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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304313865
Report Date: 07/22/2022
Date Signed: 07/22/2022 03:32:56 PM

Document Has Been Signed on 07/22/2022 03:32 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:BENAVIDES, GENNYFACILITY NUMBER:
304313865
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
07/22/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Licensee Ms. Benavides, Genny TIME COMPLETED:
03:45 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. Benavides, Genny caring for 1 infant (6 months) and 1 Toddler (18 month old). Licensee has been a care provider for a Small Family child care home since March 2021, 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 is only (2) adult 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, 6.00 AM to 6.00 PM, care and supervision shall be provided to children ages 1 month to 12 years of age (Infants to School age).

During today’s inspection, LPA and licensee toured the inside and outside areas identified in the facility sketch as accessible to child care children.

Licensee has installed a child safety gate in front of the bathroom designated for children, making the home inaccessible to children. Licensee has also installed child safety lock stoppers on the bedroom handles making the two bedrooms inaccessible to children. Front yard of the home is also made inaccessible by a locked fencing around it, there is a water fountain in the front yard. Kitchen is open all the cabinets were observed to have child safety locks. (1)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE: DATE: 07/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/22/2022
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: BENAVIDES, GENNY
FACILITY NUMBER: 304313865
VISIT DATE: 07/22/2022
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Detergents, cleaning compounds, medicines, and other items which could pose a danger if readily available to children were stored inaccessible to children.

Off Limit areas: . Licensee has designated Two bedrooms, one bathroom in the Master bedroom, kitchen, dining area, garage, side yard and Laundry room and Front yard as Off-limits areas. There is a fire place in the newly added living area, the barrier across it is bolted and it has additional items in front making it inaccessible to children.

Designated Day care area: New rooms have been added to the Day care areas, due to change in capacity. Licensee shall now use one bedroom / Living area and family room for Day Care area. Family room is adjoining the living room. Bedroom has all the needed Infant care items, there is a monitor in this room and family room has a surrounding cloth mesh barrier surrounding it, keeping the passage area open for walking. These section also has safe padding mat flooring with activities items. Living area is open and children usually gather for watching TV. Dining activities are also held in family room and the day care areas were spacious, with the needed activity items. The bathroom is next to the day care room, on the right side in the small hallway across the Master-bed room. It was observed to be safe and free of hazardous items. There are several cabinets under the sink, they were observed to be safe with child safety locks installed. There is a small step tool for children in the bathroom. Young infants nap in the bassinets/ older infants and toddlers in portable pac and play and older children use the blue cots during nap time.

OUTDOOR PLAY AREA: Licensee have designated back yard area for outdoor activities, it was observed to be fenced on all the sides, with a completely shaded patio, it has appropriate barriers on the side end making one side yard inaccessible to the children. There is fencing installed across the planters. LPA observed age appropriate toys and climbing structures for the children. It has concrete flooring over the covered patio area and grass in the open space where climbing structures are placed.


Per Licensee there are No weapons or Firearms on the premises.

Bodies of Water: (Water fountain) There is water fountain in the front yard which was observed to be completely fenced and this area is inaccessible to children. The fencing around it four feet high and has a locked gate. The front yard is accessed through the main door of the home, which is inaccessible to children. Pets: Licensee has one small pet dog which remains in the off limit areas during operating hours.

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

DATE: 07/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2022
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: BENAVIDES, GENNY
FACILITY NUMBER: 304313865
VISIT DATE: 07/22/2022
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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. Licensee Ms. Genny also provides additional formula and diapers if needed for the child

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



The licensee does have a current roster of children in care and the 2 records 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 and the assistant holds a valid Pediatric CPR/First Aid certification is valid through September 2022 and have 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.

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

DATE: 07/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2022
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: BENAVIDES, GENNY
FACILITY NUMBER: 304313865
VISIT DATE: 07/22/2022
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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 1 month and above. Infant items were observed to be appropriate. There is a changing table and infants needs are provided by parents.

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 LA County Fire Department, have granted the fire clearance.

LPA discussed the following items with the Licensee Ms. Benavides, Genny during the Exit interview:

Criminal Record statement: Facility Representative Ms. Benavides, Genny 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.
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2022
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: BENAVIDES, GENNY
FACILITY NUMBER: 304313865
VISIT DATE: 07/22/2022
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Safe Sleep : LPA discussed the safe sleep regulations with Facility Licensee Ms. Benavides, Genny & 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. Benavides, Genny 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.

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

DATE: 07/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2022
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: BENAVIDES, GENNY
FACILITY NUMBER: 304313865
VISIT DATE: 07/22/2022
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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. Children records were reviewed, meets the requirements.

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: 07/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2022
LIC809 (FAS) - (06/04)
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