198015730-5-30-2023-54-CC-SSAZ-CSBTEB-20230530143940

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198015730
Report Date: 05/30/2023
Date Signed: 05/30/2023 02:39:48 PM

Document Has Been Signed on 05/30/2023 02:39 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:	ROACHE FAMILY CHILD CARE		FACILITY NUMBER:	198015730
ADMINISTRATOR:	ROACHE, JENNIFER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 633-6144
CITY:	PARAMOUNT	STATE: CA	ZIP CODE:	90723
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 8	CENSUS: 5	DATE:	05/30/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Jennifer Roache, Licensee		TIME COMPLETED:	03:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analysts (LPA) Susann Sanchez conducted an unannounced annual required inspection at the above facility on 5/30/2023 at 1:00PM. LPA met with Jennifer Roache, Licensee who guided analysts on a tour of the facility. There were 5 children, 1 infant and the Licensee present when LPA arrived. Facility capacity is in compliance for a Large Family Child Care Home. Hours of operation are Mon-Fri 6:30 AM - 6:00PM however Licensee is flexible if a child needs more hours. Food is provided by Licensee. This is a 2-story home which consists of 2 bedrooms, 2 1/2 bathrooms, kitchen, dining room, daycare room, living room, 2 balconies. There is no front yard or backyard at this facility. Per Licensee, children use the daycare room downstairs. The children use the bathroom located next to the daycare room. Per Licensee, areas off limits to children and parents include: the areas upstairs which include the 2 bedrooms, 1 1/2 bathrooms, dining room, living room, 2 balconies, and kitchen. Individuals residing in the home have been discussed and noted. All adults present in the home have obtained a criminal record clearance or exemption. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection: LPA reviewed required posted documentation for Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. Facility records were reviewed for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster drill log, last drill conducted on 3/16/2023. The home maintains telephone service via landline and 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 detergents, cleaning compounds and medication are stored in the locked hallway cabinet and inaccessible to children.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2023

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: ROACHE FAMILY CHILD CARE	FACILITY NUMBER: 198015730
	VISIT DATE: 05/30/2023

NARRATIVE

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LPA was unable to test smoke detectors and carbon monoxide detector due to children sleeping. Licensee will test smoke and carbon detectors via Facetime with LPA on 06/1/2023. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was purchased on 05/4/2023. Per State Fire Marshall standards, fire extinguishers shall be serviced or purchased annually.

Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, not only inaccessible to children. Isolation area for sick children waiting to be picked up is in hallway, away from the other children. Per Licensee there are no firearms or weapons stored in the home.

Currently licensee does care for 1 infant. LPA reminded Licensee of the following: napping equipment cannot block entrances or exits, infant mattresses were observed to be firm with tightly fitted sheets and cribs or play pens cannot have loose object, bumpers, objects hanging, or objects attached. LPA reviewed licensee of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months.

Currently, children are using the open driveway area for nature walks and for play time. The facility is located in a gated community area. A declaration from is on file indicating that supervision including visual supervision is always provided and children are never left unattended. There are no pools or spas, or other bodies of water.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunizations Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights.

Staff records were reviewed for approved Pediatric First Aid and CPR certification (expires 05/2025), 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 of Child and Mandated Reporter Training Certificate (expires 04/19/2025) .

During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2023

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: ROACHE FAMILY CHILD CARE	FACILITY NUMBER: 198015730
	VISIT DATE: 05/30/2023

NARRATIVE

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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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm

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/process.

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.

Based on the LPA's observations and records review no deficiencies will be cited today 5/30/23. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee J. Roache. Appeal Right were given and explained.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2023

LIC809 (FAS) - (06/04)

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