304201008-8-4-2021-06-CC-YVIA-C5KTBU-20210804143542

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304201008
Report Date: 08/04/2021
Date Signed: 08/04/2021 02:35:51 PM

Document Has Been Signed on 08/04/2021 02:35 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	FELICIANO, JOYCE		FACILITY NUMBER:	304201008
ADMINISTRATOR:	FELICIANO, JOYCE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(714) 609-0984
CITY:	CYPRESS	STATE: CA	ZIP CODE:	90630
CAPACITY: 12	TOTAL ENROLLED CHILDREN: 0	CENSUS: 4	DATE:	08/04/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:50 PM
MET WITH:	Joyce Feliciano, Licensee		TIME COMPLETED:	02:30 PM

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	An Annual Random inspection was conducted at the facility by Licensing Program Analyst (LPA) Villa and LPA Rivas. LPAs were greeted by the Licensee Joyce Feliciano. LPAs observed 4 children present 3 toddlers and 1 infant at approximately 12:45PM upon arrival. All children were laying on blue napping cots. Licensee’s son was present in an off-limit area of the room. The licensees daughter Katlyn Corralez showed up to the facility about 20 minutes after arrival. Per Licensee Katlyn also assists her when necessary with the children. A review of the Facility Personnel Report Summary on this date indicates all facility residents, staff, or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Licensee was operating within the licensed capacity as specified on license. Licensee states there are 5 adults including the licensee living in the facility. Facility Day care hours are 7am-5:30pm Monday through Friday. During today’s inspection, LPAs and licensee toured the inside and outside areas identified in the facility sketch as accessible to childcare children. Off limits areas are made inaccessible by means of locked doors and supervision as stated by the Licensee. The areas used by the children are the living room and the back room of the home which is the main childcare area. The children use the restroom in the hallway to the left of the hallway and the backyard as per the Licensee. The licensee states there are currently 8 children enrolled at the facility. A children roster was in compliance and updated. The licensee states the main day-care area used by children is the backroom the room was found to be neat and with age appropriate toys free of hazards.

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Yesenia Villa
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2021

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: FELICIANO, JOYCE	FACILITY NUMBER: 304201008
	VISIT DATE: 08/04/2021

NARRATIVE

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There are working carbon monoxide, smoke detector, and fire extinguishers in the home that meet statutory and State Fire Marshall standards.

Detergents, cleaning compounds, medicines, and other items which could pose a danger if readily available to children were stored inaccessible to children. Licensee stated there are no firearms and/or other dangerous weapons in the facility, and none were observed during today's inspections.

There is a fireplace it is screened by a glass cover and inaccessible to children in care.

The home has age appropriate toys for the ages served. LPA verified there is a working telephone service (cellular service). Licensee stated the backyard is used for outdoor play, the backyard was observed to be fenced, shaded and with age appropriate toys. There are no bodies of water on the premises.

The licensee has a current roster of children in care. Four children’s records were reviewed for LIC700 and Immunization's and were found to be in compliance.

The licensee and assistant both have valid CPR/First Aid certifications with an expiration date of 01/2023. Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles.

Proof of immunization against pertussis, measles for (licensee and assistant) were reviewed and within compliance. Immunizations records were found to be in compliance for both the licensee and the assistant. Beginning March 31, 2018, H&S Code 1596.8662 requires all licensed providers and employees to complete mandated reporting training, and to renew the training every two years.

The licensee’s provider mandated reporter was completed and expires on 09/30/2021.She will submit the general training certificate to LPA Villa by 08/06/21. A technical advisory was issued for this requirement.

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Yesenia Villa
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2021

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: FELICIANO, JOYCE	FACILITY NUMBER: 304201008
	VISIT DATE: 08/04/2021

NARRATIVE

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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

The licensee understands she must be present in the facility and must ensure children in care are always supervised. Children are not to be left alone in parked vehicles. When the licensee is temporarily absent from the facility, arrangements must be made for a qualified substitute adult to care and supervise children while absent. The substitute adult must have the required criminal record, child abuse index clearances, immunizations, Pediatric CPR/First Aid, and mandated reporter training. LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

CCLD website www.ccld.ca.gov was provided to licensee to access regulations, updates, and licensing forms. Licensee was advised to register through childcareadvocatesprogram@dss.ca.gov in order to receive quarterly updates. Licensee was advised of their responsibility to review the Provider Information Notices (PIN) found on the CCLD website. Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials
LPA reviewed with licensee the following safe sleep best practices:
· Always place infants on their backs for sleeping
· Use only a tight-fitting sheet on the crib or play yard mattress
· Do not hang any items from the crib or above the crib
· Keep all items, including blankets, out of the crib or play yard
· Pacifiers may be used if they do not have items attached to them
· Infants should not be swaddled or have any items covering them while sleeping
· The temperature of the room should be comfortable enough for an adult to wear a t-shirt and not be too hot or too cold.

In the areas that were evaluated, NO deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Yesenia Villa
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2021

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: FELICIANO, JOYCE	FACILITY NUMBER: 304201008
	VISIT DATE: 08/04/2021

NARRATIVE

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An exit interview was conducted with licensee Joyce Feliciano. Appeal Rights were explained. The Licensee was provided a copy of appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above.

The Notice of Site Visit was posted and discussed as required by H&S Code Sec. 1596.817. Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.00. The Notice of Site Visit must be posted on or adjacent to the door.

End of Report.

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Yesenia Villa
LICENSING EVALUATOR SIGNATURE:	DATE: 08/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2021

LIC809 (FAS) - (06/04)

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