198014941-9-11-2024-12-CC-JTAO-D8ZT4C-20240911142343

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198014941
Report Date: 09/11/2024
Date Signed: 09/11/2024 02:24:47 PM

Document Has Been Signed on 09/11/2024 02:24 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	LOPEZ FAMILY CHILD CARE		FACILITY NUMBER:	198014941
ADMINISTRATOR/ DIRECTOR:	AURORA LOPEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 470-9974
CITY:	SUN VALLEY	STATE: CA	ZIP CODE:	91352
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 3	DATE:	09/11/2024
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:50 PM
MET WITH:	Aurora Lopez, Licensee		TIME VISIT/ INSPECTION COMPLETED:	03:00 PM

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On 09/11/2024 Licensing Program Analyst (LPA) Justeene Tamayo, met with licensee, Aurora Lopez who guided analyst on a tour of the facility for the One Year Required inspection. This is a single story, 3 bedroom, 1 bathroom home. Upon arrival LPA observed 1 infant, and 2 preschool age children in care and the licensee caring for them. Family members residing in the home include 2 adults (licensee, and licensee adult son) and one minor. Facility hours of operation are Monday -Sunday 6AM- 12AM. Incidental Medical Services (IMS) policy was discussed.

There are no bodies of water on the premises.

Physical Plant: Main care is provided in the living room. LPA observed appropriate number of chairs for children to sit. At this time, the playroom is currently in use and off limits to day care children. The children use the bathroom located in the hallway to the left. The off-limits areas are all bedrooms, and the outside detached garage area which is locked during business hours. The laundry room gives access to the backyard area, however their is a safety gate barricading the laundry room area when the access area is not being used.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: LOPEZ FAMILY CHILD CARE	FACILITY NUMBER: 198014941
	VISIT DATE: 09/11/2024

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The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds which are kept underneath the bathroom sink with a safety latch, and upper kitchen cabinet with a safety latch. Medicines are kept in the top kitchen cabinet with a safety latch, and hazardous items (sharp knives are kept in the upper kitchen cabinet with a safety latch).

Safe and age appropriate toys, play equipment and materials were observed. The smoke detector, carbon monoxide detector were tested and working properly as well as the Fire Extinguisher (2A10BC) are all in operable condition. Electrical outlets are inaccessible. No recalled and or prohibited toys or sleep/ play equipment were observed on the premises. There is a designated area for ill children as necessary in the family room area. Per Licensee, there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (cell).

Fire/Disaster drills are maintained current. Last fire disaster drill was completed and documented on 07/10/2024.

Bathroom: LPA observed the toilet and faucet are clean and operable. Shampoos and body wash were observed to be high enough making them inaccessible to children. Underneath the bathroom sink are cleaning supplies with a safety latch attached.

Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. The home has a clean and fully stocked refrigerator/freezer. Licensee currently has a food program. Breakfast, lunch, snacks and dinner are provided.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2024

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: LOPEZ FAMILY CHILD CARE	FACILITY NUMBER: 198014941
	VISIT DATE: 09/11/2024

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Naps are provided on cots in the living room.

Outdoor: The front yard is off limits. The backyard is completely fenced. There is a gate separating a dog run in the backyard and the door was observed to be locked. There are two dogs on the premises. Per licensee, dogs do not come in contact when children are present. LPA observed age appropriate toys, well secured and safe for children. There is a BBQ pit on the premises in the off limits area full covered. There is a storage shed in the off-limits dog run area. The right side of the backyard has a gate that gives access to the front year and was observed to be locked. LPA observed cameras around the property. LPA observed an outdoor air conditioner without a covering. Licensee will send proof of mesh covering for the outdoor air conditioner no later than 09/16/24. At this time, the children have not been going outside due to the heat.

There are no bodies of water in the premises.

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expired on 02/05/2024. Per licensee she has a current CPR/First Aid card that was completed in May 2024, but licensee could not provide proof of current CPR/First Aid. Licensee will send her completed CPR/First card to LPA Tamayo no later than 09/16/24. Facility has been cited a Type B Citation. Please see LIC809-D for deficiency page.

Mandated Reporter was reviewed and expired on 04/12/2024. Licensee will retake her mandated reporter training and send proof of completion to LPA Tamayo no later than 09/16/24. LPA reminded licensee; mandated reporter training must be completed every 2 years.

Documents Provided and or Discussed: Fire Drill Log, Postings, Employee's and Children's records, Safe Sleep PIN 20-24-CCP and Individual Sleeping Plan (LIC9227). Licensee currently does not have child care insurance.

Licensee Aurora 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 deficiencies have been cited at this time.

An exit interview was conducted, a copy of this report was reviewed and provided to licensee along with the appeal rights.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/11/2024 02:24 PM - It Cannot Be Edited

Created By: Justeene Tamayo On 09/11/2024 at 02:16 PM

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
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: LOPEZ FAMILY CHILD CARE	FACILITY NUMBER: 198014941
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/11/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102416(c)

Personnel Requirements

(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. Licensee could not provide current CPR/First Aid, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/16/2024
	Plan of Correction
1 2 3 4	Licensee will send proof of CPR/First aid to LPA Tamayo no later than 09/16/24.

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:

Mariela Ramon

LICENSING EVALUATOR NAME:

Justeene Tamayo

LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2024

LIC809 (FAS) - (06/04)

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