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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011417
Report Date: 06/24/2024
Date Signed: 06/25/2024 08:32:39 AM

Document Has Been Signed on 06/25/2024 08:32 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:LOBOS FAMILY CHILD CAREFACILITY NUMBER:
198011417
ADMINISTRATOR/
DIRECTOR:
LOBOS, ALBALINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 960-1789
CITY:BALDWIN PARKSTATE: CAZIP CODE:
91706
CAPACITY: 14TOTAL ENROLLED CHILDREN: 2CENSUS: 0DATE:
06/24/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:Licensee Albalina LobosTIME VISIT/
INSPECTION COMPLETED:
03:50 PM
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Visit Conducted in Spanish

Licensing Program Analyst (LPA) Mary Silva conducted an unannounced annual random inspection at the above facility on 06/24/24. Licensing staff met with Licensee Albalina Lobos, whom the reason for the visit was explained. LPA was guided on a tour of the facility. There were no children present during the inspection. Facility capacity is in compliance for a Large Family Child Care Home. Per licensee two children are currently enrolled. Hours of operation are Monday-Friday from 6:00 AM - 6:00 PM.

This is a single story home which consists of 3 bedrooms, 2 bathrooms, kitchen, living room, dinning room laundry room, attached garage/activity room, fenced front and fenced backyard. Currently residing in the home are three adults and no minor children.

Areas accessible to children were inspected as follows: Kitchen, living room, dining room, one bathroom located next to the kitchen, fenced back yard, and garage converted into an activity area.

Areas off limits include: three bedrooms and one bathroom located in the hallway, laundry room, and front yard.

LPA observed the following required posted documentation in the main entry way of the facility: Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPA reviewed facility records for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan. LPA observed disaster drill conducted on 05/12/2024.

The home was observed to be clean and orderly, with central air and heating. Licensing staff observed the smoke detector and the carbon monoxide detector to be in operable condition and the valve on the required 2A 10BC fire extinguisher indicates fully charged with service tag dated 03/24/2024. _____Page 1_
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE: DATE: 06/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/24/2024
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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Document Has Been Signed on 06/25/2024 08:32 AM - It Cannot Be Edited


Created By: Mary Silva On 06/24/2024 at 01:08 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LOBOS FAMILY CHILD CARE

FACILITY NUMBER: 198011417

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 06/24/2024

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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Based on record review, the licensee did not comply with the section cited above Mandated Repoter Training has been renewed it expired in March 2024, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/08/2024
Plan of Correction
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Per licensee will complete mandated reporter training and submit copy of certificate by due date.
Type B
Section Cited
CCR
102418(a)
Immunizations
(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.

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, child #1 did not have immunization records in the file, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/08/2024
Plan of Correction
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Per licensee will provide proof of immunization records for child #1 by 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:Christina Gabelman
LICENSING EVALUATOR NAME:Mary Silva
LICENSING EVALUATOR SIGNATURE:
DATE: 06/24/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/24/2024


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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: LOBOS FAMILY CHILD CARE
FACILITY NUMBER: 198011417
VISIT DATE: 06/24/2024
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Reminded licensee fire extinguisher should be serviced yearly. LPA observed a fireplace with a clear screen in the living room. The home maintains telephone service via land line and cell phone. There are toys and other age-appropriate material available for children. Licensee prepares breakfast, lunch, and snacks for the children in care. Licensee transports children before and afterschool.

Licensee states that there are no poisons stored in the home and understands that all poisons must be locked, to be made inaccessible to children. Per Licensee there are no firearms or weapons stored in the home. Licensing staff reminded licensee smoking is not allowed in the home.

The Licensee uses the back yard for outdoor play. The outdoor play areas were observed to be fenced. Licensing staff observed that the outdoor yard have toys and other materials for children to play with. LPA did not observe bodies of water during this visit.



Child’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization's Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, and LIC 995A Notification of Parents’ Rights. LPA observed immunization records child #1 were not available for review.

Licensee file was reviewed for the following: LIC 508- Criminal Record Statement, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse Pediatric First Aid and CPR certification expires on 03/15/2026. Mandated Reporter Training expired on 03/12/2024 for licensee. www.mandatedreporterca.com

LPA discussed the safe sleep regulations with licensee 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. Licensee does not have infants enrolled. LPA also informed licensee 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.

__________________________Page 2____________________________________

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2024
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: LOBOS FAMILY CHILD CARE
FACILITY NUMBER: 198011417
VISIT DATE: 06/24/2024
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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/.

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/process.

Licensee 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.

MyChildCarePlan.org – Centers and Family Child Care Homes - Licensee, 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.

Megan’s Law - Family Child Care Homes - During the exit interview, Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Based on Licensing staff observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) 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 and safety.



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. Appeal rights was given.

Exit interview was conducted and report was reviewed with licensee Albalina Lobos.

_________________________Page 3________________________________

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2024
LIC809 (FAS) - (06/04)
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