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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020575
Report Date: 04/02/2024
Date Signed: 04/02/2024 11:50:38 AM

Document Has Been Signed on 04/02/2024 11:50 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:ORNELAS FAMILY CHILD CAREFACILITY NUMBER:
198020575
ADMINISTRATOR:GUADALUPE ORNELASFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 708-8714
CITY:EL MONTESTATE: CAZIP CODE:
91732
CAPACITY: 14TOTAL ENROLLED CHILDREN: 7CENSUS: 4DATE:
04/02/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Licensee, Guadalupe OrnelasTIME COMPLETED:
12:15 PM
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At 10:25 am Licensing Program Analysts (LPAs) Roxana Lopez and Jessica Hopkins- Hernandez conducted an announced case management other inspection to the above facility on this date. LPAs met with Guadalupe Ornelas, Licensee, who guided analysts on a tour of the facility. The purpose of this inspection is to ensure that Licensee is in compliance with previous citations cited on 9/21/2023. There were 4 children present upon arrival. 1 being an infant. Also present during inspection was Licensee's adult daughter.

At 10:35 am LPA's observed the home to not be oderly- food particles were observed on the floors throughout the house and on the table that children use. The bedroom designated for use of children had various items of clothing on the floor- paperwork and there was also two buckets full of batteries, labeled old batteries. Poisons and cleaning compounds were accessible to the children in the living room, bathroom, and backyard. LPA’s advised that all poisons should be locked under key or combination lock. Poisons and cleaning supplies were removed during inspection. This poses an immediate risk for the health and safety for children in care- civil penalties were assessed on this date. LPA Lopez offered the Technical Support Program (TSP) to Licensee- per Licensee they will think about it.

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 04/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/02/2024
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 04/02/2024 11:50 AM - It Cannot Be Edited


Created By: Roxana Lopez On 04/02/2024 at 11:15 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ORNELAS FAMILY CHILD CARE
FACILITY NUMBER: 198020575

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/02/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/02/2024
Section Cited
CCR
102417(g)(4)

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(g) The home shall be free from defects or conditions which might endanger a child. (4) Poisons, detergents, cleaning compounds..., medicine...and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This req. is not met as evidenced by
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Licensee removed items during the inspection.Licensee will write a decleration with written plan to keep poisons off limits to children by 4/8/2024.
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Based on observation, the licensee did not comply with the section cited above in Poisons, cleaning compounds and batteries were accesible to the children in the living room, bathroom, bedroomwhich poses an immediate health, safety or personal rights risk to persons in care.
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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:Brandi VanOosten
LICENSING EVALUATOR NAME:Roxana Lopez
LICENSING EVALUATOR SIGNATURE:
DATE: 04/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/02/2024


LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 04/02/2024 11:50 AM - It Cannot Be Edited


Created By: Roxana Lopez On 04/02/2024 at 11:23 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ORNELAS FAMILY CHILD CARE
FACILITY NUMBER: 198020575

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/02/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/12/2024
Section Cited
CCR
102417(b)

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(b) The home shall be kept clean and orderly, with heating and ventilation for safety and comfort.

This requirement is not met as evidenced by:
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Per licensee, they will clean the inside and outside of the home. Licensee, will submit pictures to LPA of corrections by 4/12/2024..
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Based on observation,the licensee did not comply with the section cited above in the home to not be oderly- food particles were observed on the floors throughout the house and the table. The bedroom designated for use of children had various items of clothing and
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paperwork on the floor which poses/posed a potential health, safety or personal rights risk to persons in care.

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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:Brandi VanOosten
LICENSING EVALUATOR NAME:Roxana Lopez
LICENSING EVALUATOR SIGNATURE:
DATE: 04/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/02/2024


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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ORNELAS FAMILY CHILD CARE
FACILITY NUMBER: 198020575
VISIT DATE: 04/02/2024
NARRATIVE
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LPA Roxana Lopez informed licensee Guadalupe Ornelas that this report dated 4/2/2024 document(s) 1 Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Roxana Lopez informed the licensee to provide a copy of this licensing report dated (insert visit date) that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt

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 Licensee, Guadalupe Ornelas.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2024
LIC809 (FAS) - (06/04)
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