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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400325
Report Date: 11/10/2021
Date Signed: 11/10/2021 11:49:56 AM

Document Has Been Signed on 11/10/2021 11:49 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:ROMERO FAMILY CHILD CAREFACILITY NUMBER:
198400325
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
11/10/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Licensee - Florencia RomeroTIME COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA) R. Derraco conducted an unannounced required one year inspection to the above facility on 11/10/21. LPA arrived at the facility at 9:20 AM and met with licensee, Florencia Romero, who guided analyst on a tour of the facility. Per Licensee, there are eight children that are currently enrolled. There were three children present upon arrival. LPA observed one child being dropped off for care at 9:35 AM. LPA observed S2 arriving at the home at 9:45 AM. S2 provided a translation for LPA and licensee during the inspection.

This is a one-story home which consists of four bedrooms, two bathrooms, kitchen, dining room, living room, a detached garage, front yard and backyard (fenced). The off limit areas include three bedrooms, one bathroom, detached garage, front yard area, and half of the backyard area. The living room has been converted to the main care area. LPA observed age appropriate toys/materials, a wall mounted television, a couch, two storage cubbies for toys, a storage cubby for children's personal belongings, a Cosco playpen, child sized table and chairs. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed on the wall next to the front door. A wall heater was observed in the main care area. LPA observed a service tag dated December 3rd, 2020 indicating "wall furnace off at house line valve per customer request". A smoke detector/carbon monoxide detector was tested and is operable. A dining table was observed in the dining area along with a shelf stocked with drinks for the children in care and personal protective equipment supplies. A baby gate was observed in a door way leading to the off-limits hall way. The entrance to the restroom designated for children in care is located across the off limits hall way and was observed to also have a door labeled "restroom". LPA observed the restroom to be clean and free of defects. A bedroom door was observed in the dining area leading to a room designated for day care. Per licensee, the room is only used to separate children that are feeling ill. A playpen, a baby stroller, two twin sized beds, and a dresser drawer were observed in the room. LPA observed child proof door knob cover on the door leading to the room from the dining area. Another door with door knob cover was observed in the bedroom leading to an off (page 1 of 3)
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE: DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/10/2021
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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ROMERO FAMILY CHILD CARE
FACILITY NUMBER: 198400325
VISIT DATE: 11/10/2021
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limits bedroom and off limits bathroom. An additional baby gate was observed leading from the dining area to the off limits kitchen. Per licensee, cleaning products and detergents are stored in a locked cabinet beneath the kitchen sink. LPA observed cabinets in the off limits kitchen to have child proof locks. A door way from the off limits kitchen was observed to lead to the back yard play area. The back yard play area was observed to have perimeter fencing, a tent for shade, age appropriate toys and materials. A locked wooden gate was observed to separate the backyard play area from the off limits back yard area. LPA observed an entrance to the off limits garage in the off limits back yard area. LPA did not observe any objects that were accessible that can pose a danger to children in care.

The licensee states that she provides food for children in care. Individuals who reside in the home were noted and discussed. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed childcare home. Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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. Licensee states that there are no firearms stored in the home. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a cellphone and the cellphone stays at the facility during operation hours. Day care area was observed with safe toys, play equipment and materials. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked, not just inaccessible. The valve on the required 2A 10BC fire extinguisher indicates fully charged. A purchase receipt dated 11/27/20 was observed to be attached to the fire extinguisher. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs. No bodies of water were observed in the back yard play area. There are no pets on the premises. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

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
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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021
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: ROMERO FAMILY CHILD CARE
FACILITY NUMBER: 198400325
VISIT DATE: 11/10/2021
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recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on July 2022. LPA observed that the Licensee and assistant do have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. File review was observed to have proper mandated immunization records. Children’s records were reviewed, including emergency information and were observed to be complete. A current children’s roster was not available. LPA advised a technical violation will be issued regarding keeping a current roster of children in care.
Incidental Medical Services (IMS):
IMS was discussed with licensee. Per licensee, there are no children enrolled that require IMS at this time. 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.

LPA advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov. LPA also discussed and provided the following: the Provider Information Notices (PINS) on Recently Approved Safe Sleep Regulations in Effect: PIN 20-24-CCP, Child Care Facility Roster: LIC 9040

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

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.
A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Florencia Romero
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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021
LIC809 (FAS) - (06/04)
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