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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020795
Report Date: 10/13/2022
Date Signed: 10/13/2022 12:26:24 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 10/13/2022 12:26 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:HERNANDEZ FAMILY CHILD CAREFACILITY NUMBER:
198020795
ADMINISTRATOR:ARQUIMIDEZ E. HERNANDEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 497-3724
CITY:LOS ANGELESSTATE: CAZIP CODE:
90005
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
10/13/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Arquimidez Hernandez TIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Seung Lee conducted an unannounced required inspection. Upon arrival LPA Lee met with Licensee Arquimidez Hernandez.

This large family child care home is located in a 4 unit multiplex. The unit has a total of 2 bedrooms, 2 restrooms, living room, dining area, and kitchen. During the inspection Licensee stated that the only off limits area in the home is the laundry area near the rear exit of the unit. Licensee stated that the residents that currently live in this home are himself and his mother and father. Hours for the family child care home are Monday - Saturday 5AM-11:30PM.

The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. There are age appropriate toys and napping equipment on the premises. Per applicant there are no firearms in the home. Licensee stated that there 2 indoor cats that reside in the home. Licensee stated that food and water for the cats is kept off limits to children during business hours.

LPA Lee observed that the fire extinguisher was the appropriate size and was last serviced on 10/12/2021. Licensee's CPR and first aide expires 02/2024. LPA observed a operational smoke detector and carbon monoxide detector located by the front door.

During the inspection LPA reviewed Sudden Infant Death Syndrome (SIDS), Shaken Baby Syndrome, and safe sleep practices with applicant. *Infants should always sleep on their backs, mouths facing up, light bedding.*
SUPERVISORS NAME: Guangorena Claudia
LICENSING EVALUATOR NAME: Seung Lee
LICENSING EVALUATOR SIGNATURE: DATE: 10/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/13/2022
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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: HERNANDEZ FAMILY CHILD CARE
FACILITY NUMBER: 198020795
VISIT DATE: 10/13/2022
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During the inspection LPA Lee confirmed that the Licensee mother does live in the residence since the Licensee has submitted an application to add his mother Elsi Escobar as a co-Licensee. This individual was co-Licensee along with the current licensee in the previous license 198020005. Licensee was informed that the pending update application will still need to be approved and processed before a new updated license can be provided.

LPA advised the applicant how to access forms, regulations and quarterly updates, and Provider Information Notices (PIN) on the Child Care Licensing website at: www.ccld.ca.gov

LPA advised the facility to continue to comply with the latest guidelines for family child care homes from the CA department of public health.

Children's files were reviewed during the inspection.

Medication: Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

No deficiencies were cited during this inspection.

The notice of site inspection must remain posted for 30 days during hours of operation. Failure to maintain posting will result in a civil penalty of $100.00 dollars.

Exit interview conducted with Licensee Arquimidez Hernandez. Appeal rights discussed and explained.

SUPERVISORS NAME: Guangorena Claudia
LICENSING EVALUATOR NAME: Seung Lee
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2022
LIC809 (FAS) - (06/04)
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