198009775-4-28-2023-54-CC-AMOY-CRBST6-20230428140900

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198009775
Report Date: 04/28/2023
Date Signed: 04/28/2023 02:09:18 PM

Document Has Been Signed on 04/28/2023 02:09 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	AQUINO FAMILY CHILD CARE		FACILITY NUMBER:	198009775
ADMINISTRATOR:	AQUINO, LETICIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 560-4621
CITY:	BELL	STATE: CA	ZIP CODE:	90201
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 6	DATE:	04/28/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Leticia Aquino, Licensee		TIME COMPLETED:	02:15 PM

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Licensing Program Analyst (LPA) Alicia Mooberry conducted a Required Annual Inspection in Spanish on this date. Upon arrival LPA met with Leticia Aquino, Licensee. LPA explained the purpose of the inspection and provided the inspection Entrance Checklist, LIC 126. Licensee provided tour of facility.

LPA inspected rooms/areas on the facility sketch in which child-care services are provided and to which children have access for safety, comfort, and cleanliness.

Per licensee the hours of operation are Monday-Friday 6:00am-6:00pm. There were 6 children present (including 1 infant). Also present was Tere Martinez, Assistant. Sonia Covarrubuas, Assistant arrived at 11:30am. Individuals residing in the home were discussed and noted. All individuals present in the home have obtained a background clearance.

This is a single story, 4 bedroom/3 bath home. There is an additional dwelling in the rear of the lot with a different address. The main childcare areas are the living room and bedroom #2. Other areas accessible to children include the kitchen, bathroom inside bedroom #2, and cemented patio on side of home observed to the covered by tent and enclosed. LPA observed a toddler swing set.

Off limit areas, per Licensee and facility sketch are: Front bedroom, 2 bedrooms and bedroom in the rear of home, laundry area next to the kitchen, made inaccessible by safety gate and storage room next to the patio.. LPA observed safety knobs on the stove and safety latches on cabinets in kitchen and bathroom.

The Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form posted at the facility entrance. LPA observed completed facility records including; LIC 610- Facility Disaster Plan and Facility Roster

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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: AQUINO FAMILY CHILD CARE	FACILITY NUMBER: 198009775
	VISIT DATE: 04/28/2023

NARRATIVE

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Smoke and carbon monoxide detectors were tested and are operable. Fire extinguisher indicated fully charged and was serviced on 07/22, Licensee was reminded that fire extinguisher needs to be serviced yearly. The home maintains telephone service via cell phone. The home is observed to be clean and orderly. There are toys and other age appropriate material available for children. LPA observed that cleaning compounds, detergents, and medications are in bathroom overhead locked cabinets, kitchen undersink cabinet and laundry room inaccessible to children. The bathroom that children use is located in bedroom/nap room observed to be clean and free of hazards.

Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, not only inaccessible to children. Per Licensee there are no firearms or weapons stored in the home.

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.

Currently, children are using the side patio for outdoor play. The outdoor play area is located on the side of home, was observed to be fenced and covered by a tent and enclosed. There is a metal frame swing set in the play area secured to the floor and walls. LPA observed a toddler swing and verified it is not recalled (photos taken). LPA observed foam cushioning under the swing set. Per licensee, there is adult supervision during time that the swings are uses. The swings are unhooked and put away when not in use.There are other toys and other materials for children to play with. Facility does not have a pool or similar bodies of water. There are currently no pets at the home.

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.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization's Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, and documentation of 15-minute Infant Sleep Check (0-24 months).

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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023

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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: AQUINO FAMILY CHILD CARE	FACILITY NUMBER: 198009775
	VISIT DATE: 04/28/2023

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Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC-501: Personnel Record, LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. Proof of immunization against Measles and pertussis for Staff #1 and #2 was not available. This poses a potential risk to the health and safety of children in care.

LPA observed that licensee is implementing current COVID-19 recommendations, precautions and procedures.

Incidental Medical Services (IMS) policy was discussed. 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 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.

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.

Based on the LPA's observations and records review the following deficiencies will be cited today in accordance with California Title 22 Regulations.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Leticia Aquino. Appeal Right discussed.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/28/2023 02:09 PM - It Cannot Be Edited

Created By: Alicia Mooberry On 04/28/2023 at 01:14 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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: AQUINO FAMILY CHILD CARE	FACILITY NUMBER: 198009775
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/28/2023

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
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in that 2 out of 2 staff present did not have proof of completing of Mandated Reporter (AB1207) training which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/19/2023
	Plan of Correction
1 2 3 4	Per licensee, proof of completion of the Mandated Reporter training by Staff #1 and Staff #2 will be sent to LPA via email by POC due date.

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
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in that 2 out of 2 staff present did not have proof of immunization against pertisis and measles which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/19/2023
	Plan of Correction
1 2 3 4	Per licensee, proof of completion of the immunizations for Staff #1 and Staff #2 will be sent to LPA via email by POC due date.

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:

Valarie Cook

LICENSING EVALUATOR NAME:

Alicia Mooberry

LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023

LIC809 (FAS) - (06/04)

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