198004954-4-28-2025-54-CC-FWHE-DG6UTR-20250428155223

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198004954
Report Date: 04/28/2025
Date Signed: 04/28/2025 03:52:32 PM

Document Has Been Signed on 04/28/2025 03:52 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:	HERNANDEZ FAMILY CHILD CARE		FACILITY NUMBER:	198004954
ADMINISTRATOR/ DIRECTOR:	HERNANDEZ, SAHARA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 583-5711
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90001
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 4	DATE:	04/28/2025
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:00 PM
MET WITH:	Sahara Hernandez, Licensee		TIME VISIT/ INSPECTION COMPLETED:	04:15 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	Licensing Program Analyst (LPA) Franchesca White arrived at the above facility for the purpose of an unannounced 3Yr Required Annual Inspection. LPA White announced the purpose of the visit and was granted entry into the home by Licensee Sahara Hernandez. There are 27 enrolled and 4 present at the time of inspection. The ages of children served are 0 to 12 years of age. The hours of operation are 24 hours / 7 days a week. Licensee was reminded that no one child can stay a full 24 hours. All adults in the home were discussed and have current criminal background clearance. The following documents were observed on the parent board and in the Licensee's file during the inspection: License, PUB - Parent's Rights, Emergency Disaster Plan, Disaster Drill Log with the last trill conducted 4/4/2025, and the Facility Roster. All life saving devices were inspected and were operable at the time of inspection. The dual smoke and carbon monoxide detector is located in the family room. The 2A 10BC fire extinguisher is located in the kitchen and has a service tag dated 2/27/2025. This is a single-story home which consists of two bedrooms and two bathrooms, kitchen, and daycare space. Facility is front unit of duplex property, back house address is 1551 1/2 E. 76th St. Areas used by the children include daycare space (located upon entry of the home stretching to the back of home), Kitchen (located to the right upon entry), and Bathroom 1 (located down hallway through front daycare space). Per Licensee, areas off limits to children and parents include Bedroom 1 and Bedroom 2 with Bathroom 2. Per Licensee, off limit areas are closed and locked during operating hours, LPA observed doors to be locked. ......................................................Report Continues 1 of 4 Pages........................................................

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Franchesca White
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: HERNANDEZ FAMILY CHILD CARE	FACILITY NUMBER: 198004954
	VISIT DATE: 04/28/2025

NARRATIVE

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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. LPA observed A/C wall units through out home. There is a working telephone maintained in the home.

At 2:25, LPA White observed the living room area to have dramatic play area with plenty of child size trinkets and toys appropriate for children. There are toy dinosaurs, and posters on the walls of emotions, painted pictures, and colors and shapes. There are tables for sitting and children activities. There are tables with puzzles ofr the children, and a storage book case with shelves filled with activities and materials. There is a mounted tv on the wall. A first aid kit is mounted on the wall of the living room. There is a changing table with a supply cabinet underneath. There is a pack -n-play for infant sleeping. There are cots stored against the wall. There is a kidney table in the kitchen space with 4 chairs. Licensee states this is where the children eat their meals. At 2:30, LPA White observed the kitchen to be open facing the main care space. All the cabinets have child safety locks on them making them inaccessible to children in care. Licensee states that knives are stored in the drawer and made inaccessible with the use of child safety locks. LPA observed the knives to be stored in the drawer and made inaccessible with the use of child safety locks.

At 2:45 p.m., LPA White observed the bathroom to have one toilet, one sink, and toilet paper dispenser, paper towel dispenser, trash can, and several guided posters for hand washing, toileting, washing face, and showering. There were no flooring hazards, or chemicals observed in the bathroom.

At 2:50 p.m., LPA White observed the back yard to have age appropriate toys for the children with shading for comfort. LPA observed tables and chairs suitable for children's activities. LPA observed a large storage shed. Licensee states that this storage is for extra supplies for the facility and housing larger toys for the children. Licensee states there is a lock for the shed that makes it inaccessible to children in care. LPA observed Licensee unlock the shed for LPA to see inside, and lock it back after inspection of the storage shed. Off limit areas of the back yard were observed to have locks on them making the area inaccessible to children in care. LPA observed the perimeter of the play area to be completely fenced in with shrubbery lining the perimeter.

LPA White did not observe any bodies of water or pets during today's inspection. Licensee states that there are no firearms or weapons in the home LPA White did not observe any firearms or weapons in the home.
................................................................Report Continues 2 of 4 Pages............................................

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Franchesca White
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2025

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: HERNANDEZ FAMILY CHILD CARE	FACILITY NUMBER: 198004954
	VISIT DATE: 04/28/2025

NARRATIVE

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At 3:00 p.m., LPA White observe the second main care space woth have a sectional couch with a large flat screen mounted to the wall. Licensee states this room is used for older day care children. There is a patio sliding door the leads to the outdoor play area for the children. LPA observed this area to be clean and neat for the day care children.

At 3:00 p.m., LPA White reviewed the children's files. All files had immunization records and required department documents accurately completed. At 3:35 p.m., LPA White reviewed staff files. Licensee's immunization records were available at the time of inspection. Licensee had a CPR/1st Aid certification with an expiration date of 02/2027. Mandated Reporter Training Certificate has a expiration date of 2/6/2027. Licensee's Assistant had proof of immunization records at the time of the inspection. Assistant has a CPR/1st aid certificate with an expiration date of 2/2027. Assistant has Mandated Reporter Training certificate with a expiration date of 2/2027.

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.

Licensee Sahara Hernandez 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.

LPA discussed the safe sleep regulations with licensee Sahara Hernandez 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.
.............................................Report Continues 3 of 4 Pages..................................................................

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Franchesca White
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2025

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: HERNANDEZ FAMILY CHILD CARE	FACILITY NUMBER: 198004954
	VISIT DATE: 04/28/2025

NARRATIVE

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LPA also informed licensee Sahara Hernandez 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.

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 was informed of the MyC Sahara HernandezhildCarePlan.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.

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

Based on today's observations, interviews, and record review there will be no deficiencies cited in accordance with California Title 22 regulations.

A notice of site visit was given and must remain posted for 30 days. Failure to post will result in a $100 civil penalty.

Exit interview conducted and report was reviewed with the licensee Sahara Hernandez. PIN 22-05-CCP Page Six
A copy of the report and appeal rights was given to Licensee Sahara Hernandez.
.............................................................Report Ends 4 of 4 Pages.............................................................

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Franchesca White
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2025

LIC809 (FAS) - (06/04)

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