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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304313699
Report Date: 06/23/2022
Date Signed: 06/23/2022 11:59:25 AM

Document Has Been Signed on 06/23/2022 11:59 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:TRIANA, MARIA & URA, JULIEFACILITY NUMBER:
304313699
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
06/23/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Licensee Ms. Triana, Maria TIME COMPLETED:
12:10 PM
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A Case Management (Licensee initiated) inspection for a change in capacity was conducted at the facility by Licensing Program Analyst (LPA), Desai, Ketki. LPA observed licensee Ms. Triana, Maria was providing care and supervision to 1 infant (11 months)and 1 preschool age child (2 years old) along with one assistant
Ms Romero, Vanessa . Licensee has been a care provider for a Small Family child care home since 2020 qualifying her to be a Large Family child care provider.

Licensee was operating within the licensed capacity as specified on license. A review of the Facility Personnel Report Summary on this date indicates all facility residents, staff, or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Currently there are (3) adults (including the licensee) residing in the facility.

Licensee stated, she is not currently registered with any Resource Foster Care agency or holds a Resource foster parent license. She was reminded if changes to notify the licensing office.

Per Licensee, operation hours will be Monday to Friday, 7.00 AM to 5.00 PM, care and supervision shall be provided to children ages 4 months to 12 years of age (Infants to School age).
Licensee has all the needed items for infant care in the home.

During today’s inspection, LPA and licensee toured the inside and outside areas identified in the facility sketch as accessible to child care children. Off limits areas are made inaccessible by means of child safety gate, door knobs and safety barrier across the fire place. The home has central air conditioner,the unit is in the off limit area, inaccessible to children, there is also a small wall mounted window A/C unit in the day care home over a cabinet not reachable to the children. The fireplace in the living area has a built-in fence with an additional fireplace cover and a round table in front of it making it completely inaccessible to children. (1)
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE: DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/23/2022
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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: TRIANA, MARIA & URA, JULIE
FACILITY NUMBER: 304313699
VISIT DATE: 06/23/2022
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There is a pool in the home with the required fencing and swing gate in the back yard which is off limits to the children.

Licensee stated the children's primary area is the living room in across the main entrance of the home which used only during napping time and activity room is covered den area ( patio area converted into child care room with all the needed items)

Children enter through the main door, walk to the living area, where Licensee has placed a child fence gate making the dining area, kitchen and other areas of the home inaccessible to children. There are working carbon monoxide, smoke detector, and fire extinguisher in the home that meet statutory and State Fire Marshall standards.

Detergents, cleaning compounds, medicines, and other items which could pose a danger if readily available to children were stored inaccessible to children.

Licensee has designated the den area/ living area and one bathroom on the right side of the passage area along with part of back yard area in front of the patio area for day care activities. The home has age appropriate Infant and preschool age toys / furniture and activities for children.

The designated Day Care activity area( den room) was observed to be spacious and Licensee has set up the room with toys and educational items for the children along with infant play area / changing table/ small table and chairs. TV is wall mounted. Licensee also has installed a small window A/C to maintain optimal temperature in the home. The designated bathroom is located on the right side of the passage and it was observed to be safe and free of hazardous items. There is a cabinet under the sink, was locked, Licensee has small step stool and toddle toilet seat for the young children.

Licensee uses cots with linens during nap time, all linen/blankets are provided by the Licensee and are washed by the licensee. Older Children and infants nap in the living area. Day care area is safe and appropriate set up was observed. It is well lighted with proper ventilation and air flow.

Off Limit areas: Areas that are off-limits are kitchen, dining room, laundry room, two bedrooms, master bedroom with bathroom and garage. The home has security alarm around the home with cameras. (2)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2022
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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: TRIANA, MARIA & URA, JULIE
FACILITY NUMBER: 304313699
VISIT DATE: 06/23/2022
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Licensee does provides Breakfast/ Lunch /AM and PM snacks to the enrolled children. If food is brought from home, this containers are labelled and stored in their individual cubbies.

Infants needs are provided by parents.

