198014905-3-13-2024-54-CC-RDEO-D3BQBK-20240313120141

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198014905
Report Date: 03/13/2024
Date Signed: 03/13/2024 12:01:56 PM

Document Has Been Signed on 03/13/2024 12:01 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	CARDONA FAMILY CHILD CARE		FACILITY NUMBER:	198014905
ADMINISTRATOR:	JUAN CARDONA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 587-8766
CITY:	HUNTINGTON PARK	STATE: CA	ZIP CODE:	90255
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 4	DATE:	03/13/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Licensee - Juan Cardona		TIME COMPLETED:	12:30 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 Analyst (LPA) R. Derraco and C. Kam conducted an unannounced required 3 year inspection to the above facility on 03/13/24. LPAs arrived at the facility at 9:30 and met with Licensee, Juan Cardona, who guided analysts on a tour of the facility. LPAs observed 2 additional adults and 4 children in care during the inspection. Per licensee, C4 is a resident and attends a different day care, however the child is home today because of illness. LPA C. Kam provided a Spanish translation for licensee. This is a two-story home which consists of 3 bedrooms, 3 bathrooms, kitchen/dining room, living room, garage, front yard and backyard (fenced). The off limit areas include 3 bedrooms, 2 bathrooms, garage, kitchen, dining area and front yard. The main care area is located in the living room. LPAs observed child sized table, child sized chairs, age appropriate toys, children's art supplies, a couch, a wooden storage locker for children's personal belongs, a crib, baby changing station and a wall mounted television. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted near the entrance of the front door. A Child gate was observed to be mounted to the wall at the entrance to the off limits kitchen. A second child's gate was observed to be mounted to the bannister at the bottom of the stair way. The licensee states that he provides food for children in care. The bathroom was observed to have an operable sink, faucet and toilet. A child lock was observed on the cabinet below the bathroom sink. The outdoor play area is located in the back yard. LPAs observed perimeter fencing, outdoor play equipment, a tent for shade and a storage shed. LPAs observed the storage shed to be used for storing additional chairs and tables. A lock was observed at the top of the shed door making it inaccessible to children in care. LPAs did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs. LPAs did not observe any objects that can pose a danger to children in care. No bodies of water were observed in the back yard play area. There are no pets on the premises. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one (page 1 of 3)

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2024

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 03/13/2024 12:01 PM - It Cannot Be Edited

Created By: Randy Derraco On 03/13/2024 at 11:47 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: CARDONA FAMILY CHILD CARE	FACILITY NUMBER: 198014905
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/13/2024

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
1 2 3 4	Based on observation, interview and record review, the licensee and assistant did not renew their mandated reporter training every two years which poses a potential Health, safety and/or personal rights risk to persons in care.
	POC Due Date: 03/22/2024
	Plan of Correction
1 2 3 4	Licensee will email a picture of their Mandated Reporter training certificate to LPA

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:

Denise Gibbs

LICENSING EVALUATOR NAME:

Randy Derraco

LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2024

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CARDONA FAMILY CHILD CARE	FACILITY NUMBER: 198014905
	VISIT DATE: 03/13/2024

NARRATIVE

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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 cellphone that is used and the cellphone stays at the facility during operation hours. Per Licensee, the home is equipped with central heating and air conditioning. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 09/07/23, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable.

Detergents, cleaning compounds, and other items which could pose a danger to children were observed to be kept in a cabinet above the laundry appliances in the off limits laundry room. The room is made inaccessible by a locked door. The licensee states understands that storage areas for poisons must be locked, not just made inaccessible.

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 assistant have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 07/2025. LPAs observed that the Licensee and assistant do not have proof of the Mandated Reporter AB 1207 compliant Child Care Training
(page 2 of 3)

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CARDONA FAMILY CHILD CARE	FACILITY NUMBER: 198014905
	VISIT DATE: 03/13/2024

NARRATIVE

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Certificate on file. LPA advised licensee that a citation under Health and Safety Code (HSC) section 1596.8662(b)(1) will be issued. 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.

The following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22 and Health and Safety Code. Deficiencies that are being cited need to be cleared to protect the children’s health & 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.

Exit interview conducted and report was reviewed with the licensee Juan Cardona

(page 3 of 3)

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2024

LIC809 (FAS) - (06/04)

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