<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016446
Report Date: 09/09/2022
Date Signed: 09/09/2022 03:53:54 PM

Document Has Been Signed on 09/09/2022 03:53 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:CORTEZ FAMILY CHILD CAREFACILITY NUMBER:
198016446
ADMINISTRATOR:CORTEZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 287-3909
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 5DATE:
09/09/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:12 PM
MET WITH:Maria CortezTIME COMPLETED:
04:00 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
On 9/9/22 Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced required 1 year inspection at the above facility. LPAs met with the Licensee Maria Cortez and informed her of the purpose for the visit. LPA provided Licensee with a copy of the Facility Entrance Checklist. There were 5 children and one assistant present during the inspection. All residents were noted and verified. Facility provides care to children ages 3 months to 12 years. Facility is open Monday to Friday 6AM to 6 PM.
This is a one story, 3 bedroom, 2 bathroom home, with a living room/ dining room, kitchen/laundry room, daycare room, fenced backyard and an ADU.
Per Licensee areas on limits to children are: Day care room next to kitchen, bathroom in the day care room and the fenced backyard
Per Licensee areas off limits to children are: 3 bedrooms, one bathroom, living room, dining room, kitchen, laundry room, ADU and a section of the backyard separated by a gate. The off limit areas are inaccessible. The Licensee has installed a safety door knob in the day care room to prevent access to the kitchen/main areas of the home. The children are dropped off at the back entrance to the day care room.
All areas that are accessible to children were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection: LPA observed required posted documentation- Facility license, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPA observed and reviewed a current roster LIC 9040 and a current disaster drill log. Last disaster drill was performed in 7/20/22. There is an operable carbon monoxide detector in the kitchen and an operable smoke detector in the day care room. LPA observed a 2A10BC Fire Extinguisher in the daycare room which indicated full and was last serviced October 2021. The home maintains telephone service (cell phone). Food is provided by Licensee. Licensee was reminded if children bring food from home it must be labeled with the child’s name and properly stored or refrigerated.
There are toys and other age appropriate materials available for children to use in the day care room and in the backyard. Sharp objects, detergents and cleaning compounds were inaccessible to children in care. Knives are kept in a kitchen drawer, Cleaning products are in a cabinet under the sink, detergent is in the laundry room.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE: DATE: 09/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/09/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: CORTEZ FAMILY CHILD CARE
FACILITY NUMBER: 198016446
VISIT DATE: 09/09/2022
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
26
27
28
29
30
31
32
Page 2
Per Licensee, personal medication is stored in the ADU . Per Licensee, no children enrolled require medication. The facility has central air and heating. There were no fireplaces observed. Children nap in the day care room and they are provided appropriate napping equipment. Children use the restroom in daycare room/ LPA inspected cabinets in the restroom where hygiene items are stored.
Children use the backyard for outdoor play. LPA observed the back yard is fully fenced. Per Licensee, children are supervised while playing outside. Per Licensee, there are no poisons in the home. Licensee understands that all poisons must be locked, not only inaccessible to children. Isolation area for sick children waiting to be picked up is in a section of the day care room, separated from other children. Per Licensee, there are no firearms or weapons stored in the home. LPA did not observe any pools or spas, or other bodies of water. There is one pet dog in the home. The dog is contained in an off limits area of the backyard that is separated by another gate.
Infant Care: Currently licensee has 1 infant enrolled. Per Licensee, there are no infants under 12 months enrolled. LPA observed infant napping on a cot. Licensee was advised Infants shall not be swaddled in care. Car seats shall not be used for sleeping. LPAs discussed the new Safe sleep regulation, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months, LPAs provided a copy of PIN 20-24-CCP and the infant safe sleep regulation 102425.
Overnight Care: There is no overnight care provided at the moment. LPAs discussed the following: Licensee is aware that they must remain awake while children are awake. If children sleep in separate area from licensee, the door must remain open. If licensee cannot hear children when they wake up, video or audio device can be used.
Children's records were reviewed: Children's records contained (LIC) 282- Affidavit Regarding Liability Insurance, Immunization Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights and the 15 minute infant sleep log.
Staff records were reviewed: Licensee's pediatric CPR/First Aid was completed on 12/5/20, Assistant's pediatric cpr/first was completed on 3/12/22. Staff had proof of required immunizations (measles, pertussis, flu-declination on file for Licensee). Staff had proof of TB clearance. Licensee's Mandated Reporter training was completed in 6/6/21. Assistant's Mandated Reporter training was completed on 4/16/22. LIC 508, LIC 9108 and LIC 9052 were on file.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

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

DATE: 09/09/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: CORTEZ FAMILY CHILD CARE
FACILITY NUMBER: 198016446
VISIT DATE: 09/09/2022
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
26
27
28
29
30
31
32
Page 3
During inspection the child present was observed to be treated with dignity and respect, and free from corporal and/or unusual punishment.
Incidental Medical Services (IMS): 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
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 athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleephttps://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. 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.

No deficiencies were observed in the areas inspected today.

Exit interview conducted and report was reviewed with the Licensee, Maria Cortez . A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:

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

DATE: 09/09/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3