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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017236
Report Date: 06/07/2022
Date Signed: 06/07/2022 01:23:52 PM

Document Has Been Signed on 06/07/2022 01:23 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:HERNANDEZ FAMILY CHILD CAREFACILITY NUMBER:
198017236
ADMINISTRATOR:MARIA HERNANDEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 580-2034
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 1DATE:
06/07/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Maria Hernandez & Blanca Flores TIME COMPLETED:
01:45 PM
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 THIS INSPECTION WAS CONDUCTED IN SPANISH
Licensing Program Analyst (LPA) Rita Ramos conducted an unannounced required 1 year inspection to the above facility on 06/07/22. LPA arrived at the facility at 11:45AM, identified self and initially met with Blanca Flores Hernadez, Assistant, who guided analyst on a tour of the facility. LPA provided Assistant with a copy of the LIC 126 Entrance Checklist to help facilitate the inspection. LPA was later met by Licensee, Maria Hernandez. Per Licensee, operation hours are Monday through Friday 6AM to 12AM. There are 9 children that are currently enrolled. A current children’s roster was available for review.

This is a one-story home which consists of 4 bedrooms, 3 bathrooms, kitchen, dining room, living room, front yard and backyard (fenced). The children use the bathroom in the hallway. Per Licensee, areas off limits to children and parents include: 2 bedrooms and 2 bathrooms. The licensee provides food for children in care.

Individuals who reside in the home were noted and discussed. Per Licensee, they currently have 2 assistants.

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

Licensee states that there are no firearms stored in the home.

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SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Rita Ramos
LICENSING EVALUATOR SIGNATURE: DATE: 06/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/07/2022
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: HERNANDEZ FAMILY CHILD CARE
FACILITY NUMBER: 198017236
VISIT DATE: 06/07/2022
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All areas identified on this report that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a landline and a cellphone. There is ventilation and heating (central). Safe toys play equipment and materials were observed.

Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. Poisons were observed to be locked in the back storage room. The restroom that children use was observed to be safe and sanitary.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 01/04/22, as indicated on service tag. Smoke and carbon monoxide detectors were tested to ensure that they are operable.

Licensee states that she is currently caring for infants. Licensee states that infants sleep in the living room where they are constantly supervised. LPA observed play yards in the living room. Cribs or play yard did not hinder the entrance or exit from the sleeping space, mattresses were observed to be firm and covered with a fitted sheet that overlaps the underside so it cannot be dislodged. LPA observed blankets hanging and other items in the pay yards. Per Licensee, the items are removed if infants are in care. No infants were in care during the inspection. LPA advised that infants cannot be swaddled while in care. LPA advised the Licensee that infants shall be placed on their backs for sleeping and shall be 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. A copy of the LIC 9227 was provided to Licensee. a copy of the Provider Information Notice (PIN) 20-24 CCP: Recently Approved Safe Sleep Regulations in Effect.

LPA discussed the safe sleep regulations with licensee [or facility representative] 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 [facility representative] 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. ----Page 2 of 4
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Rita Ramos
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2022
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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: HERNANDEZ FAMILY CHILD CARE
FACILITY NUMBER: 198017236
VISIT DATE: 06/07/2022
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Currently, children are using the back yard for outdoor play time. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with, however, LPA also observed that there are a lot of extra cleaning and supplies and emergency food supplies stored outside which limit the outdoor play space and can cause a tripping hazard. LPA advised that the items be organized or put away in the sheds and storage rooms that are available outdoors. The Licensee states that supervision is always provided.

The licensee is observed to be operating within the license capacity limitations. LPA did not observe any children left in parked vehicles. Car seats shall only be used for transportation. LPA did not observe any children sleeping in car seats.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 07/23. There are first aid supplies available. LPA advised that if a child shows signs of illness he/she/they shall be separated from other children.

Children’s records were reviewed, including emergency information and were observed to be complete.

The licensee does have proof of immunization against influenza, pertussis, and measles.

LPA observed that the Licensee and assistant do not have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file and advised that the training be taken.

All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill documented was conducted on May of 2021. LPA advised that Licensee conduct a fire or earthquake drill and document the date and time of the drill.



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

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted. --Pg 3 of 4
SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Rita Ramos
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2022
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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: HERNANDEZ FAMILY CHILD CARE
FACILITY NUMBER: 198017236
VISIT DATE: 06/07/2022
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LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

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.

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



The following deficiency listed on the attached deficiency page is being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

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

Exit interview conducted and report was reviewed with the licensee, Maria Hernandez.

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Rita Ramos
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/07/2022 01:23 PM - It Cannot Be Edited


Created By: Rita Ramos On 06/07/2022 at 01:06 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: HERNANDEZ FAMILY CHILD CARE
FACILITY NUMBER: 198017236

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/07/2022

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 and record review, the licensee did not comply with the section cited above due to not providing proof of taking the training and admitting that they have not taken the training which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/21/2022
Plan of Correction
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Per Licensee, they will take the training and submit copies of the certificates by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Trevino Cochran
LICENSING EVALUATOR NAME:Rita Ramos
LICENSING EVALUATOR SIGNATURE:
DATE: 06/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/07/2022


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