LPAs Susan Brewer and Raymond Moorehead, discussed the safe sleep regulations with licensee Edith Michelle Perez 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. LPAs 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.

No citations or civil penalties have been assessed.

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

Exit interview conducted and report was reviewed with the licensee Edith Michelle Perez.

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Raymond Moorehead	TELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2023

LIC809 (FAS) - (06/04)

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