197409621-3-3-2023-30-CC-JLAO-CPJ2VE-20230301164350

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197409621
Report Date: 03/01/2023
Date Signed: 03/03/2023 01:52:17 PM

Document Has Been Signed on 03/03/2023 01:52 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	ZEPEDA FAMILY CHILD CARE		FACILITY NUMBER:	197409621
ADMINISTRATOR:	ZEPEDA, RENEE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 479-1809
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90064
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 8	DATE:	03/01/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:40 AM
MET WITH:	Renee Zepeda		TIME COMPLETED:	02:30 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 3/1/2023 at approximately 11:45 a.m. Program Analyst (LPA), Judy Laureano conducted an unannounced Annual Required Inspection at 2493 Stoner Avenue, Los Angeles, CA 90064 and was met by Renee Zepeda. Facility operates Monday through Friday 7:30 a.m. to 5:00 p.m. Currently licensee cares for children ages birth to 5 years old and is NOT available for overnight care or weekend care. LPA toured the home inside and outside and a census was taken; 8 children were present during the inspection with licensee and assistant, J.Flores. The home is a single-family home with 2 bedrooms, 1bathroom and one master bedroom and bathroom, a living room, dining room, kitchen area and detached garage. Licensee confirmed living room, dining room and bathroom are used for the day care children. Children only use bedroom 2, next to the bathroom, for napping only. LPA reminded licensee to always notified CCL when an area deemed as OFF LIMITS will be used- Technical Advisory was issued. Kitchen is OFF LIMITS but is used as a walkway to access the back yard. LPA observed safety latches on cabinets. Living room and dinning room area have been designated as daycare use. LPA observed a changing table in the living/dining room space. Licensee confirmed that children nap and eat in the space. Dinning room area was observed to have a locked laundry closet where the washer and dryer equipment is stored. Licensee uses the kitchen to occasionally prepare snacks and families bring meals, but children are not allowed in the space. LPA observed one working carbon monoxide detector in the kitchen area. The following areas are confirmed as OFF LIMITS: Kitchen area, bedroom 1 located next to the living room, master bedroom and bathroom and detached garage outside.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ZEPEDA FAMILY CHILD CARE	FACILITY NUMBER: 197409621
	VISIT DATE: 03/01/2023

NARRATIVE

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During today’s inspection, Licensee confirmed that children are not going to use the outdoor space due to repairs. Grass outside is being repaired doing non operating days and hours of day care operations. Licensee was instructed to submit pictures and notification when outdoor space is completed and ready for children to use.

There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents and cleaning compounds are kept in the top cabinet in the kitchen area. Sharp object and knives were observed stored in the back area of the counter space- inaccessible to the children in care. Kitchen cabinets were observed to have safety latches on bottom cabinets, making the content inaccessible to the children in care. LPA observed a carbon monoxide and smoke detectors in the living room and dinning room area.

LPA discussed Safe Sleep Regulations with licensee. There is one crib or play yard for each infant in care, cribs and play yards are kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

Adequate heating and ventilation for safety and comfort were observed in the space. LPA observed a barricaded open face heater in the living/dining room area. Licensee stated the Gas company has turned off the services and will be requesting a notification to submit to LPA.

Safe toys and play equipment were observed. The home has working telephone service and LPA confirmed the phone number 310-479-1809.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ZEPEDA FAMILY CHILD CARE	FACILITY NUMBER: 197409621
	VISIT DATE: 03/01/2023

NARRATIVE

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Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children.
Capacity as specified on the license is being maintained.

LPA reviewed a sample of 5 children’s file and files were complete. LPA discussed the LIC 311D- Records to be maintain in the facility and provided licensee with a current copy.

Licensee’s Pediatric CPR and First certification was reviewed, Licensee has current certification completed on 5/6/2021. Licensee’s Mandated Reporter training was reviewed with a date of completion of 9/28/2022. Assistant’s, J. Flores, Mandated Reporter training was completed on 9/28/2022 and Pediatric CPR and First Aid certification completed on 5/6/2021. Assistant’s file was not available for review, LPA issues two Technical Violation- missing employee rights form and proof of immunization which includes MMR, Dtap and Flu.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.
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/inspection-process.

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.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ZEPEDA FAMILY CHILD CARE	FACILITY NUMBER: 197409621
	VISIT DATE: 03/01/2023

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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.

A notice of site visit was given and must remain posted for 30 days.
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Renee Zepeda.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023

LIC809 (FAS) - (06/04)

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