<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198012836
Report Date: 04/14/2022
Date Signed: 04/14/2022 01:13:28 PM

Document Has Been Signed on 04/14/2022 01:13 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:OSEGUERA FAMILY CHILD CAREFACILITY NUMBER:
198012836
ADMINISTRATOR:OSEGUERA, AMALIA MILAGROFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 632-1939
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY: 14TOTAL ENROLLED CHILDREN: 4CENSUS: 4DATE:
04/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:07 AM
MET WITH:Amalia Oseguera, LicenseeTIME COMPLETED:
01:40 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
THIS INSPECTION WAS CONDUCTED IN ENGLISH AND IN SPANISH
Licensing Program Analyst (LPA) Rita Ramos conducted an unannounced required 1 year inspection to the above facility on 04/14/2022. LPA arrived at the facility at 9:00AM in the front yard and identified self to Benito Oseguera, Licensee's husband who informed LPA that Licensee was inside the home. At 9:06AM LPA was still outside in the front yard and knocked on the door. Licensee Amalia Oseguera opened the front door at 9:07AM and allowed LPA to enter the home. Licensee gestured for LPA to commence the tour in the backyard. LPA asked how many children were present and Licensee began to look around. LPA noted that there were 4 children present and asked Licensee for Child #1's name due to how LPA observed Child #1. At 9:09AM LPA observed Child #1 singularly laying on their back in the play pen with a bottle, blanket, pacifier, and 3 extra layers of padding underneath Child #1. LPA advised Licensee to remove the objects and extra padding from the play (picture was taken). LPA provided Licensee with a copy of the LIC 126 Entrance Checklist to help facilitate the inspection. LPA observed that also present during this inspection, was Alicia Oceguera, Licensee’s Assistant and Laura Alonso, Licensee's daughter-in-law. LPA observed 4 children upon arrival. Per Licensee, operation hours are 6AM to 6PM Monday through Friday. There are 4 children that are currently enrolled. Per Licensee, they do not have a current children's roster for review.


At 9:10AM Licensee guided LPA on a tour of the backyard. LPA asked if there are any other adults present in the home besides husband, assistant, daughter-in-law, and Licensee. Licensee stated no. LPA asked if there was anyone in the garage and Licensee stated no. LPA was directed to go back inside the home and tour the inside. At 9:13AM LPA was not being toured to inspect one of the bedrooms. LPA asked Licensee why they are not allowing access to the bedroom. Per Licensee, the bedroom next to the bedroom opposite Licensee's bedroom is not accessible. LPA reminded Licensee that per the facility sketch and LPAs inspection on 01/02/2020, Licensee applied for an increase in capacity by allowing that the bedroom be accessible to children in care. ----Page 1 of 5
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Rita Ramos
LICENSING EVALUATOR SIGNATURE: DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/14/2022
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 9
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: OSEGUERA FAMILY CHILD CARE
FACILITY NUMBER: 198012836
VISIT DATE: 04/14/2022
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
26
27
28
29
30
31
32
LPA advised Licensee to open the bedroom since LPA has inspection authority. LPA entered the bedroom and took pictures. Licensee stated that they forgot to inform the department that they are no longer going to have the bedroom accessible. LPA asked Licensee if they are wishing to decrease their capacity since they are reducing the space available to children in care and Licensee stated no.

This is a one-story home which consists of 3 bedrooms, 1 bathroom, kitchen, living room, small front yard, backyard (fenced), garage. The children use the bathroom available indoors. LPA observed that there is no fireplace. Per Licensee, areas off limits to children and parents include: all 3 bedrooms, garage, and part of the backyard. The licensee provides food for children in care.

