197418012-10-5-2023-58-CC-KCHE-CWBNFQ-20231005102555

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197418012
Report Date: 10/05/2023
Date Signed: 10/05/2023 10:26:03 AM

Document Has Been Signed on 10/05/2023 10:26 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	MORA FAMILY CHILD CARE		FACILITY NUMBER:	197418012
ADMINISTRATOR:	MORA, ADRIANA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 891-8630
CITY:	PANORAMA	STATE: CA	ZIP CODE:	91402
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 18	CENSUS: 4	DATE:	10/05/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Adriana Mora, Licensee		TIME COMPLETED:	11:00 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 10/05/2023 at 8:58 AM, Licensing Program Analyst (LPA)Katrina Chicote conducted an Unannounced Required – 1 Year inspection to the above facility. Upon arrival, LPA disclosed the purpose of the inspection and met with Licensee, Adriana Mora, who granted entry to facility and guided the LPA on a tour of the facility. Adults in the home were discussed and all have criminal record clearance. Also present was Licensee’s son who is her Assistant. There were four day care children present during today’s inspection. Licensee states that there are currently 18 children enrolled. The children's roster was reviewed and is current. Per Licensee, she operates 24 hours 7 days a week, upon family's request. LPA reviewed license limitations with Licensee not being able to provide care for a child longer than 23 hours. Licensee discussed Overnight procedures with LPA at time of inspection. Emergency Disaster Plan, License, and Parents’ Rights were posted at the time of inspection. Disaster drill log was also available during today’s inspection, last disaster drill conducted on 09/2023. LIC 126 was provided upon entry of the home. This is a single-story home which consists of two bedrooms and one bathroom, Kitchen, Living Room, Day Care Activity Room, and attached garage. Areas used by the children include the Living Room (located upon entry of the home), Day Care Activity Room (located to the left of Living Room), and Bathroom 1 (located down hallway to the right of the home). Per Licensee, areas off limits to children and parents include Kitchen, attached garage, and all bedrooms(2). LPA observed that there is an operable baby gate blocking access to Kitchen making it off limits and doors to garage and bedrooms to have operable child proof door knobs making these areas off limits to children in care. Beginning at 9:04 AM, all areas identified by Licensee as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. LPA observed central A/C and heat through out the home. There is a working telephone maintained in the home. LPA observed Living Room to have age appropriate tables and chairs available that is well maintained. Licensee states she Report continues- Page 1 of 4

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023

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 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MORA FAMILY CHILD CARE	FACILITY NUMBER: 197418012
	VISIT DATE: 10/05/2023

NARRATIVE

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provides food to children in care and use Living Room for eating. LPA observed TV hanging on wall, shelves with books and art materials as well as cubbies for children's belongings in Living Room. LPA observed Day Care Activity Room to have shelves with soft blocks, puzzles, plastic manipulatives, and a variety of age appropriate toys, free of loose and sharp parts available for children. LPA observed Bathroom 1 to have adequate hand washing and toileting supplies and to have general area safety and sanitation. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. At 9:07 AM, LPA observed these items stored in cabinet under the sink with operable child safety lock at time of inspection. At 9:10 AM, LPA observed sharp knives and utensils to be kept in a drawer in off limits Kitchen area with operable child safety lock at time of inspection. The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the age of children in care.

Per Licensee, the children will have access to backyard for outdoor play which LPA observed to be accessible through sliding glass door in Day Care Activity Room. At 9:12 AM, LPA observed backyard has brick flooring surface well maintained and adequate perimeter fencing through-out the yard. LPA observed plastic play equipment, tricycles, and shelves filled with a variety of age appropriate toys free of loose and sharp parts. LPA observed toy storage and age appropriate tables and chairs made for outdoor use at time of inspection. LPA observed all trees, shrubs, and plants are maintained. LPA observed a storage shed in the rear of backyard that is locked requiring a key. LPA inspected backyard for hazards and bodies of water and none were observed at time of inspection.

Licensee states she has a dog that is kept separate from children when children are present, LPA did not observe the dog or hear the dog during inspection. Per Licensee, there are no weapons, firearms in the home, LPA observation did not see any firearms/weapons at time of inspection.

At 9:13 AM, the valve on the required 2A 10BC fire extinguisher indicates fully charged with service tag dated 03/01/2023. At 9:06 AM, LPA tested smoke and carbon monoxide detector which were observed to be in operable condition at time of inspection. Per Licensee, First Aid kit is kept in the hallway to Bathroom 1, LPA observed First Aid kit and was inventoried for necessary supplies. The Licensee has current Pediatric First Aid and CPR valid until 11/2024. Proof of immunization against influenza, pertussis, and measles was readily available for Licensee and Assistant during today’s inspection. The Licensee and Assistant have taken the required AB1207 Mandated Reporter Training that are current. Children's records were reviewed for completeness and discussed. Licensee states isolation area for sick children is in area of home not being used. Report Continues - Page 2 of 4

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MORA FAMILY CHILD CARE	FACILITY NUMBER: 197418012
	VISIT DATE: 10/05/2023

NARRATIVE

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The following were discussed:
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 Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Licensee (or facility representative) 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.

Rooms that are off-limits need to be made inaccessible during operating hours. NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers and any other item that falls into that category are permitted in the facility.

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.

AB 1207: Beginning on January 1, 2018, this law requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: http://www.mandatedreporterca.com/

Report Continues - Page 3 of 4

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MORA FAMILY CHILD CARE	FACILITY NUMBER: 197418012
	VISIT DATE: 10/05/2023

NARRATIVE

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Senate Bill 792: this bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the visit.

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.

MyChildCarePlan.org – Centers and Family Child Care Homes Licensee [or facility representative] 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

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited only advisories given today, 10/05/2023

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

Exit interview was conducted and report was reviewed with the Licensee, Adriana Mora.

During the exit interview, the LICENSEE, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Report Ends - Page 4 of 4

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023

LIC809 (FAS) - (06/04)

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