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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364844898
Report Date: 10/12/2021
Date Signed: 10/12/2021 02:21:01 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:RAMIREZ FAMILY CHILD CAREFACILITY NUMBER:
364844898
ADMINISTRATOR:STEPHANIE RAMIREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 206-3149
CITY:YUCAIPASTATE: CAZIP CODE:
92399
CAPACITY:14CENSUS: 7DATE:
10/12/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Licensee, Stephanie RamirezTIME COMPLETED:
02:25 PM
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On 10/12/2021 at 09:15am, Licensing Program Analyst (LPA) Destinee Hogue arrived at the facility to conduct a required annual inspection. Present during this inspection was Licensee, Stephanie Ramirez; Licensee's Spouse/Assistant, Hector Ramirez; and seven day care children. LPA toured the facility, inside and out, records were reviewed, and the following was observed and/or discussed with Licensee:

Normal days and hours of operation are: Monday through Friday from 6:00am to 6:00pm
OFF-LIMIT AREAS INCLUDE: Entire upstairs, garage, laundry room, front yard and side of backyard.

- ZERO TOLERANCE: No bodies of water observed at the time of this inspection. 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.
- ZERO TOLERANCE: 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. - Storage areas for poisons are observed to be inaccessible and stored behind key-locked garage.
- All hazardous items are inaccessible, this includes; detergents, cleaning compounds, medications, and other items.
- There is a properly barricaded fire place
- Appropriate fire extinguisher, smoke detector and carbon monoxide detector are present and were tested by the applicant during this inspection.
- Home is clean and orderly, with heating and ventilation for safety and comfort
- Staircases are properly barricaded.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee HogueTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2021
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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 364844898
VISIT DATE: 10/12/2021
NARRATIVE
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- ZERO TOLERANCE: The Department shall notify a Licensee to immediately terminate the employment of, or to remove/bar any person with specified convictions or for other reasons. The Licensee shall comply with the notice.
- 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 10/12/2021.

- ZERO TOLERANCE: Any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advance notice.

- This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 understands each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the Licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to: To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

- The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov

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

- The Duty Officer is available to answer questions Monday – Friday from 8:00am to 5:00pm at (951)782-4200.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee HogueTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2021
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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 364844898
VISIT DATE: 10/12/2021
NARRATIVE
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- 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/inspection-process.

- 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.

See LIC809D for cited deficiencies.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS ALONG WITH A COPY OF ALL TYPE A DEFICIENCIES (LIC809D) CITED DURING THIS INSPECTION. A COPY OF ALL TYPE A DEFICIENCIES CITED DURING THIS INSPECTION MUST ALSO BE IMMEDIATELY (WITHIN 24 HOURS OF THE CHILD’S NEXT DAY IN CARE) GIVEN TO THE PARENTS OF ALL CHILDREN ENROLLED IN THE CHILD CARE FACILITY AND ANY CHILDREN ENROLLED INTO THE CHILD CARE FACILITY OVER THE NEXT 12 MONTHS (AT THE TIME OF ENROLLMENT).

Exit interview conducted and report was reviewed with the Licensee, Stephanie Ramirez

SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee HogueTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2021
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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 364844898
VISIT DATE: 10/12/2021
NARRATIVE
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- A working telephone is present.
- ZERO TOLERANCE: The Licensee shall be present in the home and shall ensure that children in care are supervised at all times.
- When temporarily absent from the home, the Licensee shall arrange for a substitute adult to care for and supervise children.
- ZERO TOLERANCE: Children shall not be left in parked vehicles.
- Outdoor play areas are fenced, and appropriate supervision was observed at the time of this inspection.
- The facility is operating within the licensed capacity and appropriate ratios were observed at the time of this inspection.

NEW Safe Sleep Regulations (Effective September 15, 2020):
LPA discussed the safe sleep regulations with licensee 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 [facility representative] 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.
- During this inspection, LPA Hogue provided a copy of Provider Information Notice (PIN) 20-14-CCP - New Safe Sleep Regulations

Facility Records Review:
- Each child’s file contains a copy of the emergency information card with required information
- Pediatric CPR and First Aid Card expires on 08/2022
- AB 1207 Mandated Child Abuse Reporter Training completed on 03/07/2021
- Documentation of emergency disaster drills on file. Emergency disaster drill completed on 01/25/2021, SEE LIC809D for cited deficiencies.
- Review of staff records did not contain proof staff are immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year or provide a statement denying the influenza vaccination.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee HogueTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2021
LIC809 (FAS) - (06/04)
Page: 4 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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 364844898
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/12/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102425(b)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above. LPA Hogue observed Child #1 sleeping in a play yard with a loose blanket and pillows. This poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/12/2021
Plan of Correction
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During this inspection, Licensee removed the loose items from the play yard and agreed to adhere to Title 22 Regulations. Licensee stated she understands children under 24 months who are sleeping in a crib or play yard shall not have loose articles and objects in the sleep area.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee HogueTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:
DATE: 10/12/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/12/2021
LIC809 (FAS) - (06/04)
Page: 9 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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 364844898
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/12/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. Last emergency disaster drill was conducted on 01/25/2021. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/19/2021
Plan of Correction
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Licensee agrees to conduct an emergency disaster drill and agrees to continue conducting drills every six months. Licensee agrees to submit proof of completed emergency disaster drill by 10/19/2021. Proof of completed emergency disaster drill can be submitted via email or mail.
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(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.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. Licensee did not have proof of immunization against influenza (Flu), pertussis (Tdap), and measles (MMR) available for Licensee and Licensee's Spouse/Assistant. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/26/2021
Plan of Correction
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During this inspection, Licensee agreed to submit proof of MMR, Tdap and Flu vaccinations for Licensee and Licensee's Spouse. Proof of MMR, Tdap, and flu or statement denying flu can be submitted via email or email by 10/26/2021.
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: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee HogueTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:
DATE: 10/12/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/12/2021
LIC809 (FAS) - (06/04)
Page: 8 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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 364844898
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/12/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102418(g)(1)
Immunizations
(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. (1) This requirement includes updating each child's PM 286 (6/95) when the child is due to receive required immunizations after enrollment in the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. Licensee had immunization records available and documented on CDPH286, however Licensee has not updated CDPH286 for Child #2, Child #4, and Child #5. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/26/2021
Plan of Correction
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During this inspection, Licensee agreed to update CDPH286 for Child #2, Child #4, and Child #5. Licensee agreed to submit updated CDPH for Child #2, Child #4, and Child #5 via email or mail by 10/26/2021.
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. Licensee did not have proof of LIC9227-Individual Infant Sleeping Plan on file for Child #1. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/26/2021
Plan of Correction
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During this inspection, Licensee agreed to have parent of Child #1 complete LIC9227-Individual Infant Sleeping Plan and agreed to submit proof of completed LIC9227 via email or mail by 10/26/2021.
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: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee HogueTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:
DATE: 10/12/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/12/2021
LIC809 (FAS) - (06/04)
Page: 11 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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 364844898
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/12/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)(D)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. Per Licensee, she utilizes ProCare app which tracks children sleep times and schedules a 15-minute reminder to check on sleeping infants, however, Licensee did not have 15-minute sleep check documentation readily available at the time of LPA's request. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/19/2021
Plan of Correction
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Licensee agrees to print out 15-minute sleep check log from ProCare app and/or Licensee agrees to provide written documentation with proof 15-minute sleep checks are conducted at the facility. Licensee agrees to submit 15-minute sleep check log via email or mail by 10/19/2021.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee HogueTELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:
DATE: 10/12/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/12/2021
LIC809 (FAS) - (06/04)
Page: 5 of 11