Due to Licensee stating that the bedroom that was once accessible is no longer accessible to children in care, LPA asked if they can inspect the garage. Licensee asked LPA why an LPA stated that due to Licensee making changes to what was once inaccessible, LPA would like to ensure that the garage continues to be inaccessible. At 9:18AM, Licensee opened the garage for LPA but stood in the doorway. LPA asked if there is anyone in the garage and Licensee stated no. LPA asked Licensee who the individual in the back wall that LPA was observing is. Licensee stated that it is their brother-in-law. LPA asked for the individual's identification and the name of the individual is Arturo Oceguera Ocanas. LPA asked Arturo Oceguera Ocana how long they have been present in the home and Licensee tried to intervene. LPA asked if Arturo Oceguera Ocanas could respond. Arturo Oceguera Ocanas stated that they have been sleeping and staying in the home for 5 days. A civil penalty of $500.00 is being assessed during today's visit. LPA took a picture of Arturo Oceguera Ocanas identification and the address of residence noted on the identification card is the facility address. Individuals who reside in the home were noted and discussed. Per Licensee, they currently have one assistant.

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

Licensee states that there are no firearms stored in the home. ----Page 2 of 5
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Rita Ramos
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2022
LIC809 (FAS) - (06/04)
Page: 2 of 9
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: OSEGUERA FAMILY CHILD CARE
FACILITY NUMBER: 198012836
VISIT DATE: 04/14/2022
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
26
27
28
29
30
31
32
All areas identified on the facility sketch were inspected for safety, comfort, and cleanliness. There is telephone service via a land line and cellphone that is used. There is ventilation and heating (open face observed to be screened/barricaded). 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. Per Licensee, there are no poisons stored 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 was last serviced 04/05/22. Per Licensee they have a scheduled date to have the extinguisher serviced. Smoke and carbon monoxide detectors were tested and are operable.

Licensee states that infants sleep in the living room. Play yards did not hinder the entrance or exit from the sleeping space. LPA reminded Licensee that mattresses shall be firm and covered with a fitted sheet that overlaps the underside so it cannot be dislodged and play yards need 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 was also provided.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. 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 3 of 5
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Rita Ramos
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2022
LIC809 (FAS) - (06/04)
Page: 3 of 9
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: OSEGUERA FAMILY CHILD CARE
FACILITY NUMBER: 198012836
VISIT DATE: 04/14/2022
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
26
27
28
29
30
31
32
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 06/26/23. 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.

Children’s records were reviewed, including emergency information and were observed to be incomplete.

The licensee does have proof of immunization against influenza, pertussis, and measles.

LPA observed that the Licensee and assistant do not 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, per licensee, was in June of 2022. LPA informed Licensee that it is impossible to have conducted a drill on June of 2022. Licensee showed LPA the drill log documenting drills conducted in May of 2022 and June of 2022. LPA asked Licensee if the dates to conduct the drills are pre-selected as a reminder to conduct them and Licensee stated no that the log is accurate of drills already conducted. LPA noticed that there was a number one underneath the year 2022 and asked Licensee if they changed the 2021 to 2022 and Licensee stated no. LPA took a picture. Licensee was adamant that the dates are true of drills already conducted.

There is a dog in the home that was observed to be on the side of the garage in the dog run.

LPA did not observe any pools, spas, hot tubs, fish ponds, or similar bodies of water during the inspection.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted. ---Page 4 of 5
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Rita Ramos
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2022
LIC809 (FAS) - (06/04)
Page: 4 of 9
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: OSEGUERA FAMILY CHILD CARE
FACILITY NUMBER: 198012836
VISIT DATE: 04/14/2022
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
26
27
28
29
30
31
32
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 child care facility.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

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.

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/inspection-process



The following deficiencies listed on the attached 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 & safety.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit.

