198017760-11-9-2021-33-CC-SROZ-C8LPZZ-20211109104622

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198017760
Report Date: 11/09/2021
Date Signed: 11/09/2021 10:46:41 AM

Document Has Been Signed on 11/09/2021 10:46 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	CORTEZ FAMILY CHILD CARE		FACILITY NUMBER:	198017760
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS:	DATE:	11/09/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Socorro Cortez, Licensee		TIME COMPLETED:	11:00 AM

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) Steven Rodriguez conducted an unannounced annual required inspection at the above facility on 11/09/21 at 9:00 AM. LPA met with Licensee, Socorro Cortez, who guided analysts on a tour of the facility at 09:20 am. A prior covid-19 pre screening was performed prior to the inspection being conducted. All members of the family have not acquired or been in contact with anyone with covid-19. This is a one story apartment home which consists of two bedrooms, two bathrooms, kitchen, living room and outside balcony which is locked. Areas accessible to children were inspected as follows: living room/ play area, one bathroom dining room for eating and a section of the outside yard for play time. There is no pool on the premises. Main care is provided in the playroom which is also the living room and can be accessed from the main entrance of the house. The children use the bathroom that is adjacent to the dinning room. LPA observed there is no fire place in the home. The house contains central air for cooling and heating. No wall heater was observed. Per Licensee, the off-limit areas are both bedrooms, one of the bathrooms and the kitchen and the balcony. Only areas used are play area/living room, dining room, bathroom, and front yard play area. Hours of operation is Monday-Saturday 8am-7pm. Individuals residing in the home have been discussed and noted. There are three adults total living in the home. All have clearance and have been associated. Licensee states that there are no firearms or weapons stored in the home. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is operable telephone service at the facility via cell phones.

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Steven Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2021

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CORTEZ FAMILY CHILD CARE	FACILITY NUMBER: 198017760
	VISIT DATE: 11/09/2021

NARRATIVE

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The following was observed and reviewed during this inspection:
LPA observed that cleaning products are stored under the sink which is locked and made innacessible to children. The licensee states that there are no poisons stored in the home. Isolation area for sick children waiting to be picked up is located in one of the rooms that is not occupied away from other children.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and has a purchase date of 08/04/2021. Smoke and carbon monoxide detectors were tested and are operable (dual).

The home is observed to be clean and orderly. There are toys and other age appropriate material available for children. Children nap on cots in the main living room/play area. The bathroom that children use was observed to be clean and free of hazards.

Infant Care: Currently, the licensee only has children over the age of four years old under care and does not plan on having infants. Older children nap on cots in the living room. LPA informed licensee of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute check documentation for infants 0-24 months, and provided PIN 20-24-CCP.

Currently, the children will use the front outside grassy area for some outdoor play time. LPA did not observe any objects that could be hazardous to children in care.

The licensee has obtained Pediatric CPR and first aid. The expiration date is on 08/14/2022. Licensee does have proof of immunization against pertussis, and measles. Declination of flu vaccine from the licensee was submitted and is signed and dated. Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. Exp. Date for licensee is 06/30/2023.

Incidental Medical Services (IMS):
The licensee states that she will not provide IMS. Per licensee, there are no children enrolled that require IMS at this time. 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:

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Steven Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2021

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CORTEZ FAMILY CHILD CARE	FACILITY NUMBER: 198017760
	VISIT DATE: 11/09/2021

NARRATIVE

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Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

Health and Safety Code 1596.7996 Effective January 1, 2019, Child Care Centers and Family Child Care Homes are required to provide parents and guardians of children enrolled, enrolling or re-enrolling in care with written information on the risks and effects of lead exposure, blood lead testing requirements and recommendations and options for locations of affordable blood lead tests. 2019 Lead flyer Provided.

Based on the LPA's observations and records review no deficiencies will be cited today 11/09/21.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Licensee Socorro Cortez, including, but not limited to Appeal Procedures and Appeal Rights.

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Steven Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2021

LIC809 (FAS) - (06/04)

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