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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198009775
Report Date: 03/14/2024
Date Signed: 03/15/2024 08:15:08 AM

Document Has Been Signed on 03/15/2024 08:15 AM - 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 CAREFACILITY NUMBER:
198009775
ADMINISTRATOR:AQUINO, LETICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 560-4621
CITY:BELLSTATE: CAZIP CODE:
90201
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
03/14/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Leticia Aquino, LicenseeTIME COMPLETED:
04:45 PM
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Licensing Program Analysts (LPAs) Alicia Mooberry Ashley Calderon conducted a Required Annual Inspection in Spanish on this date. Upon arrival LPAs met with Leticia Aquino, Licensee. LPAs 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. At 12:44pm LPA's inspected the bedroom where 7 children were napping. Child #1, a 13 month infant was observed napping inside a play yard enclosure not approved by Safe Sleep regulation. Child #1 was observed sleeping with a pacifier attached to clothing with a string, There was a mobile toy hanging over the inside of play yard and lose blankets and pillows (photos taken). This poses an immediate risk to the health and safety of children in care. The licensee removed the infant from the play yard, placed in a safe play yard and removed the play yard enclosure. LPAs provided safe sleep technical assistance.

Per licensee the hours of operation are Monday-Friday 6:00am-6:00pm. There were 6 children present (including 1 infant). Also present was Assistant. Sonia Covarrubuas. 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 enclosed and cemented patio on side of home observed to the covered by tent.

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.

----------Page 1 -Report Continues

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE: DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/14/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: 03/14/2024
NARRATIVE
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LPA observed 2 play yards and 2 cribs had lose items inside the crib, Child #2 (age 3) was observed sleeping in a crib and Child #3 (age 2.5) was standing inside a crib which poses a potential health, safety or personal rights risk to persons in care. 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.

Smoke and carbon monoxide detectors were tested and are operable. Fire extinguisher indicated fully charged and was serviced on 08/23, 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 or fire arms stored in the home and understands that all poisons must be lock, not only inaccessible to children.

LPA discussed the safe sleep regulations including keeping sleep log and writing down every 15 minute when infants up to 24 months 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 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 and Personnel records were reviewed and found completed according the LIC 126. --------Page 2 – Report Continues

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
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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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: AQUINO FAMILY CHILD CARE
FACILITY NUMBER: 198009775
VISIT DATE: 03/14/2024
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Incidental Medical Services (IMS) policy was discussed. 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 facility is cite 1 "A" and 3 "B" deficiencies as a result of this inspection in accordance with California Title 22 Regulations.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). Licensee was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form LIC 9224 (Spanish) during this visit. A copy of the Parent Notification Requirements was also provided to the licensee. The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent.

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 and a copy in Spanish provided.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/15/2024 08:15 AM - It Cannot Be Edited


Created By: Alicia Mooberry On 03/14/2024 at 03:36 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: 03/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102425(i)
Infant Safe Sleep
If an infant falls asleep before being placed in a crib or play yard, the provider shall move the infant to a crib or play yard as soon as possible.

This requirement is not met as evidenced by:
Deficient Practice Statement
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3
4
Based on observation, the licensee did not comply with the section cited above in that 1 out of 1 infant in care was observed sleeping in a play yard enclosure not approved by Safe Sleep regulation. LPAs observed lose blakets and pillows in play yard, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 03/14/2024
Plan of Correction
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The licensee removed Child #1 and place in safe play yard and removed the play yard enclosure. LPA provided Safe Sleep technical assistance. Per licensee, Safe sleep regulations will be followed.
Section Cited
Deficient Practice Statement
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4
POC Due Date:
Plan of Correction
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2
3
4
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: 03/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/14/2024


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Document Has Been Signed on 03/15/2024 08:15 AM - It Cannot Be Edited


Created By: Alicia Mooberry On 03/14/2024 at 03:36 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: 03/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(b)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on observation, the licensee did not comply with the section cited above due to blankets pillows, and a hanging toys were observed in play yard used for infant to nap which posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/14/2024
Plan of Correction
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2
3
4
The Licensee removed the lose items and hanging toys from the play yards and cribs that the children use for napping.
Type B
Section Cited
CCR
102425(b)(1)(A)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects. (1) Pacifiers shall be allowed in the crib or play yard if the following provisions are in place: (A) There shall not be anything attached to the pacifier.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation the licensee did not comply with the section cited above in that Child #, 13 month infant was napping with pacifier attached to clothing with a string which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/14/2024
Plan of Correction
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The licensee, removed the pacifier from the infant and was observed to return in to the parent. Licensee state they will ensure to follow Safe Sleep regulations.
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: 03/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/14/2024


LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 03/15/2024 08:15 AM - It Cannot Be Edited


Created By: Alicia Mooberry On 03/14/2024 at 03:36 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: 03/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102423(a)(2)
Personal Rights
(a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on observation, the licensee did not comply with the section cited above in the Child #2 (age 3) was observed sleeping in a crib and Child #3 (age 2.5) was standing inside a crib which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/14/2024
Plan of Correction
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2
3
4
Child 2 and 3 were removed from the crib. Per licensee, the children will nap on the mats
Section Cited
Deficient Practice Statement
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2
3
4
POC Due Date:
Plan of Correction
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2
3
4
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: 03/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/14/2024


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