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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400528
Report Date: 03/30/2023
Date Signed: 03/30/2023 04:13:32 PM

Document Has Been Signed on 03/30/2023 04:13 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:GARCIA FAMILY CHILD CAREFACILITY NUMBER:
198400528
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
03/30/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Licensee Connie Garcia TIME COMPLETED:
03:00 PM
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On 3/30/2023 Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced required 1 year inspection at the above facility. LPA met with Licensee Connie Garcia and informed her of the purpose for the visit. LPA provided Licensee with a copy of the Facility Entrance Checklist. During this inspection, there were 4 children and one assistant present.The facility is in compliance for a small family child care home. All residents were noted and verified. All criminal record clearances for adults present were verified.
Facility provides care to children ages 3 months to 5 years old.The facility operates Monday through Friday from 8AM to 5PM.
This is a one story 3 bedroom, 1 bathroom home with a living room, family room, kitchen, enclosed backyard and garage. Per Licensee areas on limits to children are: The living room (main day care area), family room (napping room), one bedroom ( diaper changing room), bathroom, kitchen and enclosed backyard. Areas off limits to children: two bedrooms, garage and a section of the enclosed backyard.
All areas that are accessible to children were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection: LPA observed required posted documentation- Facility license, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form, LIC 9040 Facility Roster and a disaster drill log. Licensee had a current copy of the facility roster and the last documented disaster drill was conducted on 2/3/23. There is an operable combination smoke detector/ operable carbon monoxide detector in the facility. LPA observed a 2A10BC Fire Extinguisher in the facility which indicated full. The home has an ac unit in the living room and the family room and portable heaters. There are two inaccessible wall heaters in the facility. One screened heater is in the living room and the other is in the family room. The home maintains telephone service (cell phone). Food is provided by Licensee. Licensee was reminded if children bring food from home it must be labeled with the child’s name and properly stored or refrigerated. There are toys and other age appropriate materials available for children to use in the day care areas. Sharp objects, detergents and cleaning compounds in the kitchen were inaccessible to children in care. Knives are kept in an upper kitchen cabinet and cleaning compounds are kept in an upper cabinet in the pantry area and above the refrigerator. There is a safety gate installed to prevent access to the kitchen from the living room.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/30/2023
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: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 198400528
VISIT DATE: 03/30/2023
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Per Licensee, children walk through the kitchen to access the backyard and are escorted while walking through. Per Licensee, none of the children enrolled require medication at the facility and personal medication is kept in an off limits bedroom. Children use the bathroom in the hallway. LPA did not observe any hazardous items in the bathroom. Infant children are changed in the on limits bedroom. Children use the diaper changing room or the family room for an isolation area when waiting to be picked up.
Children use the backyard for outdoor play. The backyard is separated into two areas. There is a gate separating the on limits section from the off limits section. Per Licensee, children are supervised while playing outside. Per Licensee, poisons are contained in a locked shed in the off limits section of the backyard. Licensee was advised that all poisons must be locked, not only inaccessible to children. There is a properly stored firearm in the home inaccessible to children in care. There are no pools or spas, or other bodies of water and there are no pets.
Infant Care: Currently licensee cares for two infants. LPA observed two cribs available in the facility. One crib is in the diaper changing room and the other is in the family room. LPA observed that napping equipment does not block entrances or exits. Infant mattresses were observed to be firm with tightly fitted sheets. LPA did not observe loose object, bumpers, objects hanging, or objects attached to the cribs. Each infant has their own napping equipment and bedding. Per Licensee, one infant naps in a crib and the other uses a napping cot. LPA observed sleeping logs for infants enrolled.
Overnight Care: There is no overnight care provided at the moment. LPA discussed the following in case overnight care is provided: Licensee is aware that they must remain wake while children are awake. If children sleep in separate area from licensee, the door must remain open. If licensee cannot hear children when they wake up, video or audio device can be used.
Children’s records were reviewed and included (LIC) 282- Affidavit Regarding Liability Insurance, Immunization Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights and documentation of 15-minute Infant Sleep Check (0-24 months).
Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement acknowledging requirement to report child abuse and Mandated Reporter Training Certificate.
Licensee and assistant 1 have a pediatric first aid/ child cpr certification issued by the American Heart Association. Both certifications expire on 10/2024. Licensee and Assistant 1 have completed the Mandated Reporter for Child Care Provider's training. Both certificates expire on 2/4/24.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023
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: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 198400528
VISIT DATE: 03/30/2023
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Both staff have proof of required immunization against pertussis, measles and flu and proof of TB clearance. During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.
Incidental Medical Services (IMS):
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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm
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.
LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleephttps://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.
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.
No deficiencies are being cited today. Exit interview conducted and report was reviewed with the Licensee, Connie Garcia. Copy of report was provided to Licensee. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023
LIC809 (FAS) - (06/04)
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