198012265-3-18-2022-33-CC-TRAO-CCKPCE-20220316111149

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198012265
Report Date: 03/16/2022
Date Signed: 03/18/2022 08:29:28 AM

Document Has Been Signed on 03/18/2022 08:29 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	MARIN FAMILY CHILD CARE		FACILITY NUMBER:	198012265
ADMINISTRATOR:	MARIN, ASTRID		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 672-7630
CITY:	WEST COVINA	STATE: CA	ZIP CODE:	91792
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 11	CENSUS: 7	DATE:	03/16/2022
TYPE OF VISIT:	Case Management - Annual Continuation	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Astrid Marin, Licensee		TIME COMPLETED:	11:20 AM

NARRATIVE

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Licensing Program Analyst (LPA) Thelma Razo conducted Case Management - Annual Continuation and met with Licensee Astrid Marin at 10AM.

LPA discussed the safe sleep regulations with applicant 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 applicant 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 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

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.

No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into this category are not permitted in a family child care facility.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2022

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MARIN FAMILY CHILD CARE	FACILITY NUMBER: 198012265
	VISIT DATE: 03/16/2022

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All adults present have obtained a criminal record clearance. The licensee and her assistants have proof of current pediatric first aid and CPR (expires: 05/22/2023). Licensee has completed required mandated reporter training on 6/16/2021, certificates on file.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/tion-process.

LPA obtained the following:

updated LIC279 Application for A Family Child Care Home License (FCCHL)
updated LIC 279B Current Children in Your Home Application for a FCCHL
updated sketch

A deficiency was cited under Health and Safety Code and is in LIC809-D.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee Astrid Marin.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/18/2022 08:29 AM - It Cannot Be Edited

Created By: Thelma Razo On 03/16/2022 at 10:40 AM

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: MARIN FAMILY CHILD CARE	FACILITY NUMBER: 198012265
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/16/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited


	Deficient Practice Statement
1 2 3 4	HSC 1597.622(a)(1) Employees or volunteers at family day care home; immunization requirements; records; exemptions Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement was not met as evidenced by Licensee does not have proof of measles vaccination in file. This poses a potential health and safety risk to the children in care.
	POC Due Date: 03/30/2022
	Plan of Correction
1 2 3 4	Licensee stated that she will submit the required document by 3/30/2022.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Brandi VanOosten

LICENSING EVALUATOR NAME:

Thelma Razo

LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2022

LIC809 (FAS) - (06/04)

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