198400228-2-1-2023-54-CC-AMOY-CNMMD4-20230201083032

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400228
Report Date: 01/31/2023
Date Signed: 02/01/2023 08:30:48 AM

Document Has Been Signed on 02/01/2023 08:30 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	PARTIDA & GUTIERREZ FAMILY CHILD CARE		FACILITY NUMBER:	198400228
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 7	CENSUS: 3	DATE:	01/31/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Margarita Gutierrez, Licensee		TIME COMPLETED:	01:15 PM

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Licensing Program Analyst (LPA) Alicia Mooberry conducted Required Annual inspection for the above address. LPA met with Margarita Gutierrez, Licensee and Carmen Partida, Co-licensee and provided the inspection Entrance Checklist, LIC 126. Licensee provided tour of facility. LPA inspected rooms/areas on the facility sketch in which child-care services are provided and to which children have access. Upon arrival at 10:00am LPA observed 3 child in care including one (1) infant. Per licensee the hours of operation are Monday-Friday 6:00am-6:00pm. The Licensee is requesting to increase the capacity to a Large Family Child Care with a capacity of 12-14 children. A fire clearance was granted on 12/16/22.

This is a one story home consists of 2 (two) bedrooms, 1 bathroom. Areas used by the children include the living room, dining room, kitchen one (1) restroom, front and backyard.

Per Licensee and facility sketch, areas off limits to children include: Two bedrooms, detached garage and storage shed in the backyard. The garage and storage shed were observed to be locked. The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children.

Off limit areas are made inaccessible by safety gates in the hallway leading to the bedrooms, the safety gate also makes a wall heater inaccessible to children in care. The kitchen/dining room is used for infant care and has a gate at entrance to the kitchen.

Knives and other sharp utensils are in the kitchen cabinet inaccessible to children in care in over head cabinet. Cleaning products are located in locked cabinet under the sink in kitchen and in the laundry room. Smoke detectors and carbon monoxide detector were observed, tested and found to be operable. The homes has fans and portable oscillating heaters for safety and comfort. Per licensee, there are no poisons in the home. Licensee was advised that poisons need to be locked.

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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023

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: PARTIDA & GUTIERREZ FAMILY CHILD CARE	FACILITY NUMBER: 198400228
	VISIT DATE: 01/31/2023

NARRATIVE

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The home maintains telephone service via cell phone. The home is observed to be clean and orderly. There are toys and other age appropriate material available for children. Isolation area for sick children waiting to be picked up is in living room, away from the other children. Per Licensee there are no firearms or weapons stored in the home.
The bathroom that children use is located in the hallway and observed to be clean and free of hazards.

LPA discussed Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months, and PIN 20-24-CCP.

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.

Currently, children are using the front and back yard for outdoor play. The outdoor play area was observed to be fenced. LPA observed that the front yard has toys and other materials for children to play with. The backyard was inspected and LPA observe peeling and chipping paint on concrete steps, rusted metal poles, gate rail has sharp exposed edges, children's table with exposed particle wood that is accessible to children in care which poses a potential health, safety or personal rights risk to persons in care. Per licensee the hazardous items will be fixed or removed before children have access to the yard. There's no pool, spa or similar body of water on the premise. LPA has no pets 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, LIC 995A Notification of Parents’ Rights, and documentation of 15-minute Infant Sleep Check (0-24 months)

The LIC 627 Consent for Emergency Care was missing parents signature for Child #3. which poses a potential risk for the health and safety of children in care.
Licensees have current EMSA approved Pediatric First Aid and CPR Exp: 03/2024. Applicant has proof of immunization against pertussis and measles. Mandated Reporter Training expired on 06/23. Licensee provides food for children in care. Applicant was advised to properly label and store children's food if brought from home. -------------------Page 2 – Report Continues

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023

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: PARTIDA & GUTIERREZ FAMILY CHILD CARE	FACILITY NUMBER: 198400228
	VISIT DATE: 01/31/2023

NARRATIVE

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Staff records were reviewed for approved Pediatric First Aid and CPR certification, 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 Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate.

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.

Incidental Medical Services (IMS) was discussed with licensee. 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.

Based on the LPA's observations and records review the following deficiencies will be cited today in accordance with California Title 22 Regulations.

A notice of site visit was given and must remain posted for 30 days. Appeal rights were discussed and a copy provided.

Exit interview conducted and report was reviewed with the Licensee, Margarita Gutierrez

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/01/2023 08:30 AM - It Cannot Be Edited

Created By: Alicia Mooberry On 01/31/2023 at 12:00 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: PARTIDA & GUTIERREZ FAMILY CHILD CARE	FACILITY NUMBER: 198400228
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/31/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above, due to unsafe condiiton in back yard including: peeling and chipping paint on concrete steps, rusted metal poles, gate rail has sharp exposed edges, childrens table with exposed particle wood that is accessible to children which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/06/2023
	Plan of Correction
1 2 3 4	The backyard is separated from front yard by locked metal gate, licensee stated the children will not have access to the backyard until the hazardous items are removed or fixed. Licensee will provide proof of correction via email by POC due date.

Type B

Section Cited

CCR

102417(g)(7)

Operation of A Family Child Care Home

(7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in 1 out of 3 records reviewed has an incompleted LIC 627 Consent for emergency treatment which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/06/2023
	Plan of Correction
1 2 3 4	Per licensee the LIC 627 for Child #3 will be completed and proof of correction will be sent to LPA via email by POC due date.

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:

Valarie Cook

LICENSING EVALUATOR NAME:

Alicia Mooberry

LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023

LIC809 (FAS) - (06/04)

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