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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304312411
Report Date: 03/14/2024
Date Signed: 03/14/2024 04:03:00 PM

Document Has Been Signed on 03/14/2024 04:03 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:JAUREGUI, MARTHA ALICIA & GUSTAVOFACILITY NUMBER:
304312411
ADMINISTRATOR:JAUREGUI, G & MARTHA AFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 699-1023
CITY:BUENA PARKSTATE: CAZIP CODE:
90620
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
03/14/2024
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Martha A. JaureguiTIME COMPLETED:
04:20 PM
NARRATIVE
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On 3/14/24 at approximately 1:00 PM, Licensing Program Analysts (LPAs) A. Silva and V. Trinh conducted an unannounced Case Management – Legal/Non-Compliance visit to inspect the facility for compliance. The facility was operating within staff to child ratios and licensed capacity. A review of the Personnel Summary Report shows all staff or other individuals who require clearance have received clearance or exemptions.

At about 1:00 PM during today's inspection, Licensee Martha Jauregui allowed LPAs entrance into the childcare facility. LPAs observed one assistant caring for a child who was napping. The licensee picked up additional children from school while the LPAs were at the facility with the assistants.

The LPAs toured the inside and outside areas identified in the facility sketch as accessible to childcare children. Indoor off limits areas are made inaccessible by means of baby doorknobs child proof locks on the cabinets.

The childcare area consists of the back room with built in kitchen, bathroom, and storage room. There are working carbon monoxide and smoke detectors, and a fire extinguisher 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. The facility does not have a fireplace. The facility has central air conditioning in the childcare room. The home has age appropriate toys for the ages served. The licensee stated there is a working telephone service.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE: DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/14/2024
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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Document Has Been Signed on 03/14/2024 04:03 PM - It Cannot Be Edited


Created By: Archibaldo Silva On 03/14/2024 at 03:11 PM
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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: JAUREGUI, MARTHA ALICIA & GUSTAVO
FACILITY NUMBER: 304312411

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/15/2024
Section Cited
CCR
102417(g)

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102417(g) Operation of a Family Child Care Home. The home shall be free from ... conditions which might endanger a child. Safety precautions shall include but not be limited to:
The licensee did not met the regulation above as evidenced by:
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The licensee locked the door during the inspection. The licensee stated she will ensure the door is locked at all times when children are in care.
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Based on observation, the licensee did not meet the regulation above in 1 of 1 doors to off-limits area, which is a potential risk to children's safety. LPA observed door leading to off limits area where a large dog is kept was unlocked, accessible to children in care.
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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:Patricia Magana
LICENSING EVALUATOR NAME:Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:
DATE: 03/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/14/2024


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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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: JAUREGUI, MARTHA ALICIA & GUSTAVO
FACILITY NUMBER: 304312411
VISIT DATE: 03/14/2024
NARRATIVE
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The backyard is used as the outdoor play area, LPA inspected the outdoor gates to verify doors are locked. The door leading to a side patio that is off-limits was unlocked. The licensee was reminded that off limit areas must be inaccessible (809D issued). There are no bodies of water on the premises.

The licensee had a current roster of children in care. Children’s records for children present during the inspection were reviewed for a copy of the emergency information card that contains all the information specified by regulation (LIC 700) and found to be in compliance. Licensee stated there are 3 infants under 24 months enrolled in the childcare facility at this time. Based on records review, two LIC9227 forms were missing signatures from the parents. The LPA issued a technical note to the licensee.

The licensees Pediatric CPR/First Aid certification are current. Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at a family childcare home if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, measles for licensees and assistants were reviewed and within compliance. 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 licensees and staff present in the facility had copies of current certification at the time of the inspection.

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

LPA discussed the safe sleep regulations with licensee and 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.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
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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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: JAUREGUI, MARTHA ALICIA & GUSTAVO
FACILITY NUMBER: 304312411
VISIT DATE: 03/14/2024
NARRATIVE
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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.

The Department will monitor the licensee’s compliance with the compliance plan to determine whether the licensee is operating the facility in a manner consistent with the law. The licensee understands and acknowledges that the Department, at its discretion, will make unannounced case management visits to monitor the licensee’s compliance.

The facility was not in compliance. Violations of the California Code of Regulations, Title 22, Division 12 were observed, discussed, and cited at the time of the visit. The following violations of the California Code of Regulations, Title 22; Division 12, were observed and cited today: 102417(g) Operation of a Family Child Care Home.

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.

Exit interview conducted and report was reviewed with the licensee Martha Jauregui. A notice of site visit was given and must remain posted for 30 days. Appeal were provided.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
LIC809 (FAS) - (06/04)
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