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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304313565
Report Date: 03/16/2023
Date Signed: 03/16/2023 01:08:30 PM

Document Has Been Signed on 03/16/2023 01:08 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:HERNANDEZ-GARCIA, ALBAFACILITY NUMBER:
304313565
ADMINISTRATOR:HERNANDEZ-GARCIA, ALBAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 929-5994
CITY:IRVINESTATE: CAZIP CODE:
92612
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 6DATE:
03/16/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Alba Hernandez-GarciaTIME COMPLETED:
01:30 PM
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Licensing Program Analysts (LPAs) Archibaldo Silva and Pat Rivas conducted a Required – 1 Year inspection during the hours of operation (M-F 7am – 5:30pm) accompanied by Alba Hernandez-Garcia. Upon arrival, the LPAs observed the licensee caring for six children, including one infant and 5 preschool children. The facility was operating within capacity as specified on the license and in compliance with posting requirements.

The Facility Personnel Report Summary review at the time of the inspection indicated that all facility residents, staff, or other individuals who require background checks have received criminal record and child abuse index clearances or exemptions. 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 prior to the initial presence in a licensed Family Child Care Home. A violation of this requirement will result in a citation of a deficiency and an immediate assessment of civil penalties of one hundred dollars ($100) per violation per day for a maximum of five (5) days by the Department. Four adults including the licensee and one minor (16 years) are currently living in the home according to the licensee.

During today’s inspection, the LPAs toured the inside and outside areas identified in the facility sketch and as accessible to child clients. The licensee has cameras installed inside the facility. The licensee stated that she does not use the cameras for supervision. The licensee stated she does not record anything and has no videos of previous days. Off-limits areas were inaccessible to children in care by means of baby gates and baby locks. The childcare area consists of the living room, part of the master bedroom, and a bathroom. The main childcare area is the living room play area, according to the licensee. Detergents, cleaning compounds, medicines, and other items that could pose a danger if readily available to children were stored away and inaccessible to children.
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SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE: DATE: 03/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/16/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 03/16/2023 01:08 PM - It Cannot Be Edited


Created By: Archibaldo Silva On 03/16/2023 at 11:41 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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: HERNANDEZ-GARCIA, ALBA
FACILITY NUMBER: 304313565

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/16/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(1)
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: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and records review, the licensee did not comply with the section cited above in 2 out of 2 fire extingquishers, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/23/2023
Plan of Correction
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Licensee agrees to service the current or purchase and place a new fire extinguisherin the facility by the due date and send proof of correction to LPA
Type B
Section Cited
CCR
102425(j)(2)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and records review, the licensee did not comply with the section cited above in 1 out of 6 children, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/17/2023
Plan of Correction
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Licensee agrees to physically check the infacts every 15-minutes, document it, and save the logs in a plastic filing box weekly.
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: 03/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/16/2023


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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: HERNANDEZ-GARCIA, ALBA
FACILITY NUMBER: 304313565
VISIT DATE: 03/16/2023
NARRATIVE
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Poisons or other items that could pose a danger to children were not observed during the inspection. The facility was equipped with working telephone service/cellular service. The licensee was reminded that the childcare phone shall remain the in the facility during the hours of operation. The children's bathrooms were clean and sanitary. Children nap on mats. The licensee stated that beddings are stored individually and taken home on Friday to be washed.

At the time of inspection, the facility was equipped with working carbon monoxide and smoke detectors that meets statutory. The fire extinguisher was last serviced on 2/2022. A Type B citation was issued because the extinguisher had not been serviced as required. The facility staff documented the last fire/disaster drill on 10/2022. The LPAs reminded the licensee that fire/disaster drills shall be conducted and documented at least once every six months. The fireplace is blocked with a wooden plank that is permanently screwed into the wall. The licensee stated that there are no firearms and/or other dangerous weapons in the facility, and none were observed at the time of the inspection. The facility has age-appropriate toys for the ages served. The licensee prepares food on-site and provides two meals and one snack to the children. Food prep areas were clean and sanitary at the time of inspection and food was properly stored. The LPAs observed that the floors, equipment, and furniture were clean and in good repair. Drinking water is available to children in care by means of bottles that are labeled by name.

LPAs observed that the yard was enclosed by a fence. At the time of inspections, the surface of the outdoor activity space was well-maintained and free of any observable hazards. During outside play, the children are provided drinking water by labeled bottles. The outdoor equipment and toys were in good repair and free of sharp edges. The facility’s grounds were safe, sanitary, and in good repair. There were no bodies of water (in-ground pool/ jacuzzi/ community pool/water fountain) in the facility at the time of inspection.

The LPAs reviewed three staff files out of three staff who were present during the facility inspection. The licensee’s mandated reporter will expire on 5/17/24 and the Pediatric CPR/First Aid certification expires on 1/11/24. The immunization records show that staff has been vaccinated against Tdap, MMR. A declination letter for flu vaccine was in file for one staff (S2). The licensee was reminded that 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.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023
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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: HERNANDEZ-GARCIA, ALBA
FACILITY NUMBER: 304313565
VISIT DATE: 03/16/2023
NARRATIVE
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Licensee has a current roster of children in care (a copy was obtained). The LPAs reviewed the records for the six children who were present during the inspection. All reviewed files were in compliance. The licensee stated, there is one infant under 12 months enrolled in the childcare. LPAs reviewed LIC 9227 Individual Infant Sleeping Plan and log for infants enrolled. In 1 of 6 infant records reviewed, one infant (C5) did not have 15-minute check logs (See LIC 80D).

The Incidental Medical Services (IMS) policy was discussed. A link to PIN 22-02-CCP was provided here: PIN 22-02-CCP: Best Practices Related to the Provision of Incidental Medical Services in Child Care Centers and Family Child. 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 the 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 for 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
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023
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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: HERNANDEZ-GARCIA, ALBA
FACILITY NUMBER: 304313565
VISIT DATE: 03/16/2023
NARRATIVE
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CCLD website www.cdss.ca.gov/inforesources/community-care-licensing was provided to the 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. A copy of the California Department of Social Services Lead Information Brochure was explained and provided to the licensee.

LPA reviewed the following safe sleep best practices with licensee:

· 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 a lightly clothed adult
Complete Individual Sleeping Plan LIC9227

and provided the CDSS.ca.gov Safe Sleep site 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.

LPAs is requesting a copy of the updated property lease by Monday March 20, 2023.

In the areas that were evaluated, the following deficiencies of the California Code of Regulations, Title 22, Division 12 were observed at the time of inspection: Operation of A Family Child Care Home 102417(g)(1) and Infant Safe Sleep 102425(j)(2).

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023
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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: HERNANDEZ-GARCIA, ALBA
FACILITY NUMBER: 304313565
VISIT DATE: 03/16/2023
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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/inspection-process.

The LPAs conducted an exit interview and reviewed the report with the licensee Alba Hernandez-Garcia. The “Notice of Site Visit” was posted and the licensee was reminded that it shall remain posted for 30 days.

The Appeal Rights were explained. The licensee received a copy of the Appeal Rights (LIC 9058 01/16), 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.

End of Report.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2023
LIC809 (FAS) - (06/04)
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