198003615-3-14-2023-54-CC-DCHS-CPWVHG-20230314162708

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198003615
Report Date: 03/14/2023
Date Signed: 03/14/2023 04:27:15 PM

COMPREHENSIVE INSPECTION

Document Has Been Signed on 03/14/2023 04:27 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:	CHAVEZ FAMILY CHILD CARE		FACILITY NUMBER:	198003615
ADMINISTRATOR:	CHAVEZ, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 621-0730
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90804
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 5	DATE:	03/14/2023
TYPE OF VISIT:	Case Management - Annual Continuation	UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Maria Chavez, Licensee		TIME COMPLETED:	04:45 PM

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	Inspection was conducted in English and Spanish. Licensing Program Analyst (LPA) Dayna Chambers conducted an unannounced annual inspection to the above facility on March 10, 2023. LPA arrived at the facility at 2:15PM and met with Maria Chavez. Licensee who guided analyst on a tour of the facility. The inspection was not completed. LPA returned to the facility on March 14, 2023 at 3:00pm to complete the inspection. LPA provided Licensee with a copy of the LIC 126 Entrance Checklist to help facilitate the inspection. LPA observed 5 children upon arrival. Per Licensee, operation hours are Monday through Friday 6:00am – closed Saturday and Sunday. Also present during this inspection, was assistant, Francisca Guirdi and Shirley Chavez. There are 11 children that are currently enrolled. A current children’s roster was available for review. This is a one-story home which consists of 2 bedrooms, 2 full bathrooms, kitchen, dining room, living room, detached garage converted into apartment and is off-limits, front yard, and fenced backyard. The children use the bathroom near the kitchen in napping area. Licensee has installed air conditioners for ventilation. Per Licensee, areas off limits to children and parents include the living room, bedroom #1 and #2, 1 bathroom, kitchen, Living Room One, and Front Yard. Activity room and room next to kitchen is used for children’s activies and napping. The licensee provides food for children in care. Individuals who reside in the home were noted and discussed. Per Licensee, currently have one assistant. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed childcare home. Licensee states that there are no firearms stored in the home. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via cellphone that is used, and the cellphone stays at the facility during operation hours. There is ventilation and heating installed air conditioner and electric heater. Safe toys play equipment and materials were observed. Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock. The restroom that children use was observed to be safe and sanitary. The valve on the required 2A 10BC fire extinguisher indicates fully charged and brand new p1 cont

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2023

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CHAVEZ FAMILY CHILD CARE	FACILITY NUMBER: 198003615
	VISIT DATE: 03/14/2023

NARRATIVE

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Licensee states that she is not currently caring for infants 0-12 months old. Infants sleep in the activity room near the kitchen where they are constantly supervised. Appropriate sleeping arrangements and cribs were observed. (one crib for each infant in care was observed. Cribs or play yard did not hinder the entrance or exit from the sleeping space. Mattresses shall be firm and covered with a fitted sheet that overlaps the underside so it cannot be dislodged. Cribs and play yards were observed to be free of loose articles and objects. No objects were observed to be hanging above or attached to the side of the crib. LPA did not observe any infants swaddled while in care. LPA advised the Licensee that infants shall be placed on their backs for sleeping and shall be supervised. Infants shall be checked on every 15 minutes and the time of each 15-minute check shall be documented with child’s name and date. The LIC 9227 Individual Infant Sleeping Plan shall be completed for each infant up to 12 months of age. A copy of the LIC 9227 was provided to Licensee. a copy of the Provider Information Notice (PIN) 20-24 CCP: Recently Approved Safe Sleep Regulations in Effect.
Currently, children are using the back yard for outdoor play time. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that can pose a danger to children on the outdoor yard. The licensee is observed to be operating within the license capacity limitations. LPA did not observe any children left in parked vehicles. Car seats shall only be used for transportation. LPA did not observe any children sleeping in car seats.
The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 12/29/2023. There are first aid supplies available. LPA advised that if a child shows signs of illness, he/she/they shall be separated from other children. LPA advised licensee to always separate ill children from the other daycare children.
Children’s records were reviewed, including emergency information and were observed to be complete.
The licensee and assistant have proof of immunizations: MMR, TDAP, TB Clearance and Influenza declinations. LPA observed that the Licensee and assistant do have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. LPA issued a Confidential Names List (LIC 811) to the licensee which documents staff and children’s files reviewed during this inspection. All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. Last drill documented was conducted on 02/13/2023. There are no pets on the premises. LPA observed a fountain in the front yard which is off-limits. The fountain does not have water in the fountain. The parents and children do not enter from the front of the house. The parents and children enter from the right side of the home and do not access the front yard area which is fenced. There is not entry for parents and children to go out the front door because it is off-limits. LPA did not observe any additional pools, spas, hot tubs, fishponds, or similar bodies of water during the inspection. (P2 continued)

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2023

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CHAVEZ FAMILY CHILD CARE	FACILITY NUMBER: 198003615
	VISIT DATE: 03/14/2023

NARRATIVE

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Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.
LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family childcare facility.
Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.
LPA provided the licensee with a copy of A Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. LPA also consulted and explained Child Abuse Reporting, Never Shake a Baby, and Safe Sleeping practices. 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. LPA advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov. LPA provided licensee with safe sleep regulations, Infant Safe Sleep FAQs, infant sleep chart, LIC9227 and advised to follow the regulations.
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 [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. At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited. A notice of site visit was given and must remain posted for 30 days.Exit interview conducted and report was reviewed with the licensee Maria Chavez.

P3 end

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2023

LIC809 (FAS) - (06/04)

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