198400653-6-22-2023-54-CC-KCHE-CT2P3J-20230622105736

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400653
Report Date: 06/22/2023
Date Signed: 06/22/2023 10:57:47 AM

Document Has Been Signed on 06/22/2023 10:57 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:	CRUZ FAMILY CHILD CARE		FACILITY NUMBER:	198400653
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 13	CENSUS: 0	DATE:	06/22/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Rosa Cruz, Licensee		TIME COMPLETED:	11:15 AM

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 06/22/2023 at 9:45 AM, Licensing Program Analyst (LPA) Katrina Chicote conducted an Announced - Case Management Licensee Initiated inspection to the above facility for the purpose of a Capacity Increase inspection for a large family child care home. Department received fire clearance approval on 05/31/2023 for a large family child care home. Upon arrival, LPA disclosed the purpose of the inspection and met with Licensee, Rosa Cruz, who guided the LPA on a tour of the facility both indoors and outdoors. Adults in the home were discussed and all have criminal record clearance. Also present was A1, who assisted with Spanish-English translation. There were no day care children present during today’s inspection. Licensee states that there are currently 13 children enrolled. The children's roster was reviewed and is current. LPA observed required postings posted at time of inspection. Disaster drill log was also available during today’s inspection, last disaster drill conducted on 04/07/2023. Per Licensee, operation hours will be 24 hours, 7 days a week. LPA discussed with Licensee that license limits providing care to a child no longer than 23 hours. Overnight care will be provided in Bedroom 1, LPA discussed overnight care procedures with Licensee. LPA observed cots available in Bedroom 1 for children sleep. This is a single-story home which consists of three bedrooms and two bathrooms, Kitchen, Living Room, Den, and detached garage. Areas used by the children include the Living room (located upon entry of the home), Dining Room (located next to Living Room), Bedroom 1 for Preschool Playroom/Napping Room (located through Dining Room to the right), Bathroom 1 (located in hallway right outside Bedroom 1), and Den for Activity Room (located down hallway past Bathroom 1). Kitchen and Laundry Room are only accessible to children as a walkway to backyard, LPA observed babygate blocking access to Kitchen and a door from hallway that has a hook up top to make areas inaccessible. Per Licensee, areas off limits to children and parents include entire rear area of home which consists of Bedrooms 2 and 3 and Bathroom 2. LPA observed that there is a door blocking rear area of home, per Licensee this door will remain locked when children are in care. LPA observed this door to have a lock at time of inspection. Report Continues - Page 1 of 4

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023

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 4

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: CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 198400653
	VISIT DATE: 06/22/2023

NARRATIVE

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All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children and free of hazards. LPA observed a fireplace in Living Room that is not operable and only decorative. There is a working telephone maintained in the home. At 9:47 AM, LPA observed Living Room to have couches and pack-n-play in corner used for infant sleep. Per Licensee, she will serve food to children in care and use Dining Room for eating. At 9:50 AM, LPA observed Dining Room to have rectangular table with six chairs. LPA observed additional child size chairs stacked in corner and a small table as well as a high chair used for infant eating. At 9:51 AM, LPA observed Bedroom 1, which is used as a Day Care Room, to have shelves filled with soft plush toys, and other age appropriate toys free of loose and sharp parts available for children. At 9:53 AM, LPA observed Bathroom 1 to have operable toilet and sink, adequate handwashing and toileting supplies, and general area safety and sanitation. LPA observed under cabinet sink to be locked with key combination lock which contains cleaning solutions and another cabinet against a wall with a key combination lock storing medicines. At 9:56 AM, LPA observed Den to have couch, child size chairs, and TV hanging. LPA observed second pack-n-play in Den for infant sleep. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. LPA observed additional cleaning solutions in closets in Laundry Room with an operable lock requiring a key and at 9:58 AM, LPA observed Kitchen to have operable child safety locks on under cabinet sink with cleaning solutions and drawer where LPA observed knives to be stored.

Per Licensee, the children will have access to backyard area. LPA observed backyard is accessible through backdoor in Laundry Room. At 10:02 AM, LPA observed backyard has concrete area, grass and adequate perimeter fencing through-out the yard. LPA observed plastic play houses, plastic slides, and other age appropriate toys free of loose and sharp parts available for the children in the backyard. LPA observed all trees, shrubs, and plants are maintained. LPA observed detached garage in backyard that is off limits, LPA observed door to detached garage to be locked at time of inspection. LPA observed side yard of home to be made off limits with a gate and a lock on top corner at time of inspection.

LPA did not observe any pets at time of inspection and Licensee confirms she has no pets. Per Licensee, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPA observation did not see any bodies of water around the premises or firearms/weapons at time of inspection.

Report Continues - Page 2 of 4

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023

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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 198400653
	VISIT DATE: 06/22/2023

NARRATIVE

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At 10:04 AM, LPA observed the valve on the required 2A 10BC fire extinguisher indicates fully charged with service tag dated 04/07/2023. At 10:07 AM, LPA tested smoke and carbon monoxide detectors and observed to be in operable condition at time of inspection. Per Licensee, First Aid kit is kept in the Bedroom 1. The Licensee has current Pediatric First Aid and CPR valid until 03/05/2024. The Licensee has taken the AB1207 Mandated Reporter Training on 07/30/2021. LPA reminded Licensee that she is due to retake AB1207 training next month. Proof of immunization against influenza, pertussis, and measles was readily available during today’s inspection. Per Licensee, isolation area for sick children will be in Living Room.

The following were discussed:
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

Licensee (or facility representative) 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.

Rooms that are off-limits need to be made inaccessible during operating hours. NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers and any other item that falls into that category are permitted in the facility.

LPA discussed the safe sleep regulations with licenseeand 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 recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
Report Continues - Page 3 of 4

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023

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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 198400653
	VISIT DATE: 06/22/2023

NARRATIVE

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LPA reviewed and issued the LIC 311D - Forms/Records to Keep in Your Family Child Care Home. Mandatory Forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. The Licensee was advised how to access forms and Regulations online at www.ccld.ca.gov. Licensee was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care.

AB 1207: Beginning on January 1, 2018, this law requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: http://www.mandatedreporterca.com/

Senate Bill 792: this bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the visit.

Based on LPA's observation today, 06/22/2023, LPA will submit to Manager for review and approval for a large family child care home license. Pending approval, the Licensee is required to comply with the terms and limitations stated on the license.

A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and report was reviewed with the Licensee, Rosa Cruz.

Report Ends - Page 4 of 4

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023

LIC809 (FAS) - (06/04)

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