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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014028
Report Date: 03/25/2022
Date Signed: 03/25/2022 01:03:19 PM

Document Has Been Signed on 03/25/2022 01:03 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:LOPEZ FAMILY CHILD CAREFACILITY NUMBER:
198014028
ADMINISTRATOR:MARIA & TELESFORO LOPEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 984-0016
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
03/25/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Licensee - Maria LopezTIME COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) R. Derraco conducted an unannounced annual inspection to the above facility on 03/25/22. LPA arrived at the facility at 11:15 AM and met with licensee, Maria Lopez, who guided analyst on a tour of the facility. Also present during this inspection was an assistant. Per Licensee, there are 14 children that are currently enrolled. There were 3 children present upon arrival. LPA observed Co-Licensee arriving to the home at 11:35 with an additional child.

This is a one-story home which consists of two bedrooms, one bathroom, kitchen/dining room, living room, a detached garage, front yard and backyard (fenced). The home is located in the back of the lot and there is a separate address for the home located in the front. The detached garage has been permitted by the City of Long Beach and is used as a main care area. LPA observed age appropriate toys, children reading material, storage cubby lockers for children's personal belongings, child sized tables and chairs, two Baby Trends pack and plays, a Graco feeding high chair, two wall mounted televisions, sleeping mats, sleeping cots, and a wall mounted heater/air conditioning unit. One TV is designated for security cameras throughout the facility. A bathroom in the detached garage was observed to be clean and free of defects. A gated entrance was observed to be locked to separate the off-limits storage area from the main care area. The second main care area is located in the living room of the home. LPA observed a wall mounted television, 2 additional pack and plays, a leather couch, a parent board with required postings, an infant changing station, sleeping mats, age appropriate toys, children reading material, and a Graco feeding chair. A double door was observed to separate the living room from the off limits kitchen. The second bathroom was observed to be clean and free of defects. Per licensee, the living room is used for the children arriving in the AM. Towards the day, the children move to the main care area located in the converted garage. The outdoor play area was observed to have perimeter fencing. Outdoor play equipment for children and age appropriate toys were observed in the outdoor play area. Shade is provided by an awning that covers the gap from the back entrance of the home to the front of the detached garage. A white wooden gate was observed to separate the (page 1 of 3)
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE: DATE: 03/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/25/2022
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 3
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: LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 198014028
VISIT DATE: 03/25/2022
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outdoor play area from the off-limits side of the home. The off-limits area includes the kitchen, both bedrooms, a section of the detached garage and the side of the home. Licensee states that there are no firearms stored in the home. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs. LPA did not observe any objects that can pose a danger to children in care. No bodies of water were observed on the premises. No pets were observed in home. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Individuals who reside in the home were noted and discussed. 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.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety,
comfort, and cleanliness. There is telephone service via a land line. Day care area was observed with safe toys, play equipment and materials. Detergents, cleaning compounds, and other items which could pose a danger to children were observed to be above the refrigerator in the off limits kitchen. No sharp objects were observed to be accessible in the kitchen area. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 05/26/21, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable.

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. 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.

The licensee and other personnel have completed training on preventive health practices including Pediatric
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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 198014028
VISIT DATE: 03/25/2022
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First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 02/2023. LPA observed that the Licensee and assistant do have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. File review was observed to have proper mandated immunization records. Children’s records were reviewed, including emergency information and were observed to be complete. A current children’s roster was available for review.

Incidental Medical Services (IMS):
IMS was discussed with licensee. Per licensee, there are no children enrolled that require IMS at this time. 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.

LPA advised the licensee to access forms, regulations and quarterly updates online at: www.cdss.ca.gov.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.
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 conducted, report reviewed with the licensee, and appeal rights were provided to Maria Lopez. (page 3 of 3)
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2022
LIC809 (FAS) - (06/04)
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