<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364846276
Report Date: 02/12/2024
Date Signed: 02/12/2024 02:47:37 PM

Document Has Been Signed on 02/12/2024 02:47 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:ANGELES FAMILY CHILD CAREFACILITY NUMBER:
364846276
ADMINISTRATOR:ANGELES, JUDITHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 728-2050
CITY:FONTANASTATE: CAZIP CODE:
92337
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
02/12/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Judith AngelesTIME COMPLETED:
03:10 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 date and time listed, Licensing Program Analyst (LPA) Aman Sharma arrived at the facility to conduct a required annual inspection. Upon arrival, LPA was met with licensee’s assistant who stated that licensee would be at the door shortly. LPA was granted access and immediately greeted by licensee, Judith Angeles and toured the facility, both inside and outside.
Normal days and hours of operation are: Monday-Friday 6am-6pm.
OFF LIMIT AREAS INCLUDE: Living room, garage and entire second floor of the home.
· The facility is operating within the licensed capacity and appropriate ratios.
· Appropriate supervision was being provided during this inspection.

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

· Appropriate fire extinguisher and smoke detector were in the home,but no carbon monoxide-SEE LIC809D.

· Hazardous items and toxins were accessible to daycare children-SEE LIC809D.

· 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.

· Verification of control of property is on file.

· Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights poster were posted in the home.

· Mandated Reporter Training certificate for licensee is current, but missing for staff- SEE LIC809D

· Pediatric CPR and First Aid Card for licensee& assistants have been updated and expire 01-24-26.

· Clean, safe and age appropriate toys were available to the daycare children.

· Roster was made available during today’s inspection.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Aman Sharma
LICENSING EVALUATOR SIGNATURE: DATE: 02/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/12/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 11
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: ANGELES FAMILY CHILD CARE
FACILITY NUMBER: 364846276
VISIT DATE: 02/12/2024
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
26
27
28
29
30
31
32
·Bodies of water were not observed on property at this time. Licensee understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 Regulations, which are in compliance at this time. The Department must be notified before and after installation 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.

· Documentation of last fire/disaster drill was conducted: 11/20/2023.

· 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

· Children’s records, including infant files were made available and complete.

· 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 reminded licensee of 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

-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.

-Although 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: Kimberly Williams
LICENSING EVALUATOR NAME: Aman Sharma
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2024
LIC809 (FAS) - (06/04)
Page: 2 of 11
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: ANGELES FAMILY CHILD CARE
FACILITY NUMBER: 364846276
VISIT DATE: 02/12/2024
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
26
27
28
29
30
31
32
- 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.

- 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. 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

The Licensee, Judith Angeles confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

LPA Aman Sharma informed licensee, that this report dated 02/12/2024 documenst a Type A citation. Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Licensee was reminded to provide a copy of this licensing report dated 02/12/2024, that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with the licensee, Judith Angeles.

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

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Aman Sharma
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2024
LIC809 (FAS) - (06/04)
Page: 3 of 11
Document Has Been Signed on 02/12/2024 02:47 PM - It Cannot Be Edited


Created By: Aman Sharma On 02/12/2024 at 02:05 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: ANGELES FAMILY CHILD CARE
FACILITY NUMBER: 364846276

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/12/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1597.543
Licensure Requirements
Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and licensees own admission, there is no carbon monoxide detector in the home. This poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/13/2024
Plan of Correction
1
2
3
4
Licensee agrees to install a carbon monoxide detector in the home and send proof of working detector to the department no later than the POC due date.
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 during the tour of the home, LPA found a container of "comet powder" on the window sill behind an infant on a high chair to the left of the kitchen. In the kitchen, there was also "Weiman: Stainless Steel Cleaner and Polish" on the floor, accessible to children in care. Chemicals were not kept behind a lock: Grease cleaner, Pine-Sol, other various cleaners including tide pods, washing machine cleaner tablet, Shout stain remover. This poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/13/2024
Plan of Correction
1
2
3
4
Licensee agrees to make chemicals inaccessible to daycare children by either putting them behind a lock in the on-limits area, or removing them and placing them in an "off limit " area of the home, which is also locked. Licensee agrees to submit proof of this to the department no later than the 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:Kimberly Williams
LICENSING EVALUATOR NAME:Aman Sharma
LICENSING EVALUATOR SIGNATURE:
DATE: 02/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/12/2024


LIC809 (FAS) - (06/04)
Page: 4 of 11
Document Has Been Signed on 02/12/2024 02:47 PM - It Cannot Be Edited


Created By: Aman Sharma On 02/12/2024 at 02:05 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: ANGELES FAMILY CHILD CARE
FACILITY NUMBER: 364846276

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/12/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102425(b)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, 2 cribs had multiple items in them. One crib had a blanket and bottle, while another had a pillow, blanket and bow that goes in an infants hair. This poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/13/2024
Plan of Correction
1
2
3
4
Licensee agrees to re-read the infant safe sleep regulations and send a written statement of understanding for herself and the two staff that were present during todays inspection.
Type A
Section Cited
CCR
102425(b)(3)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects. (3) There shall be no objects hanging above or attached to the side of the crib.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, Licensee removed the blanket off of a 2 plus year old sleeping in a crib and hung it off of the crib the child was sleeping in. There was another infant sleeping in another crib with a blanket and pillow, that another staff hung off the crib. There was also an attachment with multiple items hanging from the left side of the crib. This poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/13/2024
Plan of Correction
1
2
3
4
Licensee agrees to hold a meeting or training with her staff regarding safe sleep. Videos and information can be found on the licensing home page ccld.ca.gov Licensee agrees to submit the training's she plans to do with her staff no later than the Due Date. Once the training is complete, licensee will submit proof of training.
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:Kimberly Williams
LICENSING EVALUATOR NAME:Aman Sharma
LICENSING EVALUATOR SIGNATURE:
DATE: 02/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/12/2024


LIC809 (FAS) - (06/04)
Page: 5 of 11
Document Has Been Signed on 02/12/2024 02:47 PM - It Cannot Be Edited


Created By: Aman Sharma On 02/12/2024 at 02:05 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: ANGELES FAMILY CHILD CARE
FACILITY NUMBER: 364846276

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/12/2024

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 record review and licensees own admission, 2 out of 3 staff did not have her mandated reporter training on file for "Child Care Providers". This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/11/2024
Plan of Correction
1
2
3
4
Licensee agrees to submit updated mandated reporter training certificates to licensing no later than the POC due date. The training can be accessed online at mandatedrepoterca.com Both staff are required to show proof of certificate for "Child Care Providers".
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 and licensees own admission, 2 out of 3 staff present were missing their immunizations. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/11/2024
Plan of Correction
1
2
3
4
Licensee agrees to submit proof of immunizatinos for Staff 1 and Staff 2 no later than the POC due date. These immunizations include: MMR(measles), Tdap(pertussis) and TB.
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:Kimberly Williams
LICENSING EVALUATOR NAME:Aman Sharma
LICENSING EVALUATOR SIGNATURE:
DATE: 02/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/12/2024


LIC809 (FAS) - (06/04)
Page: 6 of 11