304313882-11-6-2024-06-CC-ACAO-DARRWK-20241106122317

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304313882
Report Date: 11/06/2024
Date Signed: 11/06/2024 12:23:26 PM

Document Has Been Signed on 11/06/2024 12:23 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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	YANEZ, MARIA		FACILITY NUMBER:	304313882
ADMINISTRATOR/ DIRECTOR:	YANEZ, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 658-7846
CITY:	BREA	STATE: CA	ZIP CODE:	92821
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 8	DATE:	11/06/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Licensee, Maria Yanez		TIME VISIT/ INSPECTION COMPLETED:	12:45 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	On 11/06/2024 at 9:05AM, Licensing Program Analysts (LPAs), Navar and Castro conducted a visit for the purpose of a 3 Year Inspection. At 9:05AM LPA observed licensee Maria Yanez and 1 Assistant caring for 5 preschool children 3 infants eating breakfast. Licensee was operating within the licensed capacity as specified on license. Facility Day care hours are 6:00 AM – 6:00 PM, Monday through Friday. 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. During today’s inspection, LPAs toured the inside and outside areas identified in the facility sketch as accessible to childcare children. Off limit areas are garage, 4 bedrooms, and 2 bathrooms, attic, and front yard. Off limit area doors are made inaccessible with a key lock. The childcare area consists of living room, family room, kitchen, dining room, one bathroom, and backyard. Childcare bathroom is located next to kitchen. Children nap on mats and infants in pack n plays. Licensee provides food for children. The facility has a fireplace inside the living that is inaccessible to children in care by the means of a fireplace screen. There is a working carbon monoxide, smoke detector, and a fire extinguisher in the home that meet statutory and State Fire Marshall standards. Last fire/disaster drill documented on 6/19/2024. Detergents, cleaning compounds, medicines, and other items which could pose a danger if readily available to children were stored inaccessible to children. Licensee had one unlocked cabinet with soap and mouth wash in the bathroom that was accessible to children in care. Children were not present and were playing in the living room. Licensee locked cabinet with a child’s safety lock and LPA’s informed licensee that items that can pose a risk to children in care must be inaccessible at all times during business hours. Licensee stated there are no firearms and/or other dangerous weapons in the facility, and none were observed during today's inspections. Continue to page 2

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Alma Castro
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: YANEZ, MARIA	FACILITY NUMBER: 304313882
	VISIT DATE: 11/06/2024

NARRATIVE

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The home has age-appropriate toys for the ages served. LPAs verified there is a working telephone service (cellular service). Licensee stated, they use the back yard for outdoor play, LPAs inspected the back yard, and it was found to be incompliance. There are no bodies of water at the facility.

The licensee has a current roster of children in care. 9 children’s records for children present during LPA’s inspection were reviewed for a copy of the emergency information card that contains all the information specified by regulation (LIC 700), Immunization records, Consent for Emergency Medical Treatment (LIC627), Notification of Parent’s Rights (LIC995A) and found to be in compliance. 1 of 9 children’s records reviewed was missing the LIC627 Emergency Consent form. LPAs reviewed LIC 9227 Individual Infant Sleeping Plan and 15-minute napping log for infants in care.

The licensee Pediatric CPR/First Aid certification expires 2/10/2024. 3 staff records were reviewed. Beginning September 1, 2016, Health, and Safety (H&S)1597.622(a)(1) 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, was reviewed and within compliance. 1 staff did not have TB to record to review on file. Staff stated it is completed and will send copy.

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 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.

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. A copy of the California Department of Social Services Lead Information Brochure was explained and provided to the licensee.

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SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Alma Castro
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024

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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: YANEZ, MARIA	FACILITY NUMBER: 304313882
	VISIT DATE: 11/06/2024

NARRATIVE

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The licensee has a current roster of children in care. 9 children’s records for children present during LPA’s inspection were reviewed for a copy of the emergency information card that contains all the information specified by regulation (LIC 700), Immunization records, Consent for Emergency Medical Treatment (LIC627), Notification of Parent’s Rights (LIC995A) and found to be in compliance. 1 of 9 children’s records reviewed was missing the LIC627 Emergency Consent form. LPAs reviewed LIC 9227 Individual Infant Sleeping Plan and 15-minute napping log for infants in care.

The licensee Pediatric CPR/First Aid certification expires 2/10/2024. 3 staff records were reviewed. Beginning September 1, 2016, Health, and Safety (H&S)1597.622(a)(1) 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, was reviewed and within compliance. 1 staff did not have TB to record to review on file. Staff stated it is completed and will send copy.

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 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.

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SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Alma Castro
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024

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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: YANEZ, MARIA	FACILITY NUMBER: 304313882
	VISIT DATE: 11/06/2024

NARRATIVE

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LPAs provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

Licensee was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPAs Navar and Licensee Maria Yanez that this report dated 11/06/2024 documents 1 Type B citation. See LIC809D.

During the exit interview, the LICENSEE Maria Yanez, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Exit interview conducted and report was reviewed with the licensee Maria Yanez. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

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.

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Alma Castro
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 11/06/2024 12:23 PM - It Cannot Be Edited

Created By: Alma Castro On 11/06/2024 at 12:01 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: YANEZ, MARIA	FACILITY NUMBER: 304313882
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/06/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(7)

Operation of A Family Child Care Home

(7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review the licensee did not comply with the section cited above. 1 child out of 9 files reveiwed did not have LIC627 Emergency Consent form on file for child in care which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/11/2024
	Plan of Correction
1 2 3 4	Licensee stated she will have parent fill out LIC627 form and email to LPA.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Judy Hanson

LICENSING EVALUATOR NAME:

Alma Castro

LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024

LIC809 (FAS) - (06/04)

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