197408061-6-14-2023-30-CC-JLAO-CSSUKW-20230614153949

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197408061
Report Date: 06/14/2023
Date Signed: 06/14/2023 03:40:13 PM

Document Has Been Signed on 06/14/2023 03:40 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	ZEPEDA FAMILY CHILD CARE		FACILITY NUMBER:	197408061
ADMINISTRATOR:	BARBARA ZEPEDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 473-8048
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90064
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 6	DATE:	06/14/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Barbara Zepeda		TIME COMPLETED:	02:35 PM

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On 6/14/2023 Program Analysts (LPA), Judy Laureano and Sarah Garcia conducted an unannounced Annual Required Inspection at 11827 Ayres Avenue, Los Angeles, CA 90064. LPAs were greeted by licensee Barbara Zepeda.

During the initial inspection, LPAs observed 6 children in care with licensee and licensee's husband.

Facility operates Monday through Friday from 8:00 a.m. to 5:30 p.m. Currently licensee is available to care for children 3 months to 4 years old. Facility is Large Family Child Care Home with a max capacity of 14. Facility is NOT available for weekend care and/or evening care.

LPAs toured the home inside and outside. The home is a single-family home with two bedroom and one bathroom, living room dining room, kitchen area with back yard. LPAs observed a converted garage that is off limits to the children in care. The kitchen is OFF LIMITS and only used as a walkway to access the day care space in the back. Licensee confirmed that children nap in the dining room and eat in the living room space.

LPAs observed a barricaded fireplace in the living room.

Licensee confirmed the following areas are designated for day care only: Bedroom 1, used for napping only, Living room, Dining room area, playroom. The bathroom that children use is located outside the dining room area. LPAs inspected the bathroom and did not observe any medications, toxins or cleaning compounds that would pose a risk to children in care.

The following area are OFF LIMITS to the children in care: (1) Bedroom 1 and kitchen area.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023

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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ZEPEDA FAMILY CHILD CARE	FACILITY NUMBER: 197408061
	VISIT DATE: 06/14/2023

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Licensee informed LPAs of (1) dog on the premise. Dog is not on the premise with children and kept in an off-limits area. LPAs discussed the importance of making sure that parents know program has pets in the home.

All electrical outlets were observed to be covered. LPA reminded licensee to ensure all areas that have been designated as OFF LIMITS need to have doors closed doors and made inaccessible when children are present.

LPAs observed licensee test the carbon monoxide and smoke detector in the home. One working fire extinguisher was observed in the kitchen. Licensee confirmed program provides meals and snacks for children two and over. Licensee confirmed that if children have allergies, parents provide meals and snacks.

No swimming pools or bodies of water were observed in the space. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. LPAs observed cleaning compounds locked in under the sink cabinet in the kitchen- content made inaccessible to the children in care.

Licensee currently does not administer medication but is available to take children who may require medication. Licensee is aware of the required forms when administering medication. Adequate heating and ventilation for safety and comfort were observed in the space. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number 310-473-8048

Safe Sleep regulations were discussed due to program being available for infant care .
There is one crib or play yard for each infant in care, cribs and play yards are kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Infants up to 12 months of age are placed on their backs for sleeping. Individual Infant Sleeping Plan was discussed with licensee and a copy was provided.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023

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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ZEPEDA FAMILY CHILD CARE	FACILITY NUMBER: 197408061
	VISIT DATE: 06/14/2023

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Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children.
Capacity as specified on the license is being maintained during today’s inspection.

LPA reviewed 6 children’s files and observed files to be complete. LPA discussed all necessary forms needed in each children’s file and provided licensee with the LIC 311D- Records to be maintain in the facility and provided licensee with a current copy to use as a reference when auditing files. LPA reviewed Licensee’s Pediatric CPR and First certification and observed certification with an expiration date of 02/2024. Licensee’s Mandated Reporter training and licensee immunization record(s) were available for review.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

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.

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 at https://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.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the licensee Barbara Zepeda.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 06/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023

LIC809 (FAS) - (06/04)

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