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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192004056
Report Date: 10/26/2022
Date Signed: 10/26/2022 12:51:55 PM

Document Has Been Signed on 10/26/2022 12:51 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:SALAS FAMILY CHILD CAREFACILITY NUMBER:
192004056
ADMINISTRATOR:SALAS, LORETOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 868-2219
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
10/26/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Licensee Loreto Salas TIME COMPLETED:
12:55 PM
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On 10/26/22 Licensing Program Analysts (LPAs) Jeanette Estrada and Austin Estrada conducted an unannounced required 1 year inspection at the above facility. LPAs met with the Licensee Loreto Salas and informed her of the purpose for the visit. LPA provided Facility Representative with a copy of the Facility Entrance Checklist. Licensee provided LPAs with a tour of the facility. There were 11 children and 3 adults present during the inspection. All residents were noted and verified. Facility provides care to children ages 3 months to 12 years. Facility is open Monday to Friday 6AM to 6 PM.
This is a one story home with 3 bedrooms, 1 bathroom, living room, kitchen, dining room, day care room, backyard and garage.

Off Limit Areas: Three bedrooms,living room, kitchen, garage

Per Licensee areas on limits to children are: 1 bedroom used for infants, play room next to the infant room, bathroom next to the infant room and backyard.



All areas that are accessible to children were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection: LPA observed required posted documentation- Facility license, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPA observed and reviewed a current roster LIC 9040 and a current disaster drill log. Last disaster drill was performed in 7/2022. There is an operable carbon monoxide detector in the daycare room and an operable smoke detector in the infant room. LPA observed a 2A10BC Fire Extinguisher in the day care room which indicated full and was last serviced in July 2022. The home maintains telephone service (cell phone and landline). Food is provided by Licensee. Licensee was reminded if children bring food from home it must be labeled with the child’s name and properly stored or refrigerated.
There are toys and other age appropriate materials available for children to use in the infant room, day care room and in the backyard.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/26/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 10/26/2022 12:51 PM - It Cannot Be Edited


Created By: Jeanette Estrada On 10/26/2022 at 12:02 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: SALAS FAMILY CHILD CARE
FACILITY NUMBER: 192004056

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/26/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review and interview, the licensee did not comply with the section cited above. Licensee and two assistants present during the inspection have an online Pediatric first aid/ CPR certification that was completed on 10/21/21 which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/28/2022
Plan of Correction
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Licensee and assistants will complete an EMSA approved pediatric CPR/First Aid course and will submit proof to LPA via email. LPA advised courses can be found on www. emsa.ca.gov.
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:Valarie Cook
LICENSING EVALUATOR NAME:Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:
DATE: 10/26/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/26/2022


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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: SALAS FAMILY CHILD CARE
FACILITY NUMBER: 192004056
VISIT DATE: 10/26/2022
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Sharp objects, detergents and cleaning compounds were inaccessible to children in care. Knives are kept in an upper cabinet-out of reach of children, cleaning products are kept in a lower cabinet and laundry products are kept in the off limits laundry area. Personal medication is kept in an locked cabinet in the day care room. Per facility representative, no children enrolled require medication. The areas used by children have A/C. There is a barricaded fire place and wall heater in the living room. Children nap in the day care room and they are provided appropriate napping equipment. Children use the restroom in the hallway. Cabinets in the restroom are latched and per Licensee, children are guided to the restroom when needed.
Children use the backyard for outdoor play. LPA observed the back yard is fully enclosed. Per Licensee, children are supervised while playing outside. Per Licensee, there are no poisons in the home. LPA advised that all poisons must be locked, not only inaccessible to children. Isolation area for sick children waiting to be picked up is in the infant room, separated from other children. Per Licensee, there are no firearms or weapons stored in the home. LPA did not observe any pools or spas, or other bodies of water. There are no pets in the home.
Infant Care: Currently licensee has 2 infants enrolled. LPA observed one play yard in the infant room and 2 play yards in the day care room. LPA observed the play yards to be free from blankets and loose items. Licensee was advised Infants shall not be swaddled in care. Car seats shall not be used for sleeping.
Overnight Care: There is no overnight care provided at the moment. LPAs discussed the following: Licensee is aware that they must remain awake while children are awake. If children sleep in separate area from licensee, the door must remain open. If licensee cannot hear children when they wake up, video or audio device can be used.Children's records were reviewed: Children's records contained LIC 282, Immunization Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, the 15 minute infant sleep log and LIC 9227
Staff records were reviewed: Licensee and Assistant 1 and Assistant 2 have an online pediatric first aid/cpr certification on file. Certification was completed on 10/21/21. Licensee's mandated reporter was completed on 4/26/22, Assistant 1's mandated reporter was completed on 2/21/22 and Assistant 2's Mandated reporter was completed on 4/26/22. Licensee did not have proof of immunization to Measles. Assistants had proof of required immunizations and TB clearance. Staff files included LIC 508, 9108 and 9052.
During inspection the children present was observed to be treated with dignity and respect, and free from corporal and/or unusual punishment.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022
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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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: SALAS FAMILY CHILD CARE
FACILITY NUMBER: 192004056
VISIT DATE: 10/26/2022
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Incidental Medical Services (IMS): 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm
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.
LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleephttps://www.cdss.ca.gov/inforesources/child-care-licensing/ public -information-and-resources/safe-sleep as an additional resource. LPA 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.

The deficiencies listed on the following page were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. A type B citation is being issued today for regulation 102416(c) for the staff not having an approved pediatric cpr/first aid course on file. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

Exit interview conducted and report was reviewed with Licensee Loreto Salas . A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022
LIC809 (FAS) - (06/04)
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