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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198010514
Report Date: 06/13/2024
Date Signed: 09/03/2024 09:23:11 AM

Document Has Been Signed on 09/03/2024 09:23 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:LOPEZ FAMILY CHILD CAREFACILITY NUMBER:
198010514
ADMINISTRATOR/
DIRECTOR:		LOPEZ, IRMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 779-2671
CITY:LOS ANGELESSTATE: CAZIP CODE:
90003
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 15DATE:
06/13/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Irma Lopez, LicenseeTIME VISIT/
INSPECTION COMPLETED:
02:00 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 annual inspection. LPA White announced the purposed of the visit and was granted entry into the facility by Licensee Irma Lopez. There are 12 day care children enrolled in this facility. There were 15 day care children present at the time of inspection which poses an immediate risk to the health and safety of children in care. Adults in the home were discussed and have current background clearance. The facility hours of operation are 6:00 a.m. to 6:00 p.m. (Monday - Friday).

Parent Board was observed to have License, Facility Sketch, and Parent's Rights posted. Emergency Disaster Plan, and Disaster Drill Log (last drill 4/10/2024) was available during the inspection. LPAs White informed Licensee that the Emergency Disaster Plan should be posted where parents are able to see information. Licensee and assistant state that Parent Board information will be moved from the day care room in the rear of the home to the front entrance of the home.

This is a single story home which consists of four bedrooms and one bathroom, kitchen, living room, dining, back house, side covered patio, and backyard. Areas used by the children include the Living Room for napping, Bedroom 4 for napping, Bathroom 1, back house for day care activities, covered side patio, and backyard. Per Licensee, areas off limits to children and parents include Bedroom 1,2, 3, Dining Room and Kitchen are only used for a walkway in order to access Main Care Areas and back yard for outdoor play. Per licensee, off limit areas are locked during operating hours, LPAs observed doors to be locked.

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. LPAs observed fans through out home. There is a working telephone maintained in the home. Upon entry of home, LPAs observed Living Room area which Licensee states will be used for napping and isolation of sick children until they are picked up, LPAs observed wooden cribs used for napping infants. ....Report Continues 1 of 5 Pages.....................
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE: DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/13/2024
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 8
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: LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 198010514
VISIT DATE: 06/13/2024
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LPAs observed side covered patio to have child size tables and chairs, and sink; per Licensee this area will be used for eating by children. LPAs observed back house that children use for day care space to have cubbies for children's belongings, carpet, play kitchen, wooden toy shelves filled with art materials blocks, puzzles, and other age appropriate toys, free of loose and sharp parts. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. The Licensee states that there are no poisons in the home. LPA observed back laundry area to rear of off limits kitchen to have detergents and cleaning compounds on top of high shelf making it inaccessible to children in care. The Licensee does understand that poison must be locked with a key or combination lock. LPA observed Bathroom 1, which children will use, located next to kitchen to be free of hazards and with adequate hand washing supplies. LPAs observed storage cabinet to have cleaning supplies. LPA White informed Licensee that this cabinet must be locked when day care children are present.

LPA observed drawer where sharp knives are kept to be kept in off limits kitchen area, per Licensee children are never left alone in that area as it is only used as a walk way. LPA advised Licensee that although she states she has full visual supervision of children, she should place a baby gate on kitchen island to counter making the stove and cabinets inaccessible to children in care.

LPAs observed the children to have access to backyard area for outdoor play. LPA observed backyard has turf grass, an elevated garden bed, and adequate perimeter fencing through-out the yard. LPA observed large wooden structure with slides and swing to have turf grass cushioning, child size bikes, small plastic play structure, and other age appropriate toys free of loose and sharp parts available for the children in the backyard and all trees, shrubs, and plants are maintained.

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. Per licensee, they provide food for children in care.

...........................................Report Continues 2 of 4 Pages..................................................................
SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
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: LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 198010514
VISIT DATE: 06/13/2024
NARRATIVE
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LPAs observed life saving devices such as the 2A 10 BC fire extinguisher, carbon monoxide detector, and smoke detector. The 2A 10 BC Fire extinguisher did not have a current service tag, or purchase receipt. Licensee had a log sheet and states that she checks it to make sure it is green and says fully charged. LPA White explained to Licensee that fire extinguishers need to be serviced by a professional, or a new extinguisher purchased once a year. LPA White further explained to Licensee that the fire extinguisher being set to the green area does not mean that it is fully charged.

LPA's reviewed Staff Files. Licensee and Assistant have current immunization records available during today's inspection. Licensee has current CPR/First Aid - 8/1/22, Assistant - 2/10/24. Licensee and Assistant have current Mandated Reporter Training Certificates both dated for 2/11/2024. Proof of documentation was available during today's inspection.

LPA's reviewed Children's files and all files are missing the admission date on LIC 700. LPA informed Licensee that all state documents need to be completely filled out.

LPAs discussed the following information:
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 Irma Lopez 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: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
LIC809 (FAS) - (06/04)
Page: 3 of 8
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: LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 198010514
VISIT DATE: 06/13/2024
NARRATIVE
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LPA discussed the safe sleep regulations with licensee Irma Lopez 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 Irma Lopezof 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 Irma Lopez 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.


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

Based on observations, interviews, and record review, the following deficiencies will be cited on the 809D page. Deficiences cited need to be cleared for the health and safety of the children in care.

LPA White informed licensee Irma Lopez, that this report dated 6/13/2024 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

...................................Report Continues 4 of 5 Pages..................................................

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

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
LIC809 (FAS) - (06/04)
Page: 4 of 8
Document Has Been Signed on 09/03/2024 09:23 AM - It Cannot Be Edited


Created By: Franchesca White On 06/13/2024 at 12:55 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: LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 198010514

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/13/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.5(d)(2)
Staffing Ratio and Capacity
(d) For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either: (2) More than twelve and up to fourteen children only if the criteria in Section 1597.465 of the Health and Safety Code are met.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in Licensee did not adhere to the capacity specified on her license.which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 06/13/2024
Plan of Correction
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Licensee made phone call to parent. Child was picked up while LPA's were present. Licensee states that she will provide a plan of action to remain in ratio while accomodating children to LPA White on or before 6/18/2024.
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: 06/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/13/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/03/2024 09:23 AM - It Cannot Be Edited


Created By: Franchesca White On 06/13/2024 at 12:55 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: LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 198010514

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/13/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(1)
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: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in Licensee did not have a current service tag, or purchase receipt for 2A 10BC fire extinguisher which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/13/2024
Plan of Correction
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Licensee states that she will provide proof of purchase of fire extinguisher to LPA White on or before POC 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: 06/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/13/2024


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: LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 198010514
VISIT DATE: 06/13/2024
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Also, LPA White informed licensee Irma Lopez to provide a copy of this licensing report dated 06/13/2024 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit Interview was conducted with Licensee Irma Lopez. A copy of the report, Notice of Site Visit, and Appeal Rights were given to Licensee Irma Lopez.

......................................Report Ends 5 of 5 Pages.................................................................................

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

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
LIC809 (FAS) - (06/04)
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