334844818-3-12-2025-10-CC-SPUO-DEPQ7Y-20250312115554

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334844818
Report Date: 03/12/2025
Date Signed: 03/12/2025 11:57:15 AM

Document Has Been Signed on 03/12/2025 11:57 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	HERNANDEZ FAMILY CHILD CARE		FACILITY NUMBER:	334844818
ADMINISTRATOR/ DIRECTOR:	HERNANDEZ,PATRICIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(714) 234-4992
CITY:	PERRIS	STATE: CA	ZIP CODE:	92571
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 3	DATE:	03/12/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:45 AM
MET WITH:	Patricia Hernandez		TIME VISIT/ INSPECTION COMPLETED:	12:05 PM

NARRATIVE

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Licensing Program Analyst (LPA) Sandra Pulido conducted an unannounced annual inspection for a large family childcare at the above home on 03/12/2025 at 8:45 a.m. LPA met with Licensee Patricia Hernandez who guided LPA on a tour of the home. There were 3 children present with Licensee when LPA arrived.

The facility operates Monday - Friday from 5:30 AM to 6:00 PM each day. Certain areas are off-limits, including the three bedrooms, master bathroom, laundry room, attached garage, and the gated, concrete area on the side of the home. The facility is licensed as a large Family Child Care Home (FCCH) with a maximum capacity of fourteen children and is operating within the licensed capacity of the license.

During the inspection, LPA observed Licensee to be alert, responsive and aware of where the children were at all times. A working cell phone is available, and the current phone number on file is correct. A fully charged fire extinguisher (2A:10BC) was observed mounted on the kitchen wall to the left of the cabinets, along with a functioning smoke detector and carbon monoxide detector, both of which were tested by the Licensee. The fireplace is properly screened to prevent access by children by a glass screen and partial coverage by the sofa, and all hazardous items, including toxins, are stored securely and are inaccessible to children. Cleaning products are locked with a child safe latch in a cabinet underneath the sink and poisons and detergents are locked in the laundry room and garage, both being off-limits. No weapons are present, and the Licensee, Patricia Hernandez, understands that all firearms, weapons, and ammunition must be locked separately and made inaccessible as per Title 22 Regulations.

The facility provides clean, safe, and age-appropriate toys for children. A current roster is not on file, and required postings, including the Facility Sketch, Emergency Disaster Plan, and Notification of Parent’s Rights, are displayed on a parent board at the entrance of the home. Fire and disaster drill documentation is maintained, with the last drill conducted on 02/10/2025.

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Sandra Pulido
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025

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 03/12/2025 11:57 AM - It Cannot Be Edited

Created By: Sandra Pulido On 03/12/2025 at 10:55 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 STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: HERNANDEZ FAMILY CHILD CARE	FACILITY NUMBER: 334844818
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/12/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

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
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above as C2 and C4 were missing the sleep logs, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/12/2025
	Plan of Correction
1 2 3 4	Licensee will begin documenting and send photos of the logs to LPA.

Type B

Section Cited

CCR

102425(c)

Infant Safe Sleep

An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility. 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 in missing LIC 9227 infant sleep plan for C4, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/21/2025
	Plan of Correction
1 2 3 4	Licensee will have parent fill out LIC 9227 and send a photo to LPA

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:

Pauline Beschorner

LICENSING EVALUATOR NAME:

Sandra Pulido

LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025

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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: HERNANDEZ FAMILY CHILD CARE	FACILITY NUMBER: 334844818
	VISIT DATE: 03/12/2025

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There are not any pools, spas, or other bodies of water. Licensee understands that all bodies of water including ponds, above ground pools, spas, and some fountains must be properly covered or fenced per Title 22 Regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar products must be emptied immediately after use and stored in an upright position.

Both children's and employees' records were reviewed. Mandated Reporter Training has been completed and is valid until February 12, 2026. The Pediatric CPR and First Aid certification expires on September 14, 2026. Resident and staff records were reviewed, and all adults requiring caregiver background checks have received the necessary clearances and exemptions.

Licensee Patricia Hernandez was reminded that all adults 18 and over, living or working in the home, 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 licensed Family Child Care Home. 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.

LPA discussed the safe sleep regulations with Licensee Patricia Hernandez 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. Sleep logs were missing for C2 and C4 along with the LIC 9227 infant sleep plan for C4. 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Sandra Pulido
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025

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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: HERNANDEZ FAMILY CHILD CARE	FACILITY NUMBER: 334844818
	VISIT DATE: 03/12/2025

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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

On-line Licensing forms & regulations for a Child Care Center can be obtained on the Department’s website: www.ccld.ca.gov. Additionally, there is a link to “Receive Important Updates” located on the right side of the page, immediately above Quick Links. One can add their email address and choose which program(s) they wish to receive Provider Information Notices (PIN) for.

The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at: 951-782-4200

On this date, 03/11/2025, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process for CARE tools, please send the email inquiries 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/process.

There are deficiencies being cited on the attached 809-D page.

A notice of site visit was given and must remain posted for 30 days.

An exit interview was conducted, and a copy of this this report was reviewed with and handed to Licensee Patricia Hernandez.

Appeal rights were discussed and provided during the exit interview.

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Sandra Pulido
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025

LIC809 (FAS) - (06/04)

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