Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016467
Report Date: 01/17/2017
Date Signed: 01/17/2017 11:29:04 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:MEDRANO & AGUIRRE FAMILY CHILD CAREFACILITY NUMBER:
198016467
ADMINISTRATOR:MEDRANO, M & AGUIRRE, WFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 699-2549
CITY:WHITTIERSTATE: CAZIP CODE:
90606
CAPACITY:14CENSUS: 13DATE:
01/17/2017
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Marlen Medrano & Jessica HuertaTIME COMPLETED:
11:35 AM
NARRATIVE
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Case management inspection conducted by LPA(s) Jennifer Hua and Raul Navarro. Upon arrival, LPA observed 12 children in care supervised by Licensee. Per licensee, assistant left 5 minutes ago to pick up medicine. Assistant arrived at 8:57am. During the visit, at 9:32am, LPA(s) observed another infant was dropped off. Total children in care during this visit 13 children, 4 of whom are infants and none are school-age. The oldest child(ren) in care is 4 years old.

Note: Licensee is primarily Spanish speaking, LPA Navarro translated during this visit.

Based on the LPAs' observation, the following deficiency is cited on attached 809D.

An exit interview conducted copy of report given. Appeals rights provided and explained.

Confidential Name list was created during this visit.

A copy of the Notice of site visit & type A citation report must be posted for 30 consecutive days, failure to maintain posting as required will result in a $100.00 civil penalty. A copy of this report must be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report must also be provided to the parent/guardian of newly enrolled children for the next 12 months. Form LIC 9224, (Acknowledgement of Receipt of the Licensing Report must also be provided to parents/guarding along with report for parents to sign. Licensee to file signed LIC 9224 in children's files. Form provided to licensee during this visit.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 854-6738
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2017
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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MEDRANO & AGUIRRE FAMILY CHILD CARE
FACILITY NUMBER: 198016467
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/17/2017
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/18/2017
Section Cited
102416.5(d)2ab
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Staffing Ratio and Capacity. For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either:
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Per Licensee, will not have assistant leave and for her to do errands after hours from now on to ensure compliance.
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More than twelve and up to fourteen children only if the criteria in Section 1597.465 of the Health and Safety Code are met. At least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age. No more than three infants are cared for during any time when more than 12 children are being cared for. Upon arrival, LPA observed 12 children in care supervised by Licensee. Assistant arrived 15 minutes later. During this, another infant was dropped off, totally 13 kids, 4 of whom are infants and no school-age kid in care.

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Per licensee, one child was not suppose to come today, but the mom brought the child. Will call parent and inform parent will no longer care for child to stay in compliance.
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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: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Jennifer HuaTELEPHONE: (323) 854-6738
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2017
LIC809 (FAS) - (06/04)
Page: 2 of 2