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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192004068
Report Date: 11/08/2024
Date Signed: 11/08/2024 03:33:21 PM

Document Has Been Signed on 11/08/2024 03:33 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:VALDOVINOS FAMILY CHILD CAREFACILITY NUMBER:
192004068
ADMINISTRATOR/
DIRECTOR:		VALDOVINAS, SOFIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 428-0619
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
11/08/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Marua Perez TIME VISIT/
INSPECTION COMPLETED:
03:45 PM
NARRATIVE
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On November 8, 2024 at 11:15a.m., Licensing Program Analyst (LPA) Keneisha Dunlap and Licensing Program Manager (LPM) Karen Chambers arrived at the above facility for the purpose of an unannounced Annual Inspection. LPA Dunlap announced the purpose of the visit and was granted entry into the facility by Assistant- Maria Perez. There are 14 children enrolled, and 2 children present at the time of inspection. The hours of operation are Monday- Friday from 12:00am-12:00pm. All adults in the home were discussed and background and fingerprinted cleared. License, facility sketch, earthquake disaster checklist, disaster plan and PUB 394 posted. Licensee does have current LIC 9040 (facility roster). Licensee does have not a current disaster log drill. This poses a potential health and safety risk to children in care. Type B deficiency will be issued.

From 11:25am-11:46am LPA conversation was translated with the interpreter service until Cristina Garcia arrived.

This is a one-story home which consists of 4 bedrooms, 2 bathrooms, kitchen, dining room, living room, front yard and fenced backyard.



The kitchen area is in accessible to the children. All knives are stored in a lockbox in a high cabinet.
At 11:40am. LPA Dunlap observed unlocked cabinet in bathroom with cleaning products accessible to children in care. This poses an immediate health and safety risks to children in care. Type A violation will be issued .
LPA Dunlap observed the lights be out in the bathroom and hallway. LPA asked Assistant if the light was not working. The Assistant stated that the lights has been off since 9:40am due to power outage. LPA asked Assistant if they had contacted parents and the assistant said no. The LPA asked how were they were going to make meals for children in care. The Assistant stated that they would be ordering food for the children. This poses an immediate health and safety risk to children in care Type A deficiency will be issued. (Power was out until 2:30pm). Page 1 of 5
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE: DATE: 11/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2024
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 12
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: VALDOVINOS FAMILY CHILD CARE
FACILITY NUMBER: 192004068
VISIT DATE: 11/08/2024
NARRATIVE
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In the second main care area LPA observed age appropriate toys, cubbies, and cribs. There are cots stored in this room and also used for napping.
11:55a.m., LPA Dunlap observed in a area that was accessible to children to have uncovered electrical outlets (pictures were taken). The Assistant placed covers on outlets during visit.

At 11:56am LPA Dunlap observed accessible 2 stairway entrances with no barricade. This poses an immediate health and safety risk to children in care (pictures were taken)Type A deficiency will be issued.

At 11:58am LPA Dunlap observed stacked boxes on top of refrigerator area in off limits area which is accessible to children. This poses an immediate health and safety risk to children in care (pictures were taken) Type A deficiency will be issued.

At 11:59am LPA Dunlap observed in off limits from the main care area a knife in drawer which was accessible to children. This poses an immediate health and safety risk to children in care (pictures were taken) Type A deficiency will be issued.

At 12:00pm LPA Dunlap observed a bucket water with mop. Cristina Garcia removed bucket from area and discarded water.

At 12:01pm LPA Dunlap observed in the second main care area 3 birdcages with droppings accessible to children. This poses an immediate health and safety risk to children in care (pictures were taken) Type A deficiency will be issued.

LPA Dunlap observed the outside area. The outdoor area had age appropriate toys for children.
At 12:04pm LPA Dunlap observed an unsecured rake on top of roof. This poses an immediate health and safety risk to children in care (pictures were taken) Type A deficiency will be issued.
At 12:05pm LPA Dunlap observed roses bushes with un pruned thorns on stems of flowers. This poses an immediate health and safety risk to children in care (pictures were taken) Type A deficiency will be issued

Page 2 of 6
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2024
LIC809 (FAS) - (06/04)
Page: 12 of 12
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: VALDOVINOS FAMILY CHILD CARE
FACILITY NUMBER: 192004068
VISIT DATE: 11/08/2024
NARRATIVE
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At 12:07pm LPA Dunlap observed 3 square pods at the bottom of canopies with ridge edges (sharp)- This poses an potential health and safety risk to children in care (pictures were taken) Type B deficiency will be issued
at 12:09pm LPA observed Cleaning products outside accessible to children in care-- This poses an immediate health and safety risk to children in care (pictures were taken) Type A deficiency will be issued.
At 12:10pm LPA Dunlap observed a damaged ball throw equipment with shreds in the material. This poses a potential health and safety risk to children in care (pictures were taken) A Type B will be issued.

