364842454-1-27-2025-09-CC-ALAA-DDBS9W-20250127124126

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364842454
Report Date: 01/27/2025
Date Signed: 01/27/2025 12:41:39 PM

Document Has Been Signed on 01/27/2025 12:41 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:	ZICK FAMILY CHILD CARE		FACILITY NUMBER:	364842454
ADMINISTRATOR/ DIRECTOR:	PATRICIA ZICK		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(909) 262-3794
CITY:	ONTARIO	STATE: CA	ZIP CODE:	91761
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS:	DATE:	01/27/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Patricia Zick		TIME VISIT/ INSPECTION COMPLETED:	01:00 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 licensee, Patricia Zick. Also present were 1 assistant, 1 resident of the home and 4 children were in care for the duration of this inspection. Licensees assistant, Ashley Zick granted access to the home to LPA, who then toured the on-limits indoor and outdoor areas of the facility. Licensee, Patricia Zick was in the home and shortly joined the inspection.

Normal days and hours of operation are listed as: Monday-Friday, 6:30am-4:30pm.

OFF-LIMIT AREAS ARE LISTED AS FOLLOWS: Bedrooms 1, 2, and 5, garage and restroom.

· A working telephone is present and current phone number is on file.

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

· LPA observed hazards inaccessible to daycare child(ren).

· There is a gun kept in the home, which was inspected on this date. All guns, weapons and ammunition must be key locked separately, made inaccessible, and must remain in compliance with Title 22 Regulations-SEE LIC809D

· Licensee had appropriate postings posted near the entrance of the daycare area.

· Mandated Reporter Training certificate for licensee and assistant expire 01/2026..

· Pediatric CPR and First Aid Card for licensee and assistant expire 06/2025.

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

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Aman Lama
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025

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 01/27/2025 12:41 PM - It Cannot Be Edited

Created By: Aman Lama On 01/27/2025 at 12:10 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: ZICK FAMILY CHILD CARE	FACILITY NUMBER: 364842454
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/27/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(4)(B)1

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. (B) In lieu of locked storage of firearms, the license may use trigger locks or remove the firing pin. 1. Firing pins shall be stored and locked separately from firearms. 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. Although the firearm in the home had a lock on it, was not loaded and was in an off-limit area of the home, the ammunition was not key locked/stored separately. This poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/31/2025
	Plan of Correction
1 2 3 4	Licensee agrees to submit proof of ammunition and firearm in two separate key-locked storage boxes, in an off-limit area of the home. This is due to the department no later than the POC due date.

Type B

Section Cited

CCR

102425(j)(5)

Infant Safe Sleep

The provider shall supervise infants while they are sleeping and adhere to the following requirements: If the infant is sleeping in a separate room from where the provider is stationed, the door to the room the infant is sleeping in shall remain open at all times. 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. During todays inspection, there was an infant sleeping in an on-limit area of the home with the door closed. Due to the licensee having a recording device with her during the inspection, this is being downgraded to a Type B citation. This still poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/31/2025
	Plan of Correction
1 2 3 4	Licensee agrees to submit a written understanding of safe sleep regulations. This is due to the department no later than POC due date.

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: 01/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025

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

FACILITY NAME: ZICK FAMILY CHILD CARE	FACILITY NUMBER: 364842454
	VISIT DATE: 01/27/2025

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·Bodies of water were not observed on the property during todays inspection. Licensees are 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. Licensee was informed of the new PIN regarding new items needed for the pool. Licensee understood and noted items needed. 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.

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

· Documentation of last fire/disaster drill was available. Last drill conducted: 11-13-2024.

· 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

-LPA reviewed & provided the safe sleep regulations, and the Safe Sleep PIN 20-24-CCP from September 15, 2020. LPA also 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

-LPA informed licensees 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: 01/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025

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

FACILITY NAME: ZICK FAMILY CHILD CARE	FACILITY NUMBER: 364842454
	VISIT DATE: 01/27/2025

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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.

- 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, Patricia Zick, confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

Exit interview was conducted and report was reviewed with the licensee, Patricia Zick.

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: 01/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025

LIC809 (FAS) - (06/04)

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