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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017760
Report Date: 01/27/2023
Date Signed: 01/27/2023 12:11:20 PM

Document Has Been Signed on 01/27/2023 12:11 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:CORTEZ FAMILY CHILD CAREFACILITY NUMBER:
198017760
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
01/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Licensee, Socorro CortezTIME COMPLETED:
12:30 PM
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This inspection was conducted in Spanish


Licensing Program Analyst (LPA) Veronica MartinezGarza conducted an unannounced annual random inspection at the above facility on 01/27/23 at 08:30AM. The purpose of the inspection is also for an increase in capacity. The home is currently licensed for 8 children and a request for a capacity of 14 children was received. A COVID risk assessment was conducted upon entry- appropriate PPE was used. LPA met with Socorro Cortez, Licensee who guided analyst on a tour of the facility. There were 0 children present during this inspection. Per licensee, 08 children are enrolled. Present during the inspection was the Licensee’s husband. Operation hours are Monday – Saturday 06:00AM – 07:00PM. Currently licensee only cares for school age children.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety comfort, and cleanliness. This is an apartment complex and parents must use the call box to be allowed in to drop off or pick up children. Apartment is located on the first floor which consists of 2 bedrooms, 2 bathrooms, kitchen, dining room, living room/play area, and balcony (fenced). Per Licensee, family members residing in the home are 2 adults and 0 minors. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing, or volunteering in a licensed home. Individuals living in the home are identified on the attached LIC811.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE: DATE: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/27/2023
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CORTEZ FAMILY CHILD CARE
FACILITY NUMBER: 198017760
VISIT DATE: 01/27/2023
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LPA toured all areas used by children during this visit. Areas accessible to children include living room/play area, dining room, bedroom #1 and bedroom #2, 2 bathrooms (1 located inside bedroom #2 and 1 located next to the entrance). The bathroom children use was observed to be safe and sanitary. Per licensee, areas off limits to children and parents include kitchen and balcony (fenced). Kitchen knives are stored on a top drawer and all kitchen drawers have locks making it inaccessible to children. The living room connects to the balcony via a sliding door which has a lock to make it inaccessible to children. Licensee states there are no pets on the premises. Licensee does understand that licensing staff may have access to off-limit areas during inspection visit if necessary.

LPA observed plenty of age-appropriate toys, books, and play equipment for children to use. LPA observed and inspected sleeping equipment for children. All equipment meets the US Consumer Product Safety Commission safety standards. Per licensee, food is provided to all children in care. Licensee provides transportation to children in care (only after school pick up). LPA provided consultation.

There is telephone service via a landline. There is central ventilation and heating.

Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock. At 8:58AM smoke and carbon monoxide detectors were tested and are operable. The valve on the required 3A 40BC fire extinguisher indicates fully charged and purchased on 01/10/23, as indicated on the purchase receipt. Per State Fire Marshall standards, fire extinguishers shall be serviced or purchased annually.

LPA observed a first aid kit readily available in the dining room on top of the children’s cubbies. Isolation area for sick children waiting to be picked up is in bedroom #1 of the home with supervision. Per Licensee, there are no firearms or weapons stored in the home.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: 01/27/2023
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LPA observed the following required posted documentation in the dining room of the facility: Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPA reviewed facility records for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster drill log. 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 01/04/23. Children's roster was reviewed and is current.

Currently children use the apartment walkway for play with adequate shade. Licensee provides play equipment such as play mats for hopscotch, balls, hula hoops and paint easel. LPA did not observe any objects that could be hazardous to children in care. LPA did not observe any pools, spas, hot tubs, fishponds, or similar bodies of water during the inspection.

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

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

Licensee’s records were reviewed for approved Pediatric First Aid and CPR certification, expires 08/21/24, LIC 508- Criminal Record Statement, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. Licensee's mandated reporter training expires 07/14/24. Licensee’s records were observed to be complete. LPA issued a technical violation due to licensee not having proof of influenza vaccine.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: 01/27/2023
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Currently licensee does not have an assistant. LPA informed licensee that upon hiring an assistant, the following is required prior to the assistant being present in the home: fingerprint clearance, LIC 508- Criminal Record Statement, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current a Mandated Reporter Training Certificate.

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. Licensee currently does not care for infants. No infant walkers, No baby bouncers, No Johnny jumpers, No exersaucers and any other item that falls into that category.

Incidental Medical Services (IMS) policy was discussed. Per Licensee, there are no children on medications. 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

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023
LIC809 (FAS) - (06/04)
Page: 6 of 6
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: 01/27/2023
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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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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

The facility has requested an increase of capacity from 8 to 14 on 11/08/22. Fire clearance was granted on 12/19/22. Capacity Increase will be granted, pending final file review. License will be amended to reflect new capacity of fourteen (14) children. Increase is contingent upon a Licensing Program Manager review and approval.

Currently, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: 01/27/2023
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A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Socorro Cruz and appeal rights.

Page 6 of 6.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023
LIC809 (FAS) - (06/04)
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