LPA observed the smoke detector and carbon monoxide detector to be operable.

LPA observed a fire extinguisher with no expiration and/or tag date. This poses an potential health and safety risk to children in care. Type B deficiency will be issued

Staff Files:

Staff # 1

No required licensing documents in folders. Missing required immunization's. No Health & Safety Certificate.

CPR expiration date of 5/28/25

Mandated Reporter 6/9/2024

Staff # 2

Required immunization record

No required licensing documents in folders. No Health & Safety Certificate.

CPR expiration date of 4/11/23

Mandated Reporter expiration date of 1/18/22

Licensing documents, missing immunization's, expired CPR, expired Mandated reporter, no Health & Safety Certificate. This poses an potential health and safety risk to children in care. Type B deficiency will be issued.

Page 3 of 5

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2024
LIC809 (FAS) - (06/04)
Page: 11 of 12
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: VALDOVINOS FAMILY CHILD CARE
FACILITY NUMBER: 192004068
VISIT DATE: 11/08/2024
NARRATIVE
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Children Files:
Child #1 All required licensing forms are in file. File is missing immunization record. This poses an potential health and safety risk to children in care. Type B deficiency will be issued.

Child #2 All required licensing forms and immunization record are in file.

The Licensee stated that they do provide meals for children.


The Licensee stated that they communicate with parents via phone. The Licensee has a cell phone that they use.

The Licensee stated they do not have any children that they administer medication to at this time.

The Licensee states that when children are in sick, they are placed in the second main care area.

The Licensee stated there are no firearms in the home.

The Licensee stated that there are no smokers in the home.

The Licensee stated that they do provide transportation for children in the morning and afternoon.

The Licensee stated that they do have first aid kit.

No large bodies of water on premises.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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

Page 4 of 5

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2024
LIC809 (FAS) - (06/04)
Page: 10 of 12
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: VALDOVINOS FAMILY CHILD CARE
FACILITY NUMBER: 192004068
VISIT DATE: 11/08/2024
NARRATIVE
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Criminal Record Clearance - Family Child Care Homes Assistant Cristina Garcia was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

MyChildCarePlan.org – Centers and Family Child Care Homes Assistant Cristina Garcia was informed of the

MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Megan’s Law - Family Child Care Homes During the exit interview, the Assistant Cristina Garcia confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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

Appeal rights explained and given to Licensee- Assistant Cristina Garcia

Exit interview conducted and report was reviewed with the Assistant Cristina Garcia

TYPE A DEFICIENCIES

Based on this information the following deficiencies on the LIC 809 D are being cited today 11/8/2024

LPA Keneisha Dunlap informed Assistant Cristina Garcia that this report dated 11/8/24 document(s) 4- Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.


Also, LPA Keneisha Dunlap informed the Assistant Cristina Garcia to provide a copy of this licensing report dated 11/8/24 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Page 5 of 5


SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2024
LIC809 (FAS) - (06/04)
Page: 9 of 12
Document Has Been Signed on 11/08/2024 03:33 PM - It Cannot Be Edited


Created By: Keneisha Dunlap On 11/08/2024 at 02:16 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: VALDOVINOS FAMILY CHILD CARE
FACILITY NUMBER: 192004068

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(b)
Operation of A Family Child Care Home
(b) The home shall be kept clean and orderly, with heating and ventilation for safety and comfort.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in did not have power outage for more than 3 hours, and porperly stored boxes on top of regrigertaors which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/15/2024
Plan of Correction
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The Licensee will remove boxes from on top of refrigerator and relocate by POC date.
The Licensee will keep area clear of further objects that may fall on children in the future.
Type A
Section Cited
CCR
102417(g)
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:

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 in did not have dethorned rose bush , had an accessible rake, ridge edges on canopy, birdcage droppoings, and unsecured ladder on roof, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/15/2024
Plan of Correction
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The Licensee willl remove and repair all items listed above by POC date.
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:Karen Chambers
LICENSING EVALUATOR NAME:Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2024


LIC809 (FAS) - (06/04)
Page: 2 of 12
Document Has Been Signed on 11/08/2024 03:33 PM - It Cannot Be Edited


Created By: Keneisha Dunlap On 11/08/2024 at 02:16 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: VALDOVINOS FAMILY CHILD CARE
FACILITY NUMBER: 192004068

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(3)
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: (3) Where children are less than five years old are in care, stairs shall be fenced or barricaded.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in did not have not safety barricade, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/11/2024
Plan of Correction
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The Licensee will purchase barricades for steps for both stairways.
Type A
Section Cited
CCR
102417(g)(4)
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: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
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4
Based on observation, the licensee did not comply with the section cited above in there were chemicals and a knife accessible to children, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/08/2024
Plan of Correction
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The Licensee must place knife inaccesble to children immediately.
The Licensee must place safety latch on cabinet where clean products are acessible to children immediately.
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:Karen Chambers
LICENSING EVALUATOR NAME:Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2024


