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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197405591
Report Date: 08/09/2022
Date Signed: 08/09/2022 05:32:34 PM

Document Has Been Signed on 08/09/2022 05:32 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:LOPEZ FAMILY CHILD CAREFACILITY NUMBER:
197405591
ADMINISTRATOR:LOPEZ, MARIA & ALMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 673-3398
CITY:LENNOXSTATE: CAZIP CODE:
90304
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
08/09/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Maria and Alma Lopez (Licensees)TIME COMPLETED:
05:45 PM
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Licensing Program Analyst (LPA), Keyona Scott, conducted an unannounced Annual Required inspection to the Family Child Care Home on 08/09/2022 at 12:25 PM. LPA met with Licensee Alma Lopez at 12:55 PM and Licensee Maria Lopez at 12:56 PM while guided to the the childcare playroom to conduct cenus of children in care. Present during today's inspection were Licensees and eleven children which includes one infant. All Adults present during the inspection have a criminal record clearance or exemption.

PHYSICAL PLANT

All areas on the facility sketch were identified. This a one-story home with three bedrooms, three bathrooms, changing room, kitchen and living room. Hours of operation are Monday through Friday, 7:30 AM to 5:00 PM. The primary childcare area is in the playroom located at the rear of the home. Children in care utilize the changing room adjacent to the playroom to store belongings brought from home and to change infant(s) in care. The children utilize the bathroom located in the playroom. Children also utilize the playroom to dine during meal and snack time. Per Licensees, children are served two meals (breakfast and lunch) and two snacks (morning and afternoon snack). The living room is used as an isolation area when children in care become ill, until parents arrive. Per Licensees, child(ren) in isolation area are supervised by an Adult at all times.

Outdoor play is conducted in the front yard at the entrance of the homey. The outdoor play area is fully fenced in and free of dangerous and hazardous conditions. LPA observed age-appropriate toys in the outdoor play area. LPA advised Licensee that children in care are to be supervised at all times.

The home was inspected for safety, comfort and cleaniness. The home has working telephone service. The telephone number on file with the Department was confirmed and verified. All poisons, to include, detergents, cleaning compounds, medication and other hazardous materials are inaccessible to children in care. There is a fully charged fire extinguisher that is at least a 2A: 10BC in the home. There is at least one working dual carbon monoxide and smoke detector in the home. Centralized heat, air ventilation system and portable fans are used as heating and cooling sources. LPA observed safe and age-appropriate toys and play equipment in the home. Per Licensee, there are no weapons, firearms or ammunition on the premises. Licensee was informed if obtains, firearms and ammunition must be stored and locked separately. PAGE 1
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Keyona Scott
LICENSING EVALUATOR SIGNATURE: DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/09/2022
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: LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 197405591
VISIT DATE: 08/09/2022
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FACILITY RECORDS

LPA observed Licensees' current Pediatric CPR and First Aid certificates with expiration dates of 06/28/2024. LPA did not observe Mandated Reporter training certificates for Licensees. LPA advised Licensees to complete mandated reporter training online at: www.mandatedreporter.ca .

LPA provided Licensee Maria Lopez with the following forms to complete during today's inspection and place in file at childcare home: LIC 9052 (Employee Rights), LIC 9108 (Statement Acknowledging Requirement to Report Child Abuse. LPA observed completed forms prior to end of inspection.

LPA provided Licensee Alma Lopez with the following forms to complete during today's inspection and place in file at childcare home: LIC 508 (Criminal Record Statement), LIC 9052 (Employee Rights), LIC 9108 (Statement Acknowledging Requirement to Report Child Abuse). LPA observed completed forms prior to end of inspection.

LPA reviewed children's files during today's inspection and observed the following Children's Records: LIC 282 (Affidavit Regarding Liability Insurance), Immunization Records, LIC 700 (Identification and Emergency Information), LIC 627 (Consent for Emergency Medical Treatment), LIC 995A (Notification of Parents' Rights)

LPA observed the following required posting on Parent Board in childcare playroom:
  • Facility License

LPA provided Licensees with the following required postings to post on parent board:
  • PUB 394- Notification of Parents' Rights (completed with Department and Complaint Line Information)
  • LIC 9148- Earthquake Preparedness Checklist


LPA provided Licensees with the following document to complete and keep on file at the family childcare home for review upon request:
  • LIC 610A- Emergency Disaster Plan (LPA observed completed LIC 610A, prior to end of inspection)

LPA reviewed the following documents during today's inspection:
  • Verification of Disaster Fire Drills: Per LPA review, fire disaster drills are conducted monthly; LPA observed last fire disaster drill was conducted on 07/28/2022. PAGE 2
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Keyona Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022
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: LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 197405591
VISIT DATE: 08/09/2022
NARRATIVE
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The following was thoroughly discussed with Licensee:
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.

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.

The facility was operating in substantial compliance during today’s inspection on 08/09/2022. Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited.

Exit interview conducted and report was reviewed with the licensee, Alma Lopez.


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.
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SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Keyona Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022
LIC809 (FAS) - (06/04)
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