198014599-12-16-2022-33-CC-VMGA-CM6VRY-20221216154042

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198014599
Report Date: 12/16/2022
Date Signed: 12/16/2022 03:40:58 PM

Document Has Been Signed on 12/16/2022 03:40 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	LOPEZ FAMILY CHILD CARE		FACILITY NUMBER:	198014599
ADMINISTRATOR:	LOPEZ, ELVA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 269-1774
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90063
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 9	DATE:	12/16/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:35 PM
MET WITH:	Licensee Elva Lopez		TIME COMPLETED:	04:00 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

Licensing Program Analysts (LPAs) Veronica MartinezGarza and Nolan Tcheng conducted an unannounced annual 1-year required inspection at the above facility on 12/16/22 at 01:35PM. A COVID risk assessment was conducted upon entry- appropriate PPE was used. LPAs met with Elva Lopez, Licensee who guided analysts on a tour of the facility. There were 09 children present during this inspection. Per licensee, 11 children are enrolled. Present during the inspection was the Licensee’s husband and licensee’s assistant. Operation hours are Monday – Friday 07:00AM – 05:00PM. The licensee is operating within proper capacity and ratios. LPAs observed licensee to be present at the home and providing adequate care and supervision.

This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen, living room, front yard (fenced) and side yard (fenced) and back yard (fenced). The children use the bathroom located inside bedroom 1. Bedroom # 1 is off limits, but children walk through the bedroom to always use the bathroom (with 100% supervision), living room, and front yard (fenced) for play. Per licensee, areas off limits to children and parents include 3 bedrooms, 1 bathroom side and back yard (fenced). Licensee has 1 small dog with the required vaccines. The LPAs toured all areas used by children during this visit.

**Rooms that are off-limits need to be made inaccessible during operating hours**

Areas accessible to children were inspected to ensure that they are clean and working wall air conditioning and wall heater made inaccessible to children, and ventilation observed for safety and comfort. There are toys and other age-appropriate materials available for children. Children were observed to be napping and sleeping in mats. There is a working telephone service maintained in the home via landline and cell phone. All food items are prepared by the Licensee: AM snack, lunch and PM snack and provides drinking water and milk.

Page 1 of 4

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2022

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 4

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: LOPEZ FAMILY CHILD CARE	FACILITY NUMBER: 198014599
	VISIT DATE: 12/16/2022

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

Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible in all areas of the home. Smoke and carbon monoxide detectors were tested and are operable. Fire extinguisher indicates fully charged, serviced 07/22/22.

LPAs 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. LPAs reviewed facility records for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster drill log, last drill documented was 11/28/22. Children's roster was reviewed and is current.

Licensee states that there are no poisons stored in the home and understands that all poisons must be locked, not only inaccessible to children. Isolation area for sick children waiting to be picked up is always in the front patio of the home with supervision. Per Licensee there are no firearms or weapons stored in the home. LPAs observed first aid kit and earthquake equipment readily available in the living room and in the front yard (fenced).

Currently children use the front yard for outdoor play. The outdoor play area was observed to be fenced. LPAs observed that the outdoor yard has toys and other materials for children to play with. LPAs did not observe any objects that could be hazardous to children in care.

Licensee states no one smokes in the home.

Children’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, LIC 995A Notification of Parents’ Rights. Children's records were observed to be complete.

Staff records were reviewed for approved Pediatric First Aid and CPR certification, expires 09/2023, LIC 508- Criminal Record Statement, Proof of immunization's against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. Licensee's mandated reporter training was completed on 07/13/24. Staff records were observed to be complete.

Page 2 of 4

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2022

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: LOPEZ FAMILY CHILD CARE	FACILITY NUMBER: 198014599
	VISIT DATE: 12/16/2022

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

Infant Care: Per Licensee, she currently does not care for children under 12 months. LPAs informed licensee of the new Safe Sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months. LPAs 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. LPAs 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. Per Licensee, there are no children on medications. 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 Center 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.

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.

Page 3 of 4

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2022

LIC809 (FAS) - (06/04)

Page: 4 of 4

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: LOPEZ FAMILY CHILD CARE	FACILITY NUMBER: 198014599
	VISIT DATE: 12/16/2022

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

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/process

There were no deficiencies cited during today’s inspection.

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 and report was reviewed with the Licensee Elva Lopez .

Page 4 of 4

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2022

LIC809 (FAS) - (06/04)

Page: 3 of 4