198020797-3-29-2024-33-CC-SPEY-D3TNMR-20240329103533

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020797
Report Date: 03/29/2024
Date Signed: 03/29/2024 10:35:44 AM

Document Has Been Signed on 03/29/2024 10:35 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:	CORTEZ & BUSTOS FAMILY CHILD CARE		FACILITY NUMBER:	198020797
ADMINISTRATOR:	D. CORTEZ & MAXIMO BUSTOS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(213) 384-5276
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90029
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 10	CENSUS: 8	DATE:	03/29/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:24 AM
MET WITH:	Doloros Cortez and maximo Bustos, Licensees		TIME COMPLETED:	11:00 AM

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	On 03/29/2024, Licensing Program Analysts (LPA) Staicy Perry conducted an unannounced required 3-year inspection to the above facility. A COVID risk assessment was conducted upon entry. LPA met with Licensee Dolores Cortez and Maximo Bustos, whom the reason for the visit was explained. Per Licensee, there are 10 children currently enrolled. There were 4 children and 2 adults present upon arrival. At 9:45 am 4 more children arrived. The licensee was observed to be operating within the license capacity limitations. The licensee states that 3 adults live in the home (criminal record clearances on file) and 0 minors living in the home have obtained a criminal record clearance. LIC 811 on file. This is a one-story home which consists of 2 bedrooms, 2 full restrooms, kitchen, family room, living room, backyard (fenced), front yard (fenced), pool and garage. The family room in the back of the home is the, main area for care used for the day care. The LPA toured all areas used by children during this visit. Accessible to daycare children: 1 restroom (has child size toilet, 1 adult size toilet), family room, and backyard. Off limits/inaccessible to daycare children: All bedrooms, 1 restroom, kitchen, living room, pool and the garage. These areas are made inaccessible through child safety gates and safety knobs on the doorknobs. Per licensee parents enter through driveway and walk down to the right side where there is a ramp to go up to the glass sliding door to the main entrance to the family room area which is the main area for care.. Facility License, Emergency Disaster Plan, Parent’s Rights Poster, and Earthquake Preparedness Checklist were observed to be posted on the wall next to the entrance. A current children’s roster was available for review. page 1 of 5

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 5

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: CORTEZ & BUSTOS FAMILY CHILD CARE	FACILITY NUMBER: 198020797
	VISIT DATE: 03/29/2024

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
26
27
28
29
30
31
32

During this visit, all areas identified that are accessible for children to use were inspected for the safety, comfort, and cleanliness. Licensee guided LPA on the tour of the home. LPA toured starting from the main entree way, the home opens to the main family room area which has a glass sliding door that is utilized as the main entrance for the parents and children as well as access to the backyard and pool area. To the left side of the entrance is the kitchen which is separated by a gate where children are made inaccessible to the kitchen area, the family room was observed to have 1 bathroom that contains a wall diaper changing station, I small child size toilet, 1 adult size toilet, and one shower available for children`s use and LPA did not observe anything that can pose danger to the children in care. LPA toured the kitchen where cabinets were observed to have safety locks on all kitchen cabinets where sharp knives and cleaning products are stored which are made to be inaccessible to the children along with a gate to make the kitchen area off limits to the children. LPA observed toys, books, puzzles 2 small child size tables, T.V., air conditioner mounted on wall, a quiet area cube furniture and a wooden kitchen playset. Main family room was observed to have padding on the floors. LPAs observed mats for napping along with children’s cubbies for children’s storage and belongings. Per licensee she washes all sheets and blankets on a weekly basis.

There is telephone service via a cell phone that is maintained in the facility at all times. Hours of operation are Monday-Saturday, 23 hours a day. There is air and heating in the home.

Detergents, cleaning compounds, and medications were observed to be inaccessible to children. Per Licensee, there are no poisons in the home. LPA advised that any poisons should be locked under key or combination lock. Licensee states that there are no firearms or weapons stored in the home.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and LPA observed receipt and service tag with a 10/5/2023. Which indicates it is expired per title 22 regulations. Smoke and carbon monoxide detectors were tested and are operable and are in the main family room area. LPA observed 2 fire extinguishers.

All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. Last drill documented was conducted on 3/20/24. The home is observed to be clean and orderly. There are first aid supplies available. There are age-appropriate toys available for children.

Page 2 of 5

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2024

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: CORTEZ & BUSTOS FAMILY CHILD CARE	FACILITY NUMBER: 198020797
	VISIT DATE: 03/29/2024

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
26
27
28
29
30
31
32

Per licensee, she provides food for children in care. Licensee was advised that if food is brought from the children’s homes, all containers must be labeled with child’s name and properly stored or refrigerated. Licensee provides breakfast, AM Snack, Lunch, PM Snack and dinner. Licensee does not transport children.
LPA toured the outdoor play area (backyard) and inspected its safety and condition. LPA observed perimeter fencing, and backyard is free of miscellaneous debris/hazards. All trees, shrubs and plants are maintained. Outdoor play yard was observed to have toys for the children, basketball court, toy cars, balls and a handwashing station. Backyard is adequately fenced (block wall) and there is a swimming pool on the premises which is surrounded by a 6 foot tall metal fence which is kept locked at all times/when children are present via double key dead bolt. LPA observed it to open away from the pool and self-closing.

Pictures with measurements were obtained. LPA observed the self-latching gate, to swing away from the pool, and the latch measured no more than one (1) inch from the top of the gate. The rod iron fence measures five (5) feet in height with no noticeable gaps or openings exceeding more than four (4) inches. Per Licensee, the children do not have access or use the pool. Declaration was obtained.

Licensees’ records were reviewed. The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. Both licensee's Pediatric First Aid and CPR expires on 1/27/2025.

LPA observed that both Licensee has proof of Mandated Reporter AB 1207 compliant Child Care Training Certificate on file with expiration on 6/10/25. www.mandatedreporterca.com

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

LPA created an LIC 857, Children’s Record Review, and LIC 811, confidential names which documents persons living in the home and children’s files reviewed during this inspection.

page 3 of 5

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2024

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: CORTEZ & BUSTOS FAMILY CHILD CARE	FACILITY NUMBER: 198020797
	VISIT DATE: 03/29/2024

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
26
27
28
29
30
31
32

Per licensee, there is one small cat on the premises that remains in daughters room.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.
LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that fall into these categories are not permitted in a family childcare facility.

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/.

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.

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.

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-and-resources/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.

Page 4 of 5

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2024

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: CORTEZ & BUSTOS FAMILY CHILD CARE	FACILITY NUMBER: 198020797
	VISIT DATE: 03/29/2024

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
26
27
28
29
30
31
32

LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at www.ccld.ca.gov.

Licensee 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

During the exit interview, Dolores Cortez and Maximo Bustos, confirmed that there are no Registered Sex Offenders living in the facility.

Currently, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights were provided and reviewed.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

END OF REPORT

Page 5 of 5

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2024

LIC809 (FAS) - (06/04)

Page: 5 of 5