364840599-4-4-2024-09-CC-TDIP-D3ZR3Q-20240404124020

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364840599
Report Date: 04/04/2024
Date Signed: 04/04/2024 12:40:37 PM

Document Has Been Signed on 04/04/2024 12:40 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	ARMENTA FAMILY CHILD CARE		FACILITY NUMBER:	364840599
ADMINISTRATOR/ DIRECTOR:	OLGA ARMENTA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(909) 350-7857
CITY:	FONTANA	STATE: CA	ZIP CODE:	92336
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	04/04/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:15 AM
MET WITH:	Olga Armenta		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 04/04/2024 at 9:15 AM, Licensing Program Analyst (LPA) Tiffanie Diep and Licensing Program Manager (LPM) Aaron Ross arrived at the facility to conduct an annual inspection. LPA and LPM toured the home, inside and out, records were reviewed, and the following was observed and/or discussed: Normal days and hours of operation are: Monday through Friday from 6:30 AM to 6:30 PM. Off-limits areas include: the laundry room, garage, and two bedrooms on the first floor, entire second floor, and both side yards. No day care children were present during the inspection. A working telephone was present with current number on file. An appropriate fire extinguisher, smoke detector, and carbon monoxide detector were present and tested by Licensee during the inspection. There was no fireplace in the home. All hazardous items were stored inaccessible to children. There are no weapons present in the home per Licensee. Licensee understands all firearms, weapons, and ammunition must be locked separately and made inaccessible to children in care according to Title 22 Regulations. Licensee understands all firearms, weapons, and ammunition must be locked separately and made inaccessible to children in care according to Title 22 Regulations. Stairs were barricaded by a gate. Verification of control of property on file (Deed) Facility sketches, Emergency Disaster Plan (LIC 610A), and Notification of Parents' Rights poster (PUB 394) were posted. AB1207 Mandated Reporter Training certificate expired on 04/07/2023; general training was completed on 11/03/2022. Pediatric CPR and first aid certification expires on 05/13/2025. Preventative health and safety training was completed on 05/16/2010. Continues on LIC 809-C

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024

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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Document Has Been Signed on 04/04/2024 12:40 PM - It Cannot Be Edited

Created By: Tiffanie Diep On 04/04/2024 at 11:40 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: ARMENTA FAMILY CHILD CARE	FACILITY NUMBER: 364840599
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/04/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observations, interviews conducted, and records reviewed, the licensee did not comply with the section cited above as licensee did not ensure their mandated reporter training was completed by the expiration date which poses a potential health, safety, or personal rights risk to children in care.
	POC Due Date: 05/03/2024
	Plan of Correction
1 2 3 4	LPA reminded Licensee to renew the mandated reporter training course every two years. Licensee agreed to provide completed certificate to LPA by 05/03/2024.

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:

Aaron Ross

LICENSING EVALUATOR NAME:

Tiffanie Diep

LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024

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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ARMENTA FAMILY CHILD CARE	FACILITY NUMBER: 364840599
	VISIT DATE: 04/04/2024

NARRATIVE

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Continued from LIC 809 (Page 2)

Licensee confirmed there are no bodies of water on the premises at this time. Licensee understands all bodies of water, including in-ground and above-ground pools, hot tubs, spas, and ponds, must be inaccessible to children in care and be properly covered or fenced according to Title 22 Regulations. The Department must be notified prior to installation of these and similar bodies of water.
Clean, safe, and age-appropriate toys were present.
A current roster of children on file.
Documentation of fire and disaster drills on file; last drill was conducted on 01/05/2024.
Children’s records were not complete. LPA did not observe Notification of Parents' Rights (LIC 995A) form for one out of five children. LPA did not observe Affidavit Regarding Liability Insurance for Family Child Care Home (LIC 282) for two out of five children.
Licensee was informed of their reporting requirements and was provided with the Regional Office’s Unusual Incident Reporting e-mail at UnusualIncidentReportsDO09@dss.ca.gov.
Licensee can submit transfer forms to associate new individuals or to disassociate someone from their facility via e-mail to Associations_Disassociations862@dss.ca.gov.
The Duty Officer is available to answer questions Monday through Friday from 8:00 AM to 5:00 PM at (951) 782-4200.
Resident and/or staff records reviewed during today’s inspection indicate that all adults who require caregiver background checks have received all required clearances or exemptions.

Licensee 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 five 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.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024

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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ARMENTA FAMILY CHILD CARE	FACILITY NUMBER: 364840599
	VISIT DATE: 04/04/2024

NARRATIVE

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Continued from LIC 809-C (Page 3)
LPA discussed the safe sleep regulations with Licensee 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. 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, 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) 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/.

To improve the quality and value of the new inspection process, a survey may be sent to the e-mail address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE Tool, please send e-mail inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at https://www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process. Licensee was informed of the MyChildCarePlan.org site, 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.

See attached LIC 9102 for advisory notes. Based on LPA’s observations, interviews conducted, and records reviewed, a deficiency is being cited on the attached LIC 809-D. LPA Tiffanie Diep informed the licensee, Olga Armenta, that this report dated 04/04/2024 documents one Type B citation as there was a potential risk to the safety of children in care.

An exit interview was conducted and report was reviewed with the licensee, Olga Armenta. During the exit interview, Licensee confirmed that there are no registered sex offenders (RSO) living in the facility and LPA completed the RSO profile in the Field Automation System. A notice of site visit was given to Licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024

LIC809 (FAS) - (06/04)

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