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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493609
Report Date: 01/20/2022
Date Signed: 01/20/2022 03:14:01 PM

Document Has Been Signed on 01/20/2022 03:14 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:ONTIVEROS FAMILY CHILD CAREFACILITY NUMBER:
197493609
ADMINISTRATOR:ONTIVEROS, GUADALUPEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 602-9154
CITY:LOS ANGELESSTATE: CAZIP CODE:
90002
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 0DATE:
01/20/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Guadalupe Ontiveros, Licensee TIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA)Katrina Chicote conducted an Unannounced Required – 1 Year inspection to the above facility on 01/20/22 at 1:15 PM. LPA conducted COVID-19 screening at entrance of facility. Upon arrival, LPA disclosed the purpose of the inspection and met with Licensee, Guadalupe Ontiveros, who guided the LPA on a tour of the facility. Individuals living in the home were discussed, and all adults have criminal record clearance. There were no day care children present during today’s inspection. Licensee states that there are currently nine children enrolled. The children's roster was reviewed and current. Per Licensee, the facility’s hours of operation is flexible depending on needs of families in care. 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 12/09/21.

This is a single-story home which consists of four bedrooms and 2.5 bathrooms, kitchen, living room, daycare space, and detached garage. Facility is bottom part of duplex property. Upper unit's address is 1403 E. 90th St. There is a wall heater in the home that is barricaded by a gate. Areas used by the children include the daycare space, which consists of three rooms and half bath located upon entry of the home. Per Licensee, areas off limits to children and parents include entire back portion of the house, which include all four bedrooms, two bathrooms, Kitchen, and Living Room. LPA observed that there is an operable baby gate separating areas used by children and off-limits area. LPA also observed a separate entrance to this off limits area.

All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. There is a working telephone
Report continues- Page 1 of 4
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE: DATE: 12/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/17/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: ONTIVEROS FAMILY CHILD CARE
FACILITY NUMBER: 197493609
VISIT DATE: 01/20/2022
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maintained in the home. At 1:17 PM, LPA observed Room 1 of day care space, to have cubbies for children's belongings, shelves filled with puzzles, books, and legos. At 1:18 PM, LPA observed Room 2 of day care space, next to Room 1, to have two large desks and two large filing cabinets, half bathroom is located in this room. LPA observed operable toilet and sink and to be free of hazards. At 1:19 PM, LPA observed Room 3, next to Room 2, to have diaper changing table, shelf with infant play toys, and infant ride along play toys that were free of loose and sharp parts at time of inspection. Per Licensee, there are no pets and LPA did not observe any pets. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. Licensee states these items are stored in off limits Kitchen. The Licensee states that there are no poisons in the home.

Per Licensee, the children will have access to backyard area which is accessible through entrance to day care space. At 1:24 PM, LPA observed backyard has concrete flooring and adequate perimeter fencing through-out the yard. At 1:25 PM, LPA observed child appropriate bicycles all through side wall that had handlebar covers missing. At 1:26 PM, LPA observed two large play structures, one wooden two level play structure with climbing wall and slide to the left and one two level plastic play structure with slide, bridge, and climbing steps to the rear of the home, both play structures have cushioning floor to absorb fall. LPA observed plastic matting under wooden structure and the plastic play structure with rubber mulch under. At 1:27 PM, LPA observed large trampoline in backyard to have netting that is maintained and safety zipper in tact. At 1:28 PM, LPA observed cobwebs on both play structures and LPA observed a plastic play house that was filled with various toys stacked in an unbalanced way. LPA discussed cobwebs and toys inside playhouse, Licensee states she will clear cobwebs and move toys inside playhouse into storage shed.

Per Licensee, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPA observation did not see any bodies of water around the premises or weapons in the home. Per Licensee, they provide food for children in care.

