198020159-1-29-2025-54-CC-PBIP-DDDVCJ-20250129151914

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020159
Report Date: 01/29/2025
Date Signed: 01/29/2025 03:19:26 PM

Document Has Been Signed on 01/29/2025 03:19 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:	CRUZ FAMILY CHILD CARE		FACILITY NUMBER:	198020159
ADMINISTRATOR/ DIRECTOR:	ISELA CRUZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 736-9982
CITY:	SOUTH GATE	STATE: CA	ZIP CODE:	90280
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 11	CENSUS: 4	DATE:	01/29/2025
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:50 AM
MET WITH:	Isela Cruz		TIME VISIT/ INSPECTION COMPLETED:	03:30 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's (LPA) P Bishop arrived at the above facility for the purpose of an Unannounced Annual Visit at 11:15am. Upon arrival, LPA announced the purpose of the visit and was granted entry into the facility by Licensee Isela Cruz who provided a tour of facility. LPA provided the inspection Entrance Checklist, LIC 126. LPA's inspected rooms/areas on the facility sketch in which child-care services are provided and to which children have access. Per licensee, the current hours of care provided are Monday – Friday 8:00 am -- 6:00 pm overnight care will be provided as needed. There were four children present during today's visit. Licensee stated that she and her husband, brother and daughter are the only one that lives here, and current criminal background clearances are present. LPA observed the facility license, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness forms. All documents were on Parent Board to the left upon entering the home. At 12:00pm LPA was given a tour of the facility. This is a two story - family home consists of five bedrooms, 3 bathrooms, kitchen, living/dining area and backyard and garage. Per licensee, the areas used by children include: Living Room, Bathroom 1, rear outside play area and one bedroom. At the time of the visit the bedroom was off limits. LPA observed the bedroom not to have any furniture. Areas that are used by children were inspected for safety, comfort, cleanliness, telephone service, ventilation, and heating. Off limit areas are the additional four bedrooms, kitchen and garage. Licensee states that the living room will be used as a Isolation area for sick children waiting to be picked up by a parent. Rooms that are off-limits need to be made inaccessible during operating hours. The licensee does understand that licensing staff may have access to off-limit areas during inspection visit, if necessary. At 12:15 pm, life-saving devices were inspected throughout the home. The smoke detector is located in the hallway which leads to the kitchen. The carbon monoxide detector is located in the main care area in the living room. All devices were tested and operable. The 2A 10 BC Fire extinguisher is located in the living 1 of 3

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Peter Bishop
LICENSING EVALUATOR SIGNATURE:	DATE: 01/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025

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

FACILITY NAME: CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 198020159
	VISIT DATE: 01/29/2025

NARRATIVE

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room and indicates it is out of compliance last serviced on 01/03/2024. Licensee was reminded that fire extinguisher needs to be serviced yearly. The home maintains telephone service via cell phone/LAN line.

At 12:30 pm Living Room (Main care area) was observed to be clean and orderly. There are toys and other age-appropriate materials for the children. LPA observed the living room to have a couch and other play toys. There were colorful storage boxes, and a crib.

LPA P Bishop observed the kitchen. Licensee states that the door to enter the kitchen is always closed to make off limits kitchen inaccessible to children in care. LPA observed that cleaning compounds in kitchen are made inaccessible to children in care with lock and key on cabinets. Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, not only inaccessible to children. Licensee further stated that all other pesticides are kept in the garage which is also off limits to the children

At 12:45 LPA observed that the bathroom the children use is clean and free of floor hazards. There was toilet paper, hand-washing soap, and towels for the children. LPA did not observe any chemicals stored under the sink.

Per Licensee there are no firearms or weapons stored in the home. LPA's did not observe any firearms or weapons in the home. Licensee states that there are no body of water present. LPA's did not observe any bodies of water on the premises.

LPA observed the back yard for outdoor play. The outdoor play area was observed to be completely fenced. At the time of the inspection the outdoor play area was off limits due to construction in the rear of the property. Licensee Cruz stated that the outside play area has been inaccessible since January 2025. LPA observed two parakeets and Licensee stated that they have one small dog LPA did not hear or see the small dog during the visit. Per licensee, the pet will be kept in off limits are during daycare hours away from the children.
Staff records were reviewed for approved Pediatric First Aid and CPR certification. Valid CPR/First Aide was available two of two expires 01/20/2026 and 01/16/2027. LIC-501: Personnel Record, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment was available at the time of the visit. LIC 9108- Statement Acknowledging Requirement to Report Child Abuse is available. Two of two did not have a current Mandated Reporter Certificate
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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Peter Bishop
LICENSING EVALUATOR SIGNATURE:	DATE: 01/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025

LIC809 (FAS) - (06/04)

Page: 2 of 6

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: CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 198020159
	VISIT DATE: 01/29/2025

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. Licensee Cruz stated that they do not provide IMS at this time. 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

Four Children’s records were available and reviewed.

Criminal Record Clearance - Family Child Care Homes - Licensee Cruz 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.
Licensee Cruz was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Based on the LPA Bishops observations, record review, and interviews, there wiil be two deficiencies cited today in accordance with California Title 22 Regulations. Licensee stated that the following Technical Violations will be corrected by February 12, 2025.
Mandated Reporter

Expired Fire Extinguisher

During the exit interview, the licensee, confirmed that there are no Registered Sex Offenders (RSO) living in the facility and LPA completed the RSO search in Megan’s Law Website.

A notice of site visit was given and must remain posted for 30 days. Failure to post will result in a $100 civil penalty. Exit interview conducted and report was reviewed with the Licensee Cruz. A copy of the report and appeal rights was given to Licensee Cruz.
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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Peter Bishop
LICENSING EVALUATOR SIGNATURE:	DATE: 01/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025

LIC809 (FAS) - (06/04)

Page: 3 of 6

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: CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 198020159
	VISIT DATE: 01/29/2025

NARRATIVE

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Criminal Record Clearance - Family Child Care Homes - Licensee Cruz 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.
Licensee Cruz was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Based on the LPA Bishops observations, record review, and interviews, there wiil be two deficiencies cited today in accordance with California Title 22 Regulations. Licensee stated that the following Technical Violations will be corrected by February 12, 2025.
Mandated Reporter

Expired Fire Extinguisher

During the exit interview, the licensee, confirmed that there are no Registered Sex Offenders (RSO) living in the facility and LPA completed the RSO search in Megan’s Law Website.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Peter Bishop
LICENSING EVALUATOR SIGNATURE:	DATE: 01/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025

LIC809 (FAS) - (06/04)

Page: 4 of 6

Document Has Been Signed on 01/29/2025 03:19 PM - It Cannot Be Edited

Created By: Peter Bishop On 01/29/2025 at 02:52 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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 198020159
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/29/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(1)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation the licensee did not comply with the section cited above in 1 out of 1which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/11/2025
	Plan of Correction
1 2 3 4	Licensee stated that she will get the Fire Extiguisher serviced and provide proof to LPA.

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 record review the licensee did not comply with the section cited above in 2 out of 2 persons which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/11/2025
	Plan of Correction
1 2 3 4	Licensee stated that she will complete training and submit to LPA.

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:

Karen Chambers

LICENSING EVALUATOR NAME:

Peter Bishop

LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025

LIC809 (FAS) - (06/04)

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