198016007-2-16-2024-33-CC-SLII-D2HQWY-20240216113244

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198016007
Report Date: 02/16/2024
Date Signed: 02/16/2024 11:33:03 AM

Document Has Been Signed on 02/16/2024 11:33 AM - 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	HERNANDEZ FAMILY CHILD CARE		FACILITY NUMBER:	198016007
ADMINISTRATOR:	HERNANDEZ, MARGARET		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(909) 461-6036
CITY:	POMONA	STATE: CA	ZIP CODE:	91767
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 2	CENSUS: 0	DATE:	02/16/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Licensee Magaret Hernandez		TIME COMPLETED:	12:00 PM

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At 9:20am, Licensing Program Analyst (LPA) Stephanie Li conducted an unannounced required 3 year inspection to the above facility. A risk assessment was conducted upon entry. LPA met with Licensee, Margaret Hernandez, who guided analysts on a tour of the facility. There is 1 adult and 0 children upon arrival. Per Licensee, there are currently 2 children enrolled. A current children’s roster was available for review. There were no children present due to licensee’s upcoming medical condition and upcoming surgery. Licensee is temporary closed till May. Facility capacity is in compliance for a Large Family Child Care Home. Hours of operation are Monday-Friday, 5:00am – 10:00pm.

This is a one story home which consists of 2 bedrooms, 2 bathrooms, living room, play room, office, dining room, kitchen, garage, and backyard (fenced). Currently residing in the home is Licensee only and no minor child. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed child care home.

Areas accessible to children were inspected as follows: living room, kitchen, dining room, playroom, bedroom 2, bathroom, and back yard. Fire place in living room was observed to have a secured and latched gate.

Per licensee, areas off limits to children and parents, Bedroom 1, 1 bathroom, office, and garage. The LPA toured all areas used by children during this visit. Per Licensee, there are no weapons or fire arms on the property. No bodies of water were observed. The outdoor yard is fenced.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is central ventilation and heating. There is telephone service via a cellphone and landline that stays at the facility during operation hours. pg. 1 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: HERNANDEZ FAMILY CHILD CARE	FACILITY NUMBER: 198016007
	VISIT DATE: 02/16/2024

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The following was observed and reviewed during this inspection:

LPA 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. LPA reviewed facility records for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan. All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. LPA’s observed the last drill logged was on 1/15/2024.

The home is observed to be clean and orderly, with central air and heating. There are toys available for children. Sleeping cots were observed. The valve on the required 2A 10BC fire extinguisher indicates last charged on 04/2021, as indicated on the service tag. LPA’s discussed with licensee requirements for servicing fire extinguishers yearly. Licensee stated she will get fire extinguisher serviced as soon as possible and submit photo proof to LPA via email. Smoke and carbon monoxide detectors were tested and are operable. Detergents, cleaning compounds, and medications were observed to be inaccessible to children. Per Licensee, there are no poisons in the home and understands that all poisons must be locked, to be made inaccessible to children. Licensing staff reminded licensee smoking is not allowed in a family child care home. The restroom that children use was observed to be safe and sanitary.

Licensee stated she is not servicing infants at this time. 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-andresources/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.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2024

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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: HERNANDEZ FAMILY CHILD CARE	FACILITY NUMBER: 198016007
	VISIT DATE: 02/16/2024

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Currently, children are using the back yard for outdoor play time. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA’s observed a sand box with a tarp cover on top. The tarp was observed to be sun worn and cracked in several places. Per licensee, she will get a new cover before reopening in May. At 9:45am, LPA observed side fence gate had a missing portion of the door creating a 6 inch gap from top of the fence to the bottom. Licensee stated that she will have the wooden gate door repaired before re-opening in May.

The licensee is observed to be operating within the license capacity limitations.

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

The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. The licensee Pediatric First Aid and CPR expires on 3/5/2025. Licensee stated she does not have current Mandated Reporter AB 1207 compliant Child Care Training Certificate. Licensee will complete mandated reporter training immediately and send certificate via email to LPA. LPA S Li emailed mandated reporter training link to licensees email address.

LPA observed that the Licensee does have proof of immunizations.

Licensee stated she does not provide IMS. Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: HERNANDEZ FAMILY CHILD CARE	FACILITY NUMBER: 198016007
	VISIT DATE: 02/16/2024

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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

LPA advised the licensee to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Currently, based on observation, interview, and record review, licensee does not have mandated reporter training. This violates Health and Safety code 1596.8662(b)(1). A technical violation (see LIC9201) is being issued due to licensee not servicing children until May.
A notice of site visit was given and must remain posted for 30 days.

Licensee Margaret Hernandez, confirmed that there are no Registered Sex Offenders living in the home. Exit interview conducted, report provided and appeal rights was reviewed with Licensee Margaret Hernandez. pg. 4 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2024

LIC809 (FAS) - (06/04)

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