At 1:20 PM, LPA observed the valve on the required 2A 10BC fire extinguisher indicates fully charged with service tag. At 1:22 PM, LPA observed smoke and carbon monoxide detectors are in operable
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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
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: ONTIVEROS FAMILY CHILD CARE
FACILITY NUMBER: 197493609
VISIT DATE: 01/20/2022
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condition at time of inspection. Per Licensee, First Aid kit is kept in Room 2 of daycare space, LPA
observed First Aid kit. The Licensee has Pediatric First Aid and CPR that is expired. Proof of
immunization against influenza, pertussis, and measles were not readily available during today’s inspection. The Licensee has not taken the Mandated Reporter Training
—CPR Card valid until: 12/07/2021 - expired
—Fire Extinguisher was last serviced on: 03/09/2021
—Children records and required licensing forms were discussed as well as mandated child abuse reporting and criminal record clearance requirement.

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. Effective January 1, 2010, licensees of family child care homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.

Report Continues - Page 3 of 4
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
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: ONTIVEROS FAMILY CHILD CARE
FACILITY NUMBER: 197493609
VISIT DATE: 01/20/2022
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The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

LPA discussed the safe sleep regulations with licensee [or facility representative] 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.

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/www.mandatedreporterca.com

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.

Based on this information, the following deficiencies on the attached LIC 809D are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.



Exit interview was conducted and report was reviewed with the Licensee (or facility representative), Guadalupe Ontiveros.
 Report Ends - Page 4 of 4
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/20/2022 03:14 PM - It Cannot Be Edited


Created By: Katrina Chicote On 01/20/2022 at 02:50 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: ONTIVEROS FAMILY CHILD CARE
FACILITY NUMBER: 197493609

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/20/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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
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At 2:39 PM, based on record review and interview, Licensee did not have current mandated reporter training available during today's inspection. Licensee states she recalls taking it but believes it to be expired. This poses a potential health, safety, and personal rights risk to children in care.
POC Due Date: 01/31/2022
Plan of Correction
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Licensee states she will provide proof of completion of mandated reporter training via text by POC date.
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
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At 2:38 PM, based on observation and interview, Licensee did not have immunization records (for TdaP, MMR, and Influenza) readily available during today's inspection. Per Licensee she looked but was unable to find it. This poses a potential health and safety risk to children in care
POC Due Date: 01/31/2022
Plan of Correction
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Licensee states she will provide proof of immunization to TdaP, MMR, and Influenza via text 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:Trevino Cochran
LICENSING EVALUATOR NAME:Katrina Chicote
LICENSING EVALUATOR SIGNATURE:
DATE: 01/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/20/2022


LIC809 (FAS) - (06/04)
Page: 5 of 7
Document Has Been Signed on 01/20/2022 03:14 PM - It Cannot Be Edited


Created By: Katrina Chicote On 01/20/2022 at 02:50 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: ONTIVEROS FAMILY CHILD CARE
FACILITY NUMBER: 197493609

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/20/2022

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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At 1:26 PM, based on observation and interview, LPA did not observe current Pediatric First Aid/CPR training, LPA observed Pediatric First Aid/CPR training that expired on 12/07/21. Per Licensee, this is the most recent training she has taken, which is outdated. This poses a potential health, safety, and personal rights risk to children in care.
POC Due Date: 01/31/2022
Plan of Correction
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Licensee states she will provide proof of completion of pediatric first aid/CPR via text by POC date.
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
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At 1:24 PM, LPA Chicote observed outdoor play area to have cobwebs on bicycles and play structures. LPA also observed handlebars on bicycles to be broken and to have cobwebs. LPA observed a plastic playhouse filled with various toys stacked on top of each other in an unbalanced manner. This poses a potential health, safety, and personal rights risk to children in care.
POC Due Date: 01/31/2022
Plan of Correction
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Licensee states she will provide photo proof via text of outdoor play area to be free of cobwbs and bicycles with handles missing either repaired or removed, and playhouse removed of stacked toys 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:Trevino Cochran
LICENSING EVALUATOR NAME:Katrina Chicote
LICENSING EVALUATOR SIGNATURE:
DATE: 01/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/20/2022


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