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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334819141
Report Date: 10/29/2021
Date Signed: 10/29/2021 12:09:42 PM

Document Has Been Signed on 10/29/2021 12:09 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:RAMIREZ-RUIZ FAMILY CHILD CAREFACILITY NUMBER:
334819141
ADMINISTRATOR:RAMIREZ-RUIZ, NUBIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 795-9646
CITY:CALIMESASTATE: CAZIP CODE:
92320
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
10/29/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:08 AM
MET WITH:Licensee Nubia Ramirez-RuizTIME COMPLETED:
12:15 PM
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On 10/29/2021, Licensing Program Analysts (LPAs) Destinee Hogue and Laura Mejorado arrived at the facility to conduct an inspection for another purpose. During this inspection, LPAs toured the facility inside and outside, took census, verified facility associations and reviewed facility records. The following was discussed with Licensee Nubia Ramirez-Ruiz:

Upon LPAs arrival, LPAs observed Licensee caring for one child who is under 24 months of age and Licensee stated she cares for another child who is under 24 months of age that was not present at the time of this inspection. LPAs observed a child in care, sleeping in a play yard with more than one loose blanket and sleeping on a non-fitted sheet. LPAs also reviewed facility records and at the time of this inspection, Licensee did not have an updated facility roster.

See LIC809D for deficiency cited per California Code of Regulations Title 22, Division 12.

A notice of site visit was given and must remain posted for 30 days. THE LICENSEE UNDERSTANDS FOR THE NEXT 30 DAYS A COPY OF ALL TYPE A DEFICIENCIES (LIC809D) CITED DURING THIS INSPECTION SHALL BE POSTED AT THE FACILITY. A COPY OF ALL TYPE A DEFICIENCIES CITED DURING THIS INSPECTION MUST ALSO BE IMMEDIATELY (WITHIN 24 HOURS OF THE CHILD’S NEXT DAY IN CARE) GIVEN TO THE PARENTS OF ALL CHILDREN ENROLLED IN THE CHILD CARE FACILITY AND ANY CHILDREN ENROLLED INTO THE CHILD CARE FACILITY OVER THE NEXT 12 MONTHS (AT THE TIME OF ENROLLMENT).

An exit interview was conducted, and a copy of this report was provided to Licensee on this date.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Destinee Hogue
LICENSING EVALUATOR SIGNATURE: DATE: 10/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/29/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
Document Has Been Signed on 10/29/2021 12:09 PM - It Cannot Be Edited


Created By: Destinee Hogue On 10/29/2021 at 10:57 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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: RAMIREZ-RUIZ FAMILY CHILD CARE
FACILITY NUMBER: 334819141

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/29/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/29/2021
Section Cited
CCR
102425(b)

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Infant Safe Sleep (b) Cribs or play yards shall be free from all loose articles and objects.





This requirement is not met as evidenced by:
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Immediately, Licensee removed the loose blankets from the play yard. During this inspection, LPAs discussed Infant Safe Sleep regulations which became effective on September 15, 2020 and provided Licensee with a copy of Provider Information Notice (PIN) 20-24-CCP, along with a copy of the Individual Infant Sleeping Plan (LIC9227)
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Based on observation, the Licensee did not comply with the section cited above. Upon LPAs arrival, LPAs observed Child #1 sleeping in a play yard with more than one loose blanket, this poses an immediate health, safety or personal rights risk to persons in care.
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Deficiency cleared during this inspection.
Type A
10/29/2021
Section Cited
CCR102425(a)(3)

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Infant Safe Sleep (a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. (3) Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.
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Immediately, Licensee placed a fitted sheet on the mattress used by Child #1. During this inspection, LPAs discussed Infant Safe Sleep regulations which became effective on September 15, 2020 and provided Licensee with a copy of Provider Information Notice (PIN) 20-24-CCP, along with a copy of the Individual Infant Sleeping Plan (LIC9227)
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Based on observation, the Licensee did not comply with the section cited above. Upon LPAs arrival, LPAs observed Child #1 sleeping in a play yard on a non-fitted sheet, this poses an immediate health, safety or personal rights risk to persons in care.
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Deficiency cleared during this inspection.
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:Kimberly Williams
LICENSING EVALUATOR NAME:Destinee Hogue
LICENSING EVALUATOR SIGNATURE:
DATE: 10/29/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/29/2021


LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 10/29/2021 12:09 PM - It Cannot Be Edited


Created By: Destinee Hogue On 10/29/2021 at 11:09 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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: RAMIREZ-RUIZ FAMILY CHILD CARE
FACILITY NUMBER: 334819141

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/29/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/29/2021
Section Cited
CCR
102417(g)(8)

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(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: (8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

This requirement is not met as evidenced by:
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During this inspection, Licensee added currently enrolled day care children to facility roster and Licensee informed LPAs that all currently enrolled children have been added to the facility roster.

Deficiency cleared during this inspection.
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Based on record review, Licensee did not comply with the section cited above. Licensee did not have a current roster available at the time of LPAs request. This poses a potential health, safety, and personal rights risk 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:Kimberly Williams
LICENSING EVALUATOR NAME:Destinee Hogue
LICENSING EVALUATOR SIGNATURE:
DATE: 10/29/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/29/2021


LIC809 (FAS) - (06/04)
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