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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845364
Report Date: 01/27/2022
Date Signed: 01/27/2022 03:34:28 PM

Document Has Been Signed on 01/27/2022 03:34 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:DE LA PAZ FAMILY CHILD CAREFACILITY NUMBER:
334845364
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
01/27/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Licensee - Sally De La PazTIME COMPLETED:
03:50 PM
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Licensing Program Analyst (LPA) Corral and Hogue conducted a required Annual Inspection on today’s date. Upon entrance to the Facility, there were 5 children present in care with Licensee Sally and Assistant Joanna Sanchez providing care and supervision. A review of the Facility Personnel Report Summary on 01/26/2022 indicates all facility staff who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Licensee was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Family Child Care Home. A civil penalty of $100 minimum per day and up to $500 maximum per day per person will be assessed if this regulation is violated. The hours of Operation are Monday – Friday, 6 AM – 7 PM.

A tour of the inside and outside of the facility was conducted with Licensee Sally. Rooms available to children in care were observed to have age appropriate play equipment. Off limits areas are made inaccessible by means of door locks. The second floor is made inaccessible by means of a child safety gate. The children have access to the first floor. Licensee stated the children's primary area is the childcare room that is the bedroom down the hallway to the left, the children's bathroom is located next to the childcare room. The children's bathroom, toilet and hand washing sink were observed to be clean, sanitary and in good repair. Equipment was found to be in good condition, free of sharp, loose, or pointed edges. Items which could pose a danger to children such as detergents, cleaning compounds, and medications were stored out of the reach of children. Licensee stated Poisons/Hazardous items are not kept on the premises.The facility has conducted an emergency drill within the past six months and keeps documentation of drills. The facility has one working smoke detector, carbon monoxide detector and fire extinguisher. LPA Corral verified there is working phone service. Facility meets all posting requirements. Licensee understands the Family Child Care Home shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children.

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SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Eileen Corral
LICENSING EVALUATOR SIGNATURE: DATE: 01/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/27/2022
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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: DE LA PAZ FAMILY CHILD CARE
FACILITY NUMBER: 334845364
VISIT DATE: 01/27/2022
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The outdoor activity areas were also inspected for compliance. The outdoor activity was observed to have age appropriate equipment and to be in good condition. Outdoor area was enclosed by appropriate fences and the surface of the outdoor activity space were free of hazards. Licensee was reminded visual supervision is required during outdoor play. There are no bodies of water present on on-site, Licensee was informed all wading pools or similar product must be emptied immediately after use and stored in an upright position. There is a water fountain in the front yard that is filled with water, the front yard is off limits to children in care, there are also three water fountains that have no water in the backyard.

During today’s inspection, LPA Corral and Hogue also conducted Record Review of Staff and Children Files. Each Staff’s files contain the required documentation. Licensee’s Pediatric CPR/First Aid expires on 03/2023. Mandated Child Abuse Reporter training expires on 06/08/2023. Review of staff records also contains proof of Staff who are immunized against influenza, pertussis, and measles. Each child’s file contains the required identification and emergency information. Licensee was reminded not to exceed the conditions, limitations and capacity specified on the license. Licensee was also informed to ensure each child is accorded a safe, healthful and comfortable accommodations, furnishings and equipment to meet the child's needs.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 publication : Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA discussed the Safe Sleep Regulations and 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. 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 to register all infant devices with the CPSC to be notified of recalls on purchased equipment.
CCLD website www.ccld.ca.gov was provided to licensee to access regulations, updates, and licensing forms.
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SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Eileen Corral
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2022
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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: DE LA PAZ FAMILY CHILD CARE
FACILITY NUMBER: 334845364
VISIT DATE: 01/27/2022
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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.

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/nspection-process

Licensee was reminded a request to transfer, associate/disassociate individuals can be submitted to Associations_Disassociations862@dss.ca.gov. Director was also informed of their Reporting Requirements, Unusual Incident Reporting inbox was provided UnusualIncidentReportsDO09@dss.ca.gov. Lastly, Licensee was informed the Duty Officer is available to answer questions Monday – Friday from 8:00am to 5:00pm at (951)782-4200.

Based on Today’s inspection, Facility was found to be in Compliance of Title 22 California Code of Regulations.

Exit interview was conducted and Evaluation Report was reviewed with Licensee Sally De La Paz. A Notice of Site Visit was provided, Licensee was reminded it must remain posted for 30 days.

End of Report.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Eileen Corral
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2022
LIC809 (FAS) - (06/04)
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