A notice of site visit was given and must remain posted for 30 days.Exit interview conducted and report was reviewed with the licensee, Amalia Oseguera. ----Page 5 of 5

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Rita Ramos
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2022
LIC809 (FAS) - (06/04)
Page: 5 of 9
Document Has Been Signed on 04/14/2022 01:13 PM - It Cannot Be Edited


Created By: Rita Ramos On 04/14/2022 at 11:39 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: OSEGUERA FAMILY CHILD CARE

FACILITY NUMBER: 198012836

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 04/14/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102370(d)(1)
Criminal Record Clearance
(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview, record review, the licensee did not comply with the section cited above due to having Arturo Oceguera Ocanas present in the home for 5 days or more which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 04/15/2022
Plan of Correction
1
2
3
4
Per Licensee, Arturo Oceguera Ocanas is leaving today 04/14/22. Licensee states that she will take pictures of the address in which they will be dropping off Arturo Oceguera Ocanas and submit them by POC due date.
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:Trevino Cochran
LICENSING EVALUATOR NAME:Rita Ramos
LICENSING EVALUATOR SIGNATURE:
DATE: 04/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2022


LIC809 (FAS) - (06/04)
Page: 6 of 9
Document Has Been Signed on 04/14/2022 01:13 PM - It Cannot Be Edited


Created By: Rita Ramos On 04/14/2022 at 11:39 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: OSEGUERA FAMILY CHILD CARE

FACILITY NUMBER: 198012836

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 04/14/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(a)(3)
Infant Safe Sleep
(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. (3) Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and interview the licensee did not comply with the section cited above due to having Child #1 in the play pen with 3 extra layers of padding above the matress which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/18/2022
Plan of Correction
1
2
3
4
Licensee removed Child #1 and states that they will remove the extra padding and objects. A picture will be submitted by POC due date.
Type B
Section Cited
CCR
102425(b)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and interview, the licensee did not comply with the section cited above due to having blankets, bottles, and extra paddings in the play pen while child was laying inside which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/22/2022
Plan of Correction
1
2
3
4
Per Licensee, all items will be removed. Pictures will be taken of infants sleeping with no objects and submitted by POC 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:Trevino Cochran
LICENSING EVALUATOR NAME:Rita Ramos
LICENSING EVALUATOR SIGNATURE:
DATE: 04/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2022


LIC809 (FAS) - (06/04)
Page: 7 of 9
Document Has Been Signed on 04/14/2022 01:13 PM - It Cannot Be Edited


Created By: Rita Ramos On 04/14/2022 at 11:39 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: OSEGUERA FAMILY CHILD CARE

FACILITY NUMBER: 198012836

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 04/14/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview and record review, the licensee did not comply with the section cited above due to Licensee stating that they do not have any proof of keeping track of infants sleep or logging time checks which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/22/2022
Plan of Correction
1
2
3
4
Per Licensee, they will start keeping track of infants sleep and create a log. A copy of the log will be submitted by POC due date of 04/21/22.
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
1
2
3
4
Based on observation, interview, and record review, the licensee did not comply with the section cited above due to Licensee and assistant not having proof of taking the amandated reporter training and admitting that they have not taken it which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/28/2022
Plan of Correction
1
2
3
4
Per Licensee, they will take the training and submit copies by POC 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:Trevino Cochran
LICENSING EVALUATOR NAME:Rita Ramos
LICENSING EVALUATOR SIGNATURE:
DATE: 04/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2022


LIC809 (FAS) - (06/04)
Page: 8 of 9
Document Has Been Signed on 04/14/2022 01:13 PM - It Cannot Be Edited


Created By: Rita Ramos On 04/14/2022 at 11:39 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: OSEGUERA FAMILY CHILD CARE

FACILITY NUMBER: 198012836

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 04/14/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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
1
2
3
4
Based on observation, interview, and record review, the licensee did not comply with the section cited above due to Licensee not having immunization records for any of the children in care which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/28/2022
Plan of Correction
1
2
3
4
Per Licensee, they will request immunization records from each of the parents and submit copies by POC due date.
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview and ecord review, the licensee did not comply with the section cited above due to not having any roster available for LPA to review and admitting that they do not have a roster which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/21/2022
Plan of Correction
1
2
3
4
Per Licensee, a roster will be created and copy will be submitted by POC 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:Trevino Cochran
LICENSING EVALUATOR NAME:Rita Ramos
LICENSING EVALUATOR SIGNATURE:
DATE: 04/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2022


LIC809 (FAS) - (06/04)
Page: 9 of 9