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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400403
Report Date: 08/31/2022
Date Signed: 08/31/2022 03:03:49 PM

Document Has Been Signed on 08/31/2022 03:03 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:FLORES-QUEZADA FAMILY CHILD CAREFACILITY NUMBER:
198400403
ADMINISTRATOR:FLORES-QUEZADA, CRISTINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 788-3746
CITY:LAKEWOODSTATE: CAZIP CODE:
90712
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 2DATE:
08/31/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Licensee, Cristina Flores-QuezadaTIME COMPLETED:
03:15 PM
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On August 31, 2022 at 1:40 PM, Licensing Program Analyst (LPA) Monique Ayala conducted an unannounced inspection at the facility noted above and met with Licensee, Cristina Flores-Quezada. The purpose of the inspection was to conduct the Required - 1 Year inspection. The operating hours of the facility is Monday through Friday from 7:00 AM to 5:00 PM. Entrance Checklist (LIC 126) was provided to the Licensee upon arrival. Individuals residing in the home were discussed and noted. At the time of the inspection, the Licensee's children were present but no children are currently enrolled in care. Per Licensee, she does not have a dual license at this address.

All areas identified on the facility sketch were inspected. This facility is a multi-storey home that consists of four (4) bedrooms, three (3) bathrooms, playroom, two (2) dining rooms, living room, kitchen, attached garage, and fenced backyard.

Areas that are accessible to children include: one (1) bathroom, playroom, 2 dining rooms, living room, kitchen and fenced backyard. Per Licensee, the children will utilize the fenced backyard for outdoor activity.

Areas off-limits to children include: 4 bedrooms (located upstairs), 2 bathrooms (located upstairs), and attached garage. LPA observed a child safety gate installed at the bottom of the stairs, making the stairs and upstairs area inaccessible to children in care. LPA observed the door leading into the garage closed and locked, making the inside of the garage inaccessible to children in care. The Licensee was advised that off-limit areas must be made inaccessible during operating hours.

The following documents were posted in a prominent, publicly accessible area: Facility License, Notification of Parents' Rights (PUB 394), Earthquake Preparedness (LIC 9148), and Emergency Disaster Plan (LIC 610A). Licensee was advised to conduct disaster and fire drills every six months and to document the drills, including the date and time of each drill.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Monique Ayala
LICENSING EVALUATOR SIGNATURE: DATE: 08/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/31/2022
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: FLORES-QUEZADA FAMILY CHILD CARE
FACILITY NUMBER: 198400403
VISIT DATE: 08/31/2022
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Areas used by children were inspected for safety, comfort, heating, cleanliness and telephone service. LPA did not observe any wall heaters in the facility. The facility has a fireplace located in the living room that is screened. The facility has central air and heating. Detergents, cleaning compounds and medicines were made inaccessible to children in care. Per Licensee, there are no poisons kept in the home. Licensee was advised that if any poisons are purchased, it is required to be locked with a key or combination lock.

Per Licensee, there are no bodies of water, firearms or weapons on the premises. The Licensee has a family dog that is kept in the backyard or inside in a dog crate. LPA observed age appropriate toys and napping equipment for children. LPA observed electrical outlet covers installed in the child care areas. LPA observed the required fire extinguisher (2A-10BC) that is fully charged and last serviced on April 18, 2022. Licensee was reminded to have the fire extinguisher serviced yearly. Smoke detector and carbon monoxide detector was tested and is operable. First Aid kit and emergency supplies are available and kept in the hallway near the front entrance. Licensee stated that she plans on providing meals and snacks to the children. Licensee was reminded that food that is brought from the child's home shall be labeled with the child’s name and properly stored or refrigerated.

LPA reviewed the Licensee's record. Based on the record review, the Licensee's record is complete as required by Title 22 regulations. Licensee has proof of immunization for pertussis, measles, and influenza. Licensee has on record a TB clearance. Licensee has a valid Pediatric First Aid and CPR certification (expires June 2023). Licensee completed the required Preventative Health and Safety Practices on August 11, 2019, Lead component on April 19, 2021, and Mandated Reporter Training (AB 1207) on April 14, 2021. Licensee was advised that the Mandated Reporter training (AB 1207) must be completed every 2 years and is available at www.mandatedreporterca.com.

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.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Monique Ayala
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2022
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: FLORES-QUEZADA FAMILY CHILD CARE
FACILITY NUMBER: 198400403
VISIT DATE: 08/31/2022
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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

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 (PINs), Program Quarterly Update Newsletters and other important information communication platforms.

LPA provided assistance to the Licensee on how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

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.

No deficiencies were cited. A Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Licensee, Cristina Flores-Quezada. Appeal rights were explained and provided to the facility representative.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Monique Ayala
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2022
LIC809 (FAS) - (06/04)
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