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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020609
Report Date: 05/16/2024
Date Signed: 05/16/2024 04:44:22 PM

Document Has Been Signed on 05/16/2024 04:44 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:FERDINANDUS FAMILY CHILD CAREFACILITY NUMBER:
198020609
ADMINISTRATOR/
DIRECTOR:		IONA FERDINANDUSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 231-1649
CITY:GLENDORASTATE: CAZIP CODE:
91740
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
05/16/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:31 PM
MET WITH:Iona FerdinandusTIME VISIT/
INSPECTION COMPLETED:
05:15 PM
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Licensing Program Analyst (LPA) Cynthia Reyes conducted an unannounced annual inspection on this date. This inspection is to ensure the health and safety standards as required by the regulations governing child care homes are met. LPA met with Iona Ferdinandus, Licensee. A copy of the Entrance Checklist for Child Care homes form (LIC 126) was provided. Licensee took LPA on a tour of the home. Census of children who were in care on this date was taken. LPA also observed and identified 2 adults in the home that are from Easter seals and who were observing C1 in care. Also present in the home on this date was the licensee daughter, husband and 2 other females that live in the home and were identified as volunteers. Individuals residing in the home are 6 adults and 1 child. The facility operating hours are Monday through Friday 6:30 AM-6 PM.

Areas used by children were inspected as follows: Bathroom in the hall way, day care/family room, large dinning room and back yard.

Areas off limits include: Master bedroom W/Bathroom, 3 other bedrooms, Kitchen, living room, Garage, Laundry area, and front yard. **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.



Cleaning supplies were observed in the off limit laundry room. The home has electrical outlet covers throughout and maintains a First Aid Kit in the home. There are adequate age appropriate toys, books, and games.

Licensee states there are 4 dogs on the premises. The 4 dogs are locked in the off limit garage when children are in care.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2024
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: FERDINANDUS FAMILY CHILD CARE
FACILITY NUMBER: 198020609
VISIT DATE: 05/16/2024
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Licensing staff observed the following required posted documentation in the day care room: Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Forms. LPA reviewed facility records for LIC 9040- Facility Roster and LIC 610- Facility Disaster Plan. Licensee First Aid/CPR certificate is Expired. Licensee does not have proof of Mandated Reporter certificate.

Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, and made inaccessible to children. Isolation area for sick children waiting to be picked up is in the living room and other children will be away from the sick child in the day are room.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, A current children’s roster was not available for review. Roster was completed during this inspection.

Licensee records were reviewed, LPA reviewed the LIC 508- Criminal Record Statement. Licensees does not have Proof of immunization's against measles and TDAP. or Influenza, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse.

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/.

The following was observed and reviewed during this inspection. All areas identified on the facility sketch were inspected for safety, comfort, and cleanliness. There is telephone service via a land line and a cellphone that stays at the facility during operation hours. There is ventilation and heating. Detergents, cleaning compounds, and medications were observed to be inaccessible to children. The restroom that children use was observed to be safe and sanitary
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2024
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: FERDINANDUS FAMILY CHILD CARE
FACILITY NUMBER: 198020609
VISIT DATE: 05/16/2024
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LPA Reyes observed the valve on the required 2A10BC fire extinguisher indicates fully charged, however the purchase date states 2020. Smoke detector and carbon monoxide was tested and is operable. LPA advised that all small family day care homes shall conduct fire and disaster drills at least once every 6 months and a large day care is every 3 months, and document the date and time of each drill. Last drill conducted and documented on 01/10/2024. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted on the parent board and visible to parents and all to see.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.


LPA did not observe any objects that can pose a danger to children in care. The licensee is observed to be operating within the license capacity limitations.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.

The department has On Duty Workers available for questions Monday through Friday at (323) 981-3350 from 8:00 AM - 5:00 PM.

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

Criminal Record Clearance: 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.

Report continues on next page

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2024
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: FERDINANDUS FAMILY CHILD CARE
FACILITY NUMBER: 198020609
VISIT DATE: 05/16/2024
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AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com. NEED TO TAKE

Infant Care: LPA discussed the safe sleep regulations with licensee [or facility representative] 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.

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.



The following deficiencies were cited in accordance with Title 22 of the California Code of Regulations and Health & Safety Codes. Please see 809D for documentation of deficiencies. Consultation was conducted on this date.

Exit interview conducted and report was reviewed with Iona Ferdinandus, Licensee.

During the exit interview, the Licensee Iona Ferdinandus confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/16/2024 04:44 PM - It Cannot Be Edited


Created By: Cynthia Reyes On 05/16/2024 at 02:58 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: FERDINANDUS FAMILY CHILD CARE
FACILITY NUMBER: 198020609

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/16/2024

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
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Based on record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/24/2024
Plan of Correction
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Licensee states her and her assistans will take the mandated reporter training and submit proof by the plan of corrections date.
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/24/2024
Plan of Correction
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Licensee states her and her assistans will get all their immunizatiins (TB/MMR/TDAP/FLU) and submit proof by the plan of corrections date.
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:Christina Gabelman
LICENSING EVALUATOR NAME:Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:
DATE: 05/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/16/2024


LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 05/16/2024 04:44 PM - It Cannot Be Edited


Created By: Cynthia Reyes On 05/16/2024 at 02:58 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: FERDINANDUS FAMILY CHILD CARE
FACILITY NUMBER: 198020609

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/16/2024

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
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Based on record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/24/2024
Plan of Correction
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Licensee states her and her assistans will take the Pediatric First Aid nd CPR class and submit proof by the plan of corrections date.
Type B
Section Cited
CCR
102416.1(a)
Personnel Records
(a) Personnel records shall be maintained on each employee and shall contain the following information:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/24/2024
Plan of Correction
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Licensee states her and her assistans will complete all the requiered documents for their file and submit proof by the plan of corrections date.
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:Christina Gabelman
LICENSING EVALUATOR NAME:Cynthia Reyes
LICENSING EVALUATOR SIGNATURE:
DATE: 05/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/16/2024


LIC809 (FAS) - (06/04)
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