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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197410496
Report Date: 11/14/2024
Date Signed: 11/14/2024 01:16:06 PM

Document Has Been Signed on 11/14/2024 01:16 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:VALENZUELA FAMILY CHILD CAREFACILITY NUMBER:
197410496
ADMINISTRATOR/
DIRECTOR:		VALENZUELA, M. & J.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 831-4426
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 7DATE:
11/14/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:13 AM
MET WITH:Maggy Valenzuela, LicenseeTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
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Licensing Program Analysts (LPA) Elicia Calvillo conducted an unannounced annual required inspection to the above facility on 11/14/2024. LPA arrived at the facility at 08:13 AM, identified self and met with Ana Albillo, Assistant, who guided analyst on a tour of the inside and outside of the facility. There were 8 children present at arrival. Shortly after, Maggy Valenzuela and Jesus Valenzuela arrived. Also present was Staff #1 (S1). LPA provided Assistant / Licensee with a copy of the LIC125 Entrance Checklist to help facilitate the inspection. Facility operation hours are Monday to Friday from 7:00AM to 6:00PM.

The family child care home is a two-story dueling with a living room, combined family/dining/kitchen room, play room, 5 bedrooms, 4 bathrooms, attached ADU, and detached storage room. There is a fenced front yard that is off limits to children. There is a fenced outdoor play area in the back of the house.

LPA observed the following inside areas will be used for child care: family/dining/kitchen room, play room, and bathroom #2 are used for providing care and are accessible to children. The children enter the facility from the back yard. The play room is used for dropping off and picking up children, learning activities, arts and crafts, play activities, eating and sleeping. In the play room, LPA observed mats, bed linens stored in the closet and observed toys and play items that are safe, clean, and appropriate for the ages of the children. The family/dining/kitchen room is used for eating and sleeping and LPA observed play yards and table and chairs.

All other rooms are off-limits and made inaccessible by use of door locks and safety gates. There is telephone service via a landline that is used during operation hours.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024
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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Document Has Been Signed on 11/14/2024 01:16 PM - It Cannot Be Edited


Created By: Elicia Calvillo On 11/14/2024 at 12:23 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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: VALENZUELA FAMILY CHILD CARE
FACILITY NUMBER: 197410496

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/14/2024

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
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Based on observation, interview, record review, the licensee did not comply with the section cited above in 4 out 4 personnel files did not have a current mandated reporter certificate readily available upon request which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/16/2024
Plan of Correction
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Licensee stated that the mandated reporter training will be completed and email LPA a copy of the certification by the plan of correction due date 12/16/2024.
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
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4
Based on observation, interview, record review, the licensee did not comply with the section cited above in that 4 of 4 personnel records did not contain immunization records and was not readily available upon request which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/16/2024
Plan of Correction
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4
Licensee state that the immunization records will be requested and email LPA a copy of the of the immunization records by the plan of correction due date 12/16/2024.
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:Rita Ramos
LICENSING EVALUATOR NAME:Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:
DATE: 11/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/14/2024


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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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: VALENZUELA FAMILY CHILD CARE
FACILITY NUMBER: 197410496
VISIT DATE: 11/14/2024
NARRATIVE
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Bathroom #2 located next to the family room is used for children. The vanity cabinet holds hand soap, has a child safety latch, and no hazards were observed. LPA observed that the bathroom that children will use was safe and sanitary.

Licensee stated that when a child shows signs of an illness the child will isolated away from the other children in the family/dining/kitchen room.



There is a combination smoke/carbon monoxide detector in the play room, was tested and is operable.

There is a working fire extinguisher, the valve on the required 2A 10BC fire extinguisher indicates fully charged and Licensee was not able to confirm last service date.

LPA did not observe any pools, spas, hot tubs, fish ponds, or similar bodies of water during the inspection on the property.

Per Licensee, there are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible with the use of a safety latch. Licensee has two dogs, during the hours of operations the dogs are kept in the living room and the living room is made inaccessible with the use of a child safety gate.



LPA did not observe a fireplace or an open-faced heater.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: VALENZUELA FAMILY CHILD CARE
FACILITY NUMBER: 197410496
VISIT DATE: 11/14/2024
NARRATIVE
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There are currently no infants in care under the age of 12 months. Licensee states that if an infant is enrolled, the infant will sleep in the olay room where they are constantly supervised. Infants shall be checked on every 15 minutes and the time of each 15-minute check shall be documented with child’s name and date. The LIC 9227 Individual Infant Sleeping Plan shall be completed for each infant up to 12 months of age and reference Provider Information Notice (PIN) 20-24 CCP.

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.

Licensee was reminded that children in care are to be supervised at all times and made aware that children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children.

The outdoor play area is located on the back yard of the house, is fenced and there are no hazards to children present. LPA observed the backyard is being moved around and the play items will be relocated.

Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete and documented on the LIC857.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024
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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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: VALENZUELA FAMILY CHILD CARE
FACILITY NUMBER: 197410496
VISIT DATE: 11/14/2024
NARRATIVE
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An emergency fire/disaster drill has been completed within the last 6 months (10/11/2024) and the documentation of the fire/disaster drill was not readily available upon request. Licensee’s Mandated Reporter Training was expired and an updated completion certificate was not available upon inspection. Licensee’s pediatric CPR/First Aid expires on 05/2025.

There were 2 personnel record for LPA to review and observed the file was not complete and documented on the LIC869. Personnel record was missing current Mandated Reporter training certificate and immunization record were not readily available upon request.

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.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.



Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024
LIC809 (FAS) - (06/04)
Page: 5 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: VALENZUELA FAMILY CHILD CARE
FACILITY NUMBER: 197410496
VISIT DATE: 11/14/2024
NARRATIVE
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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

The following Type B deficiencies are being cited today, 1596.8662 (b)(1) Mandated Reporter Training and 1597.622 (a)(1) Immunization Records on the attached deficiencies page are being cited in accordance with California Code of Regulations Title 22.

A Notice of Site Visit was given and must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to comply with posting requirement will result in an immediate civil penalty of $100.00.



Exit interview was conducted with Maggy and Jesus Valenzuela, Licensee including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024
LIC809 (FAS) - (06/04)
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