LPA verified there is a working telephone service (cellular service ).



OUTDOOR PLAY AREA: Per Licensee, children use the part of the back yard in front of the day care room for out door activities . Licensee has also secured the side yards with a fence.
The yard for outdoor activities, is completely fenced with concrete flooring. Outdoor area has several age appropriate outdoor toys and activities.

Bodies of water: Home has a pool and a Jaccuzzi in the backyard and it is completed fenced which is all fenced at least 5 feet high and the gate is self latched. The swimming pool meets Title 22 Regulations.
Pet: There is a dog from Pit bull breed in the house, which remains in the off limits areas during operating hours.
There are no weapons or fire arms at the home.

The licensee does have a current roster of children in care and the 2 children records and assistant files were reviewed on today's inspection , LPA reviewed the emergency information card that contains all the information specified by regulation (LIC 700) and found to be in compliance. The licensee holds a valid Pediatric CPR/First Aid certification is valid through August 2023 and has completed the required Mandated Reporter Child Abuse training.


Licensee also has conducted Emergency fire and earthquake drills, last drill conducted in May 2022.

The licensee understands she must be present in the facility, must ensure children in care are supervised at all times, and children are not to be left in parked vehicles. When the licensee is temporarily absent from the facility, arrangements must be made for a qualified substitute adult to care and supervise children while absent. The substitute adult must have the required criminal record, child abuse index clearances, immunization's, Pediatric CPR/First Aid, and mandated reporter training.
(3)
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2022
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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: TRIANA, MARIA & URA, JULIE
FACILITY NUMBER: 304313699
VISIT DATE: 06/23/2022
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A copy of the California Department of Social Services Lead Information Brochure was explained and provided to the licensee.
A copy of the 2016 “A Child Care Providers Guide to Safe Sleep” was provided to the licensee. The following electronic links were also provided:
English: https//www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

LPA reviewed with the following safe sleep best practices:
*Always place infants on their backs for sleeping
*Use only a tight-fitting sheet on the crib or play yard mattress
*Do not hang any items from the crib or above the crib
*Keep all items, including blankets, out of the crib or play yard
*Pacifiers may be used as long as they do not have items attached to them
*Infants should not be swaddled or have any items covering them while sleeping
*The temperature of the room should be comfortable enough for an adult to wear a T-shirt and not be too hot or too cold.

Per Licensee, care and supervision is provided to children ages 4 months and above. Infant items were observed to be appropriate

OTHER INFORMATION AND FORMS PROVIDED:
Capacity Handout for a Large Family Child Care Home was provided and LIC 9150 was reviewed with the Licensee
Fire inspection from Orange County Fire Authority Fire inspection services have granted the fire clearance with specific instruction where garage and the second level is not permitted for Day care.

LPA discussed the following items with the applicant Ms. Triana, Maria during the Exit interview:

Criminal Record statement: Facility Representative Ms. Triana, Maria 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. (4)
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2022
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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: TRIANA, MARIA & URA, JULIE
FACILITY NUMBER: 304313699
VISIT DATE: 06/23/2022
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Safe Sleep : LPA discussed the safe sleep regulations with Facility Licensee Ms. Triana, Maria & discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the Facility Representative Ms. Triana, Maria 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information , see PIN 22-02-CCP. 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.



Review of records to be maintained : LPA reviewed with Facility Representative the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. LIC 311D was given to the Licensee at the time of the Exit interview.

LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

Subscribe to CCLD important information
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 license- 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.

The facility was complying with Title 22 Regulations at the time of inspection.

(5)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2022
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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: TRIANA, MARIA & URA, JULIE
FACILITY NUMBER: 304313699
VISIT DATE: 06/23/2022
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A license with the change in capacity for 14 children (Large Family Child care home) will be issued after final review, in the event additional requirements are needed, Licensee will be notified.


On today’s inspection each child was observed to have a safe, healthful and comfortable accommodation furnishing and equipment’s.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

A copy of this report and Appeal rights were presented to the Licensee.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2022
LIC809 (FAS) - (06/04)
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