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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304314125
Report Date: 11/09/2023
Date Signed: 11/09/2023 11:39:37 AM

Document Has Been Signed on 11/09/2023 11:39 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:DUQUE GONZALEZ, LORNAFACILITY NUMBER:
304314125
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
11/09/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Lorna Duque GonzalezTIME COMPLETED:
11:40 AM
NARRATIVE
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This Informal Meeting was called to discuss the most current deficiencies issued to the facility. The licensee is requesting an increase in capacity from a small to a large family childcare home. The Departments mission is to ensure the health, safety, and personal rights of children in its licensed facilities.

The Licensing Program Manager (LPM) Patricia Magana explained the purpose and the process of the meeting. The purpose of the meeting was to inform the licensee that the Department has serious concerns about the following deficiencies:



Deficiencies.
06/21/23 CCR 102425(b) Infant Safe Sleep: Two play yards contained loose articles. One child was sleeping in one of the play yards with loose articles.
06/21/23 CCR 102425(h) Infant Safe Sleep: One infant sleeping in a car seat. The car seat with the infant was in the living room with a school age child.
06/21/23 CCR 102425(j)(1) Infant Safe Sleep: The licensee did not complete the 15 minutes safe sleep checks for two infants present.
06/21/23 CCR 102370(d) Criminal Record Clearance: Adult Elvira Garcia was not clear to be in the home at the time of inspection.
6/21/23 CCR 102421(b) Child’s Records: The licensee did not have a separate copy of the emergency card for two children. The licensee had the names of siblings in a single emergency card LIC700 for two families.
6/21/23 CCR 102419(d)(1) Admission Procedures and Authorized Representatives Rights: The licensee did not have a singed copy of the Parents Rights LIC995A for seven children’s records.
6/21/23 CCR 102417(m)(3) Operation of A Family Child Care Home: Four children records did not have affidavit of liability.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE: DATE: 11/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/09/2023
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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: DUQUE GONZALEZ, LORNA
FACILITY NUMBER: 304314125
VISIT DATE: 11/09/2023
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During the meeting, the Licensing Program Analyst discussed the appropriate use of highchairs. The licensee was informed that walkers, jumpers, and similar items are prohibited in a childcare licensed facility.

LPM discussed and suggested Technical Support Program, licensee agree.

The licensee stated that she has corrected all the since LPAs visit.

The licensee was registered to receive PINs during the meeting.

The licensee agreed to do the following to bring the facility into compliance no later than the following dates:



The licensee will review the safe sleep regulations highlighted in the document titled “Sueño Seguro – Preguntas Frecuentes” that was provided during the meeting. The licensee agrees to email the LPA a written declaration stating she has reviewed the document once she has done so.

The licensee will provided copies of the 15 minutes safe sleep checks for all infants. The licensee understands she must continue doing the safe sleep checks for all infants and keep the records for a minimum of 3 years.

The licensee will keep a complete, separate file for each child enrolled. A packet with the licensing forms for child’s records was provided.

The licensee will develop a protocol for the procedures listed below and email it to the LPA by 12/11/2023:
Drop off and pick procedures.
Feeding procedures.

During the meeting, the licensee was given the opportunity to discuss the deficiencies and plan of action above.

This meeting was conducted in Spanish, per the licensee’s request.

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

DATE: 11/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2023
LIC809 (FAS) - (06/04)
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