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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493609
Report Date: 05/24/2024
Date Signed: 05/24/2024 04:39:54 PM

Document Has Been Signed on 05/24/2024 04:39 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:ONTIVEROS FAMILY CHILD CAREFACILITY NUMBER:
197493609
ADMINISTRATOR/
DIRECTOR:		ONTIVEROS, GUADALUPEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 602-9154
CITY:LOS ANGELESSTATE: CAZIP CODE:
90002
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
05/24/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Guadalupe Ontiveros, LicenseeTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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Licensing Program Analysts (LPAs) F. White and K. Dunlap arrived at the above facility for the purpose of an unannounced Random Annual inspection. LPA White announced the purpose of the visit and was granted entry into the facility by Licensee Guadalupe Ontiveros. There are 9 children enrolled, and 3 preschoolers present at the time of inspection. All adults in the home were discussed, and have current criminal background clearance. Per Licensee, the hours of operation are 4:30 a.m. to 5:30 p.m. (Monday Friday). Disaster Drill Log was available during the inspection. Last drill was conducted 3/8/2024. Facility rosters was reviewed and was current. Parent Board was observed to have License, Facility Sketch, Parent's Rights, Disaster Drill Log, Facility Roster, Emergency Disaster Plan, and Fire Permit.

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.

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 1 of 4 Pages............................................................
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE: DATE: 05/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/24/2024
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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ONTIVEROS FAMILY CHILD CARE
FACILITY NUMBER: 197493609
VISIT DATE: 05/24/2024
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maintained in the home.

At 1:45 p.m., LPA's observed Room 1 to have cubbies for the children's personal belongings. There is a doll house, and a storage bookcase with puzzles, and trucks, dinosaurs, and dramatic play items for the children. There is a table with clothing, shoes, and a stroller filled with bags of clothing. Per Licensee, the items are donations left over from Yard Sale. 1:50 p.m. LPA's observed Room 2 to have a teacher's desk with older model printers, and a laptop. on it. The floors have a white powder substance and patched holes in the carpet. There is a large flat screen tv leaning against the teacher's desk. There is a children's table with a child size Minnie Mouse bumper car sitting on top of the table filled with electronics and cords. There is also a laundry basket filled with clothing, and a storage container in front of the table filled with clothing. There are Science posters on the walls, cubbies with solar system, human body, lung, and dental manipulatives on top. LPA asked about a napping space for the children. Per Licensee, the children do not take naps. LPA White informed Licensee that even though current children in care do not nap, a main care area has to be designated for children to nap. Per Licensee Room 3 will be used for napping children. Per Licensee Room 3 will be used as an Isolation space for sick children waiting to be picked up by parents.

At 2:00 p.m. LPA's observed Bathroom 1 located inside of Room 3. Bathroom had one toilet, one sink, toilet paper, paper towels, and cleaning solutions stored in an unlocked cabinet under the sink. On top of the toilet rack were more cleaning solutions, rubbing alcohol, and air fresheners. LPA reminded Licensee that cleaning agents, and chemicals must be stored and locked in an off limits area, making it inaccessible to children in care. The water faucet was inspected and when knob is twisted to full capacity, very little water came out of the faucet.

At 2:30 p.m., LPA's observed Room 3 to have a bassinet with a mesh netting overhead filled with clothing. soft toys, a toddler size play horse, unicorn, blue's clues dog, and small bike with a baby gate separating Room 2 and 3.

At 2:40 p.m., LPA's observed the kitchen to be accessible to children in care. Per Licensee children eat in the kitchen at the table. LPA White reminded Licensee that according to the facility sketch, the kitchen is an off limits area to children and parents. The department is to be notified of any use of Off Limits areas.
.................................................Report Continues 2 of 4 Pages..............................................................
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2024
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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ONTIVEROS FAMILY CHILD CARE
FACILITY NUMBER: 197493609
VISIT DATE: 05/24/2024
NARRATIVE
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LPAs observed the lower cabinets to have child safety locks. The stove did not have child safety knobs. Kitchen knives were stored in a pull out drawer under the sink. The child safety lock was broken. LPA's informed Licensee that children can no longer take meals in the Kitchen, because of potentially hazardous sharp items are accessible to children in care.

At 3:00 p.m., LPA's reviewed Staff Files. Both files had the following items:
  • Immunization records
  • Mandated Reporter Training Certificate: Staff #1 - 4/3/2024, Staff #2 - 4/3/2024
  • CPR/First Aid: Online class, EMSA sticked missing (Staff 1 & 2)


At 3:20 p.m., LPA's reviewed Children's files. 5 out of 5 files were missing parent signatures, emergency contact information on various department documents specified on LIC 857.

The following were discussed:
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.

Criminal Record Clearance

Licensee Guadalupe Ontiveros 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.

.............................................Report Continues 3 of 4 Pages........................................................................

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2024
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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ONTIVEROS FAMILY CHILD CARE
FACILITY NUMBER: 197493609
VISIT DATE: 05/24/2024
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee Guadalupe Ontiveros was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Guadalupe Ontiveros confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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, Guadalupe Ontiveros. A copy of the report, Notice of Site Visit, and Appeal Rights were given.

.......................................................Report Ends 4 of 4 Pages................................................................

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/24/2024 04:39 PM - It Cannot Be Edited


Created By: Franchesca White On 05/24/2024 at 03:38 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: 05/24/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
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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4
Based on observation, the licensee did not comply with the section cited above in cleaning solutions and chemicals stored on top of the toilet rack which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/24/2024
Plan of Correction
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Licensee states that she will removed cleaning solutions from the top rack and lock them in an off limits area.
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, the licensee did not comply with the section cited above inLicensee did not have EMSA approved CPR/First Aid which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/24/2024
Plan of Correction
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Licensee states that she will complete an approved First Aid / CPR in-person training, and provide proof by email to LPA White on or before POC due 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:Denise Gibbs
LICENSING EVALUATOR NAME:Franchesca White
LICENSING EVALUATOR SIGNATURE:
DATE: 05/24/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/24/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/24/2024 04:39 PM - It Cannot Be Edited


Created By: Franchesca White On 05/24/2024 at 03:38 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: 05/24/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102421(b)
Child's Records
(b) The licensee shall maintain, in each child's record, a copy of the emergency information card as required
in Section 102417(g)(7).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 5 out of 5 children's records did not have proper siganatures and phone numbers for emergency cards. which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/24/2024
Plan of Correction
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Licensee states that she will have parents to complete documentation on or before POC due date.
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:Denise Gibbs
LICENSING EVALUATOR NAME:Franchesca White
LICENSING EVALUATOR SIGNATURE:
DATE: 05/24/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/24/2024


LIC809 (FAS) - (06/04)
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