198400273-3-7-2023-54-CC-MRIA-CPQ2S6-20230307163837

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400273
Report Date: 03/07/2023
Date Signed: 03/07/2023 04:38:49 PM

Document Has Been Signed on 03/07/2023 04:38 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	LAGUNAS FAMILY CHILD CARE		FACILITY NUMBER:	198400273
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 5	DATE:	03/07/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Mayra Lagunas, Licensee		TIME COMPLETED:	04:45 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	On Tuesday, March 7, 2023, at 1:40 p.m., Licensing Program Analyst (LPA) Mayra Rivera conducted an unannounced annual and case management capacity increase inspection and met with licensee Mayra Lagunas who guided LPA Rivera on a tour of the facility. During this inspection, 5 children (one infant and four preschoolers) and assistant were present. LPA Rivera observed 4 children napping and one with licensee. Assistant and family members residing in the home was discussed with licensee and are background cleared. Operating hours are Monday to Friday, 7:00 a.m. to 5:00 p.m., and care for children ages 0 to 13 years. Fire clearance approval for capacity of 14 dated February 14, 2023. All areas identified on the facility sketch were inspected by LPA Rivera. This is a one single story home which consists of five bedrooms, den, two bathrooms, kitchen, laundry room, living room, front and back yard. Areas that are accessible to children and identified on the facility sketch are living room, kitchen, bathroom (located in the kitchen) daycare bedroom to the left of the living room and front yard. Areas off limits to children include: four bedrooms and bathroom located in the hallway, den, laundry room and backyard. LPA observed a gate barrier in place between the kitchen and hallway to prevent children going into the hallway and off limit areas. At approximately 1:49 p.m., LPA observed license, LIC 610A Emergency Disaster Plan, Pub 394 Notification of Parents Rights, LIC 999 Facility sketch and illness symptoms posted on the wall near the sign in area. At approximately 1:54 p.m LPA Rivera, inspected the facility for safety, comfort, cleanliness, ventilation and working phone (cell phone). For ventilation, LPA observed wall heater with fire screen protector. LPA Rivera entered the daycare area and observed the furniture, children materials, cots and a crib to be in good condition and age appropriate.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LAGUNAS FAMILY CHILD CARE	FACILITY NUMBER: 198400273
	VISIT DATE: 03/07/2023

NARRATIVE

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At approximately 1:59 p.m., LPA observed cleaning compounds items stored inside the bottom kitchen sink cabinet with a child proof lock in place making it inaccessible to children to open. Knives and sharp objects are stored inside the kitchen drawer and LPA observed all drawers with child proof locks in place making it inaccessible to children to open the drawers. For drinking water, licensee provides personal water bottles. Licensee provides the meals. During this visit licensee has no children with food allergies or prescribed or non-prescribed medication.

LPA Rivera asked if there are any pets, poisons, firearms, weapons or bodies of water. Licensee stated she has one husky dog (backyard), no firearms, or weapons nor water bodies of water. LPA did not observe the husky dog, firearms or weapons, pets, poisons, nor bodies of water. Licensee was advised that if any poisons (ex; drano, rat poison or items with skull hazard symbol), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately.

At approximately 2:06 p.m. LPA Rivera observed the required 2A10BC fire extinguisher located in the living room and the valve on the green area indicating fully charged and serviced on February 13. 2023. LPA observed carbon monoxide detector and the smoke detector located in the living room. LPA Rivera tested the carbon monoxide and the smoke detector. Carbon and smoke detectors are operable. LPA observed the first aid kit complete with band aids, gauzes, adhesive bandages and antiseptic wipes and located in the living room. LPA observed the earthquake and fire drill log dated February 6, 2023.

At approximately 2:50 p.m, LPA Rivera entered the restroom and observed the toilet, running water, hand soap and paper towels. Inside the bottom cabinet, LPA did not observe items that can pose a potential hazard to children. LPA observed the restroom to be in good condition.

At approximately 3:03 p.m., LPA inspected the outdoor area used by children for safety, comfort and cleanliness, LPA observed the front yard to be fenced all around and the side and front gate closed, and knob locked. LPA observed the play equipment to be age appropriate, in safe condition, free of sharp, no loose or pointed parts. LPA observed the surface of the outdoor activity space to have artificial grass turf.

Children’s roster, children’s and licensee files were reviewed during the inspection.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LAGUNAS FAMILY CHILD CARE	FACILITY NUMBER: 198400273
	VISIT DATE: 03/07/2023

NARRATIVE

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LPA observed licensee Mayra Lagunas Pediatric First Aid/ CPR certification dated October 1, 2021, Health and Safety certification dated November 3, 2019. Licensee has proof of immunization against Pertussis, MMR and Influenza declination. Licensee has completed the mandated reporter (AB 1207) training dated January 18, 2023. Licensee was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

The following was also discussed with licensee:

1. In the absence of the licensee a qualified adult must be present, supervising the children; a qualified adult is an individual who has a valid and current Pediatric first aid/ CPR-adult-child- infant certification and a valid criminal record clearance associated to the facility license.

2. A current roster of children enrolled must be available and maintained for a period of 3 years, even after children are no longer attending the facility.

4. Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the license shall be terminated.

5. The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.

6. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.

7. Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing (refer to LIC 624B). Mandated reporter requirements were reviewed and explained.

8. Fire and safety drills must be performed every six (6) months and documented for review by the Department.

9. Smoking is prohibited in the family childcare home.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LAGUNAS FAMILY CHILD CARE	FACILITY NUMBER: 198400273
	VISIT DATE: 03/07/2023

NARRATIVE

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10. Children and staff records must be maintained and updated as needed and be available for review by the Department.

11. Dog(s) and/or pets are recommended to be isolated from children in care.

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

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/inspection-process

Licensee Mayra Lagunas was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Family Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee Mayra Lagunas 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 Mayra Lagunas 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.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

LIC809 (FAS) - (06/04)

Page: 7 of 7

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LAGUNAS FAMILY CHILD CARE	FACILITY NUMBER: 198400273
	VISIT DATE: 03/07/2023

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	Technical violation was given during this inspection for not having Child #2 Safe Sleep Log. No citations given during this visit. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with licensee Mayra Lagunas.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Mayra Rivera
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

LIC809 (FAS) - (06/04)

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