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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364843917
Report Date: 05/08/2019
Date Signed: 05/08/2019 02:02:25 PM

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:CORTEZ FAMILY CHILD CAREFACILITY NUMBER:
364843917
ADMINISTRATOR:CORTEZ, ELAINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 471-1348
CITY:FONTANASTATE: CAZIP CODE:
92336
CAPACITY:14CENSUS: 10DATE:
05/08/2019
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:16 PM
MET WITH:Elaina Cortez TIME COMPLETED:
02:10 PM
NARRATIVE
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On 5/8/19 at 12:16pm, Licensing Program Analyst (LPA) Destinee Hogue 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 discussed:
Normal days and hours of operation are: Monday-Friday from 6:00am to 6:00pm
OFF-LIMIT AREAS INCLUDE: ENTIRE UPSTAIRS, GARAGE, and BACK LEFT SIDE OF BACKYARD.
· The Department was granted inspection authority as required by the Health and Safety Code
· 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 at this time.
    If temporarily absent from the home, the Licensee has an adult assistant who can care for and supervise children. Assistant CPR & First Aid expires 11/2019.
· A working telephone is present
· Appropriate fire extinguisher, smoke detector and carbon monoxide detector are present and tested by Licensee during this inspection.
· All hazardous items & poisons are inaccessible, locked, and stored in the kitchen pantry.
· Fireplace is properly barricaded.
· No guns or weapons present as stated by the Licensee. Licensee understands all guns, weapons and ammunition must be key-locked separately and made inaccessible per Title 22 regulations.
· Stairs are properly barricaded.
· 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.
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Destinee HogueTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019
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: CORTEZ FAMILY CHILD CARE
FACILITY NUMBER: 364843917
VISIT DATE: 05/08/2019
NARRATIVE
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· Outdoor play areas are fenced.
· Control of property on file.
· Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights poster are posted.
· Pediatric CPR and First Aid Card expire on 5/6/2020
· 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.
· Documentation of fire drills on file. Last fire drill conducted on 3/28/19.
· Each child’s file contains a copy of the emergency information card with required information.
· 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. All individuals subject to a criminal record review shall obtain a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. This was verified on 5/8/19. There are no other adults living in the home.
· Incidental Medical Services (IMS) policy was discussed. 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
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Destinee HogueTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019
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: CORTEZ FAMILY CHILD CARE
FACILITY NUMBER: 364843917
VISIT DATE: 05/08/2019
NARRATIVE
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violation the civil penalty is increased to $500 immediately assess, and $100 per day for EACH violation after that until corrected; For any repeated Zero Tolerance violation 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, 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
APPLICANT/LICENSEE RESPONSIBILITY:
- Access to forms & Regulations for Family Child Care 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 phone number must always be on file
- Failure to meet the posting requirements shall result in an immediate $100 civil penalty
- Documenting fire & earthquake drills every six months
- Responsible for being a mandated reporter
- Baby walkers, bouncy seats, exersaucers and other similar items are prohibited
- The licensee 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.
- 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 email address can also be accessed through www.ccld.ca.gov
- The Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).

See LIC809D for cited deficiencies.
Appeal rights discussed, and a copy of this report was provided to the licensee on this date.
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Destinee HogueTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019
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: CORTEZ FAMILY CHILD CARE
FACILITY NUMBER: 364843917
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/08/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/10/2019
Section Cited
HSC
1597.622
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Health & Safety Code 1597.622. Effective September 1, 2016, in accordance with California Health & Safety Code 1597.622 - A person may not be employed or volunteer at a family child care home unless he or she has been immunized against influenza (FLU), pertussis (TDAP), and measles (MMR).
This requirement is not met as evidenced by:
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Licensee has agreed to provide proof of Pertussis (TDAP/DTAP), Measles (MMR/MMVR) and Influenza (FLU) vaccinations within 30 days, on or before 06/10/2019. Licnesee can submit proof via email, fax, or text message.
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Based on a review of records, Licensee did not have a record of Staff #1 immunizations. This poses a potentional health, safety, and personal rights risk to the children in care.
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Type B
05/22/2019
Section Cited
HSC
1596.8662
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Health & Safety Code 1596.8662. Mandated Child Abuse Reporting requires all licensed providers and employees of a licensed child day care facility to complete training as specified on their mandated reporter duties and to renew their online training certificate every two (2) years.
This requirement is not met as evidenced by:
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Licensee has agreed to provide proof of Mandated Child Abuse Reporting Certificate within 14 days, on or before 05/22/2019. Training can be completed at: www.mandatedreporterca.com. Proof can be sent via email, fax, or text message.
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Licensee and all staff/assistants must complete Mandated Child Abuse Reporter Training within 14 days of today's date. This poses a potential health, safety and personal rights risk to children in care.
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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: Destinee HogueTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019
LIC809 (FAS) - (06/04)
Page: 6 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: CORTEZ FAMILY CHILD CARE
FACILITY NUMBER: 364843917
VISIT DATE: 05/08/2019
NARRATIVE
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The following was reviewed with the licensee(s):
- AB 1819 – Smoking prohibition on the premises of Family Child Care Homes, effective January 1, 2015 – This bans smoking tobacco in a home that is licensed as a family child care home, and in those areas of the family child care home where children are present. This change in law was based on demonstrated negative health effects of second and “third hand” smoke on children. Third hand smoke generally refers to the residue from tobacco smoke that sticks to surfaces after the secondhand smoke has cleared.
- 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 – Enacts new civil penalties in cases where the Department determines that a violation of licensing standards resulted in the death or serious injury or constitutes physical abuse of a child in care. The bill establishes an appeal procedure specific to these civil penalties. The bill also expands the scope of the Child Health and Safety Fund to assist parents in securing alternative child care when a Child Care Center or Family Child Care Home license has been suspended or revoked. These civil penalty amounts are scaled in relation to the total capacity of all the licensee’s facilities and not just the specific facility cited or limited to that facility type.
- 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 –
(a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
- AB2231 (2016) – Increased Civil Penalties, effective July 1, 2017 – 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 a Zero Tolerance
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Destinee HogueTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019
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: CORTEZ FAMILY CHILD CARE
FACILITY NUMBER: 364843917
VISIT DATE: 05/08/2019
NARRATIVE
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LPA Hogue provided the following documents to Licensee Elaina Cortez:
1) Spring 2019 Quarterly Update
2) Safe Sleep Provider Information Notification (PIN)
3) Lead Exposure Brochure

During the exit interview, the Licensee Elaina Cortez confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

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.

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: Destinee HogueTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019
LIC809 (FAS) - (06/04)
Page: 5 of 6