364841126-10-25-2024-09-CC-ALAA-DADU2Y-20241025151243

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364841126
Report Date: 10/25/2024
Date Signed: 10/25/2024 03:13:02 PM

Document Has Been Signed on 10/25/2024 03:13 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:	VALENZUELA FAMILY CHILD CARE		FACILITY NUMBER:	364841126
ADMINISTRATOR/ DIRECTOR:	VALENZUELA, ALISIA & DANIE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(909) 824-7415
CITY:	COLTON	STATE: CA	ZIP CODE:	92324
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 5	DATE:	10/25/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:30 AM
MET WITH:	Alisia Valenzuela		TIME VISIT/ INSPECTION COMPLETED:	03:45 PM

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On the date and time listed, Licensing Program Analyst (LPA) Aman Lama arrived at the facility to conduct an annual inspection. Upon arrival, LPA was met with assistant, who granted LPA access to the home. Licensee arrived in the home approximately 10-15 minutes later, when LPA toured the on-limits indoor and outdoor areas of the facility. There were 5 children in care during todays inspection.
Normal days and hours of operation are listed as: Monday-Friday 6am-6pm.

OFF-LIMIT AREAS ARE LISTED AS FOLLOWS: 2 bedrooms, garage, covered Patio.

Licensee is asked to update the application, LIC279 with a valid phone number. Licensee is also asked to update the Facility Sketch, LIC999 and submit both to the department within 30 days of this date.
· A working telephone was present, licensee agrees to update with licensing.

· Appropriate fire extinguisher, smoke detector and carbon monoxide detector were all in working order.

· LPA observed hazards inaccessible to daycare child(ren). Licensee was reminded the difference between which items to keep under lock, which to keep behind a latch, and how to read labels to determine the difference.

· No guns/weapons currently kept in the home. All guns, weapons and ammunition must be key locked separately and made inaccessible, per Title 22 Regulations.

· Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights poster were posted in the home. A license was printed out today and handed to the licensee to post. Licensee lost the one she had.

· LPA observed Clean, safe and age appropriate toys available for children.

· Documentation of last fire/disaster drill was available. Last drill conducted: 09-11-24.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Aman Lama
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024

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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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: VALENZUELA FAMILY CHILD CARE	FACILITY NUMBER: 364841126
	VISIT DATE: 10/25/2024

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·Mandated Reporter Training certificate for both licensee and assistant were on file and up to date.

· Pediatric CPR and First Aid Card for both licensee and assistant were also on file and up to date.

· Health & Safety Certificate for licensee has been completed and is on file.

· Bodies of water were not observed on property at this time. Licensee has a water fountain located at the front porch, but it is filled with rocks and no water. Licensee is reminded that all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly fenced per Title 22 Regulations. The Department must be notified before and after installation of any of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.

· The Licensee was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov

· Resident and/or staff records reviewed indicate that all adults who require caregiver background checks have received all required clearances or exemptions.

· The Licensee can submit transfer forms to associate new individuals or to disassociate someone from the facility at: Associations_Disassociations862@dss.ca.gov

-LPAs discussed the safe sleep regulations and discussed the Child Care Licensing Safe Sleep webpage as an additional resource at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep

-LPAs 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.

-Licensee is not currently administering medications. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes 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

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Aman Lama
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024

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: VALENZUELA FAMILY CHILD CARE	FACILITY NUMBER: 364841126
	VISIT DATE: 10/25/2024

NARRATIVE

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- The licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

See LIC809-D for cited deficiencies.

- To receive Provider Information Notices (PINs), go to the licensing webpage www.ccld.ca.gov, and click on the “Receive Important Updates” located on the right side of the page, immediately above the “Quick Links”. You can add your email address and choose which program(s) to receive PINs for.

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

The licensee, Alisia Valenzuela confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

LPA Aman Lama informed the licensee, Alisia Valenzuela to provide a copy of this licensing report dated October 25, 2025 that documents any Type A citation(s) to parents/guardians of all children currently enrolled, or newly enrolled by the next business day or the next day the child(ren) is(are) in care. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification and kept on file for 12 months from the date of this report.

Exit interview was conducted and report was reviewed with the assistant, Alisia Valenzuela.

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

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Aman Lama
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/25/2024 03:13 PM - It Cannot Be Edited

Created By: Aman Lama On 10/25/2024 at 02:22 PM

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: VALENZUELA FAMILY CHILD CARE	FACILITY NUMBER: 364841126
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/25/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102417(g)(4)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above. The on-limits "Family Room" had a helium tank standing about 2.5- 3 feet tall. The "living room" has a table on the right side, which had a spray bottle 3/4ths full of rubbing alcohol. The bottle remained on the table for the duration of this inspection. The hallway leading from the "Kitchen" to the "bath" has a dual-door cabinet to the left of the washer/dryer which had bleach and other cleaning agents stored at the bottom of the cabinet. This poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 10/25/2024
	Plan of Correction
1 2 3 4	Immediately, all items listed above were removed, bringing the facility into compliance with Title 22 Regulations.

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:

Gilbert Sena

LICENSING EVALUATOR NAME:

Aman Lama

LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024

LIC809 (FAS) - (06/04)

Page: 4 of 12

Document Has Been Signed on 10/25/2024 03:13 PM - It Cannot Be Edited

Created By: Aman Lama On 10/25/2024 at 02:22 PM

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: VALENZUELA FAMILY CHILD CARE	FACILITY NUMBER: 364841126
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/25/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. 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. Licensee did not have assistants immunizations: measles(MMR), pertussis(Tdap), or Flu shot(or declination statement) on file. This poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/29/2024
	Plan of Correction
1 2 3 4	Licensee agrees to submit proof of all immunizations for assistant listed on LIC859, no later than POC due date.

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:

Gilbert Sena

LICENSING EVALUATOR NAME:

Aman Lama

LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024

LIC809 (FAS) - (06/04)

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