198400441-10-7-2021-54-CC-DGIS-C7KQZF-20211007123641

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400441
Report Date: 10/07/2021
Date Signed: 10/07/2021 12:37:19 PM

Document Has Been Signed on 10/07/2021 12:37 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:	CORNEJO FAMILY CHILD CARE		FACILITY NUMBER:	198400441
ADMINISTRATOR:	MARITZA CORNEJO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 424-8430
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90018
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	10/07/2021
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Maritza Cornejo, Applicant		TIME COMPLETED:	12:45 PM

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This was a pre-licensing inspection conducted on 10/7/2021 at 10:45 AM by Denise Gibbs, Licensing Program Analysts (LPA). This pre-licensing inspection was conducted with Maritza Cornejo, applicant and Deborah Cornejo (for translation).

Individuals residing in the home have been discussed and noted. The applicant is requesting a large family childcare home license. Per applicant, operation hours will be Monday -Friday 8am-5pm. Applicant states that they will care for children zero to school-age.

During this inspection the applicant took LPA on a tour of the home and the following was noted:

All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a Two-story home that consists of four bedrooms and two bathrooms upstairs and living room, dining room, foyer, kitchen, laundry area, break room, one bathroom, front yard (not fenced), backyard (fenced), and detached garage downstairs.

Main care areas include living room, dining room and back yard.

Off limit areas include, four bedrooms and two bathrooms upstairs made inaccessible with child safety gates at the bottom and top of stairs and detached garage in the backyard (locked). The applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary.

Outdoor play area is located in the back yard. LPA observed that the yard is fenced and free of hazards. There are two spaces for outdoor play, the main yard and a smaller enclosed sand/garden area on the side of the house. There are no pools or spas, or other bodies of water. Applicant has small dog that stays upstairs during operating hours. -------------PAGE 1

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021

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: CORNEJO FAMILY CHILD CARE	FACILITY NUMBER: 198400441
	VISIT DATE: 10/07/2021

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LPA observed detached garage on the right side of the property. Garage will remained locked during daycare hours.

Areas that will be used by children were inspected for safety, comfort, cleanliness. There is operable telephone service via cell phones, ventilation and heating via a wall unit . LPA observed faux fire place in the living room. Detergents, cleaning compounds and hazardous items that can pose a danger to children are made inaccessible in the kitchen, under the sink with a child lock. LPA observed cleaning products on a high shelf in the main care area high enough to be inaccessible to children. Applicant states that there are no poisons kept a the facility. The applicant was advised that any poisons must be locked, not just inaccessible. There are age appropriate toys and material available for children. Children will nap on cots in the main care area. Per applicant there are no fire arms or weapons stored in the home.

LPA observed required postings in the foyer.

Infant Care: Applicant states they will care for infants. Applicant states the following for nap supervision: Infants will sleep in the main area supervised by an qualified adult at all times. Older infants will sleep on cots and younger infants will sleep in pack n plays. LPA informed applicant of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15- minute sleep check documentation for infants 0-24 months, and provided PIN 20-24-CCP.

LPA observed that the Applicant has multiple 2A10 BC fire extinguishers in the home, purchase receipt 2/2020. Applicant was informed that fire extinguishers need to be purchased or serviced every year. Dual smoke and carbon monoxide detector was tested and is operable.

The applicant states that AM and PM snack will be provided by facility and lunch will be brought by parents. Applicant was informed that any food brought from the children’s homes shall be labeled with child’s name and properly stored or refrigerated.

The applicant has completed the required Health and Safety Training, Nutrition, and Lead Training, Mandated Reporter Training and Pediatric First Aid and CPR. Required immunization's are current. There are first aid supplies available.
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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: CORNEJO FAMILY CHILD CARE	FACILITY NUMBER: 198400441
	VISIT DATE: 10/07/2021

NARRATIVE

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Incidental Medical Services (IMS):
This facility may provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

LPA Provided COVID-19 Technical Assistance by emailing applicant COVID-19 resources and self-assessment prior to visit. LPA discussed self-assessment and answered question regarding COVID-19 procedures.

Essential Protective Equipment and Supplies- Applicant and children (24 months and older) will wear facial coverings throughout the day, excluding meal and nap times. Applicant has a contact-less thermometer, hand sanitizer and disinfectant cleaning supplies in the home. Per applicant they will purchase disposable gloves.
Cleaning- Per applicant, high touched areas, bathroom and toys will be disinfected at the end of the day or as needed. There is a dirty toy box to be cleaned weekly and high touched toys daily.
Hygiene- Per applicant children will be encouraged to was their hands for 20 seconds throughout the day as needed. Applicant has the advised children's hand washing, cough and germs posting at children's level. Per applicant personal items will be placed in an individual cubby. Children will bring their own blanket and sheets for nap. The isolation area for a sick child waiting to be picked up will be in the break room next to the exit.
Arrival Procedures- Per applicant parents will drop off/pick up at the door. There are floor markers for parents to stay six feet apart while waiting. Daily temperature checks and health screenings are done at the front door, as parents will not be allowed to enter the facility. COVID-19 posters and resources are posted in the front entrance accessible to parents. Parents will be made aware of the COVID-19 policies and exclusion procedures in writing and verbal.
Group Size- We normally divide the children by age to have small groups. We also divide by areas. Some will be inside and some in the different areas outside with a teacher.. -------------PAGE 3

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: CORNEJO FAMILY CHILD CARE	FACILITY NUMBER: 198400441
	VISIT DATE: 10/07/2021

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Facility has large space to separate cots during nap time and children will be placed head to toe.

Based on the LPA observation, the following correction is need prior to obtaining a large family childcare license.

Purchased or serviced fire extinguisher is needed with date within the year

A large family childcare license will be granted upon Licensing Program Manager (LPM) Approval. Once licensed, the applicant is required to comply with the terms and limitations stated on the license.

Exit interview was conducted with Martiza Cornejo, applicant and Deborah Cornejo (for translation). This report along with a copy was provided to applicant. --------------------PAGE 4

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Denise Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021

LIC809 (FAS) - (06/04)

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