LIC809 (FAS) - (06/04)
Page: 3 of 12
Document Has Been Signed on 11/08/2024 03:33 PM - It Cannot Be Edited


Created By: Keneisha Dunlap On 11/08/2024 at 02:16 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: VALDOVINOS FAMILY CHILD CARE
FACILITY NUMBER: 192004068

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(d)
Operation of A Family Child Care Home
(d) The home shall provide safe toys, play equipment and materials.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in did not have equipment on playground that was safe for children, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/08/2024
Plan of Correction
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2
3
4
The Licensee will remove and replace on or before the POC date.
Type B
Section Cited
CCR
102417(g)(1)
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: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on observation, the licensee did not comply with the section cited above in did not have a fire extingusher with purchase date and/or service tag, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/22/2024
Plan of Correction
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2
3
4
The Licensee will have fire exitigusher serviced and/or provide receipt of purchase on or before the POC date.
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:Karen Chambers
LICENSING EVALUATOR NAME:Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2024


LIC809 (FAS) - (06/04)
Page: 4 of 12
Document Has Been Signed on 11/08/2024 03:33 PM - It Cannot Be Edited


Created By: Keneisha Dunlap On 11/08/2024 at 02:16 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: VALDOVINOS FAMILY CHILD CARE
FACILITY NUMBER: 192004068

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2024

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
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in did not have a current record of disater/fire drills, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/08/2024
Plan of Correction
1
2
3
4
The Licensee will keep a log of all disater/fire drils
The Licnesee will conduct drills every 6 months.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review)], the licensee did not comply with the section cited above in 2 out 2 staff files did not have current certificates, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/22/2024
Plan of Correction
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2
3
4
The Licensee will have staff take required class for certificate on or before POC due date.
The Licnesee will keep make copies in staff files on or before POC date.
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:Karen Chambers
LICENSING EVALUATOR NAME:Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2024


LIC809 (FAS) - (06/04)
Page: 5 of 12
Document Has Been Signed on 11/08/2024 03:33 PM - It Cannot Be Edited


Created By: Keneisha Dunlap On 11/08/2024 at 02:16 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: VALDOVINOS FAMILY CHILD CARE
FACILITY NUMBER: 192004068

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in 1 out of 2 staff files do not have immunizations, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/22/2024
Plan of Correction
1
2
3
4
The Licensee will have all staff obtain immunizations on or before POC date.
The Licensee will have make copies and staff file on or before POC date.
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
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in 2 out of 2 staff files do not have Health & Safety certificates, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/22/2024
Plan of Correction
1
2
3
4
The Licensee will have all staff take required class for certifciate on or before POC date.
The Licensee will have make copies and place in each staffs file on or before POC date.
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:Karen Chambers
LICENSING EVALUATOR NAME:Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2024


LIC809 (FAS) - (06/04)
Page: 6 of 12
Document Has Been Signed on 11/08/2024 03:33 PM - It Cannot Be Edited


Created By: Keneisha Dunlap On 11/08/2024 at 02:16 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: VALDOVINOS FAMILY CHILD CARE
FACILITY NUMBER: 192004068

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.1(a)
Personnel Records
(a) Personnel records shall be maintained on each employee and shall contain the following information:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based onrecord review, the licensee did not comply with the section cited above in 2 out of 2 staff files missing all required licensing documents. which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/11/2024
Plan of Correction
1
2
3
4
The Licensee will have all staff fill out licensing forms on or before POC Date.
The Licensee will place copies in each staff file on or before POC Date.
Type B
Section Cited
CCR
102418(a)
Immunizations
(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based onrecord review, the licensee did not comply with the section cited above in 1 out of 2 staff files missing all required immunizations, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/22/2024
Plan of Correction
1
2
3
4
The Licensee will have obtain required immunizations from parent(s) on or before POC date.
The Licensee will place copies of records in children file on or before POC date.
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:Karen Chambers
LICENSING EVALUATOR NAME:Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2024


LIC809 (FAS) - (06/04)
Page: 7 of 12
Document Has Been Signed on 11/08/2024 03:33 PM - It Cannot Be Edited


Created By: Keneisha Dunlap On 11/08/2024 at 02:16 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: VALDOVINOS FAMILY CHILD CARE
FACILITY NUMBER: 192004068

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102423(a)(2)
Personal Rights
(a) 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, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in astroturf torn which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/11/2024
Plan of Correction
1
2
3
4
The Licensee will remove and replace torn astroturf on or before POC date.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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:Karen Chambers
LICENSING EVALUATOR NAME:Keneisha Dunlap
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2024


LIC809 (FAS) - (06/04)
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