Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016467
Report Date: 03/04/2020
Date Signed: 03/04/2020 02:15:03 PM

COMPREHENSIVE INSPECTION
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: 4DATE:
03/04/2020
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Marlene Medrano, LicenseeTIME COMPLETED:
02:30 PM
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Licensing Program Analysts (LPAs) Roxana Lopez and Janeth Chavez conducted an unannounced Annual Required inspection. Upon arrival LPAs were received by Assistants Zoila Castillo and Melissa Perez. Licensee arrived to the facility within 5 minutes. Licensee Marlene Medrano guided LPAs on a tour of the facility. This is a one story home which consists of 3 bedrooms, 2 bathrooms, living room, kitchen, dining room, daycare room, den and backyard. There are 4 (3 infant) children present during today’s inspection. Licensee states that there are currently 11 children enrolled. The children's roster was reviewed and is current. Disaster drill log was available during today’s inspection. (Last drill conducted on 2/11/2020). Licensee stated she does not have Liability Insurance for a Family Child Care Home.

Areas accessible to children were inspected as follows: Den area that is converted into day care area, day care room, one bathroom in hallway, living room and back yard. Per Licensee the children sleep in the living room, the day care room is also used for sleeping infants and eating.

Areas off limits include: Two bedrooms, One Bath and kitchen (except through passing).

Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. There is a working telephone maintained in the home. Family members residing in the home are two adults (criminal record clearances on file) and three children one being 17 years old. Licensee has a fish tank in the dining room area. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. The Licensee states that there are no poisons in the home. The Licensee does understand that poison must be locked with a key or combination lock.

Per Licensee, there are no weapons, firearms on the premises. LPAs did observed a pond in the outdoors which was completely dry and barricaded which made it inaccessible to the children in care. There are safe toys, play equipment and materials observed for children.
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SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2020
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
VISIT DATE: 03/04/2020
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Emergency Disaster was posted at the time of inspection. Children’s records were reviewed to ensure that each child has an Identification and Emergency form. The valve on the required 2A 10BC fire extinguisher indicates fully charged, last serviced on 3/20/2019. Smoke and carbon monoxide detectors in the living room were tested and are in operable condition. The Licensees have current Pediatric First Aid and CPR, which will expire on 04/2021. SB 792 Immunization requirements were reviewed. The Licensees are exempt from taking the Mandated Training Certificate as English is not their first language. LPAs advised the Licensee to have her Assistant Melissa Perez take the training as she does speak and understand English.

Around 1:10 pm Licensee Wilfredo Aguirre arrived at the facility.

The following was discussed: Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.

Rooms that are off-limits need to be made inaccessible during operating hours. No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines, No baby bouncers and any other item that falls into that category are not permitted in the facility.


Role and responsibilities of being a Mandated Reporter were reviewed. The Licensee was advised how to access forms and Regulations online at www.ccld.ca.gov. Licensee was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care.

Infant Care: Licensee does provide infant care. Upon arrival LPAs observed 3 Graco Play Pens in the main daycare area (back room). Licensee stated this is where the infants sleep in. Licensee was advised to sleep infants where they can be directly supervised and advised against sleeping infants in a separate room. Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed. A hard copy of A Child Care Provider’s Guide to Safe Sleep was provided.

Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed. A hard copy of A Child Care Provider’s Guide to Safe Sleep was provided. https;//www.sidsandkidsshop.org/.
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SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2020
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
VISIT DATE: 03/04/2020
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Incidental Medical Services (IMS) policy was discussed with Licensee. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 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

Licensee stated transportation is provided to and from school. Licensee was advised to have the proper car seats and a valid liability insurance for the vehicle when transporting children.

The licensee’s email address was obtained during this inspection. The licensee was advised that email is public information.

LPA issued the Confidential Names List (LIC 811) to the licensee during this visit. The Confidential Names List documents the children’s files and staff files that were reviewed during this inspection.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.



The Licensee was provided a copy of their appeal rights (LIC 9058)The Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms

Exit interview was conducted with Marlene Medrano & Wilfredo Aguirre, Licensee including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2020
LIC809 (FAS) - (06/04)
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