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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400517
Report Date: 06/14/2024
Date Signed: 06/14/2024 11:43:28 AM

Document Has Been Signed on 06/14/2024 11:43 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:MENDEZ FAMILY CHILD CAREFACILITY NUMBER:
198400517
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 13CENSUS: 0DATE:
06/14/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Licensee Brenda MendezTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On June 14, 2024 at 9:30 am, Licensing Program Analyst (LPA) Angelica Wallin, conducted an unannounced Annual Required Inspection and was met by Licensee, Brenda Mendez. Licensee is also requesting a large license with the capacity of 14. The Fire Department has granted clearance for a maximum capacity of 14 children, fire clearance received on 5/29/24. Per licensee, hours of operation are Monday to Friday from 6:00 AM to 6:00 PM. LPA toured the home inside and outside and a census was taken.

This one story home which consists of three bedrooms and one bathroom. Areas accessible to children in care include: living room as the daycare room, one bedroom as the nap room, kitchen (only as the walkway from living room to outdoor play area in the backyard), and the back yard at this time. Per Licensee, areas off limits include: two bedrooms, outdoor storage shed, and 1/3 far back portion of the back yard containing trampoline and dog house. During inspection, there were no children present. Per licensee, 13 children enrolled at this time. Licensee and LPA discussed Title 22 regulations regarding ratio and capacity.

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. LPA noted space with age-appropriate toys. During inspection, LPA observed an outdoor electrical fireplace with glass barricade in outdoor play area. There is a working smoke and carbon monoxide detector. During inspection, LPA observed fire extinguisher with service tag dated 4/18/24. During inspection, LPA observed cleaning supplies and chemicals kitchen cabinet under the sink with child proof latch inaccessible to children in care. During inspection, per licensee, knives located in a kitchen cabinet on high shelf inaccessible to children in care. During inspection, LPA observed one bedroom used as nap room and observed perfumes, lotions, spray bottles and electrical outlets without covers accessible to children in care. Licensee immediately addressed issued by removing all perfumes, lotions, spray bottles to inaccessible off-limits bedroom and covering electrical outlets.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Angelica Wallin
LICENSING EVALUATOR SIGNATURE: DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/14/2024
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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MENDEZ FAMILY CHILD CARE
FACILITY NUMBER: 198400517
VISIT DATE: 06/14/2024
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During inspection, LPA observed main bathroom and observed shampoos and conditioners accessible to children in care. Licensee immediately addressed by removing shampoos and conditioners and placed on a high shelf inaccessible to children in care. According to the applicant, there are no weapons or firearms at the home; LPA did not observe any firearms or weapons at the time of the inspection.

Per licensee, outdoor play is conducted in backyard. During inspection, LPA observed 1/3 far back portion of the back yard containing trampoline in outdoor play area with no off-limits barricade or fencing. Per licensee, children know not to go to trampoline area. Per licensee, trampoline is for personal children’s use only. LPA discussed with licensee regarding Title 22 regulations regarding prohibited items in a family child care home. LPA discussed with licensee regarding securing off-limit areas. A type B citation issued. LPA observed dog house with two dogs in same area of the backyard with barricade metal fence. LPA observed there no swimming pool or bodies of water. Per licensee, the following services are provided: food service. Per licensee, transportation service and overnight care are not provided at this time. LPA reviewed with licensee of Title 22 regulations regarding transportation service and overnight care if desired to provide services.

During inspection, though no children present, 5 children’s records were reviewed. Per children's record review, LPA observed two files with missing parent signatures on LIC 627 and LIC 700. A technical violation citation issued. A review of staff records indicates that licensee and one staff has the following updated certificates: mandated reporter certificate for licensee with expiration date of 11/2025 and for one staff with expiration date of 6/2025, updated CPR/1st aid certificate with expiration date of 11/2025 and updated immunization records on file for measles, pertussis, influenza and TB clearance.

Licensee Mendez was advised that regulation prohibits the smoking of tobacco in a private residence licensed as a family childcare home during the hours of operation. LPA reviewed with Licensee Mendez items prohibited in FCCH, no baby bouncers, no infant walkers, No Johnny jumpers, no saucer chairs, and any other item that falls into that category are not permitted in the facility.

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.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Angelica Wallin
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/14/2024 11:43 AM - It Cannot Be Edited


Created By: Angelica Wallin On 06/14/2024 at 11:08 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MENDEZ FAMILY CHILD CARE
FACILITY NUMBER: 198400517

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(6)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (6) Outdoor play areas shall be either fenced, or outdoor play areas shall be supervised by the licensee Section 102417(g)(5).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in 1/3 far back portion of the back yard containing trampoline in outdoor play area with no off-limits barricade or fencing which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/28/2024
Plan of Correction
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Per licensee, secure fencing to be placed around 1/3 far back portion of the back yard containing trampoline to ensure area is completely off-limits. Picture proof of completion to be submitted via email.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Karen Chambers
LICENSING EVALUATOR NAME:Angelica Wallin
LICENSING EVALUATOR SIGNATURE:
DATE: 06/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/14/2024


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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MENDEZ FAMILY CHILD CARE
FACILITY NUMBER: 198400517
VISIT DATE: 06/14/2024
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LPA discussed the safe sleep regulations and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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.

This facility does not provides Incidental Medical Services – IMS. 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/

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

Applicant to address the following prior to licensure to ensure safety at all times:


· 1/3 far back portion of the back yard containing trampoline to have secure barricade or fencing to ensure area is completely off-limits by 6/28/24
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Angelica Wallin
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2024
LIC809 (FAS) - (06/04)
Page: 5 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MENDEZ FAMILY CHILD CARE
FACILITY NUMBER: 198400517
VISIT DATE: 06/14/2024
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Once deficiency is addressed and cleared, LPA will recommend the increase in capacity as the licensee meets requirements for an increase and the fire clearance was received and granted for 14 children. After further review by the department, Licensee will be notified if/when the Large license is granted. Exit interview conducted and report was reviewed with licensee, Brenda Mendez. During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Angelica Wallin
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2024
LIC809 (FAS) - (06/04)
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