304313906-7-10-2024-06-CC-MMAK-D72SR3-20240710140539

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304313906
Report Date: 07/10/2024
Date Signed: 07/10/2024 02:05:46 PM

Document Has Been Signed on 07/10/2024 02:05 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	MIRANOVICH, TATIANA		FACILITY NUMBER:	304313906
ADMINISTRATOR/ DIRECTOR:	MIRANOVICH, TATIANA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(617) 331-8588
CITY:	LADERA RANCH	STATE: CA	ZIP CODE:	92694
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 7	DATE:	07/10/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:30 AM
MET WITH:	Assistants		TIME VISIT/ INSPECTION COMPLETED:	02:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Page 1 of 4 An Annual Random inspection was conducted at the facility by Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek. LPA met with licensees two assistants, Maelynn Fletcher, and Angela Zuniga. The licensee, Tatiana Miranovich was not present during today's inspection. Upon arrival LPA observed 7 children in the living room area of whom one child was under 24 months old. No school age child was present. Licensee was operating within the licensed capacity as specified on license for Large Family Childcare Home. 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. According to facility representative, Maelynn Fletcher, there are two adults and 3 minors living in the house Facility Day care hours of operation is Monday through Thursday from 8:00 am-6:00 pm. During today’s inspection, LPA and facility representative, Maelynn Fletcher toured the inside and outside areas identified in the facility sketch as accessible to childcare children. Off limits areas are made inaccessible by means of baby gates. All areas identified on the facility sketch for childcare were inspected. This is a two story home with four Bedrooms/ three and half bathrooms, living room, kitchen with dining area, laundry room and garage. Covered side patio with side yard and a back yard accessible to children through the dining area. The childcare area consists of living room, family room, dinning area, kitchen, 2 children's bathroom, and back yard. Kitchen is open. However there were no dangerous items in the drawers and cabinets. There is a Continued on page 2

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MIRANOVICH, TATIANA	FACILITY NUMBER: 304313906
	VISIT DATE: 07/10/2024

NARRATIVE

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gate installed in front of the stairs making the upstairs off limit areas inaccessible to children. Children nap on the mats in the designated bedroom. Garage is inaccessible and is locked.

There are working carbon monoxide, smoke detector, and fire extinguishers in the home that meet statutory and State Fire Marshall standards.

Detergents, cleaning compounds, medicines, and other items which could pose a danger to children were not readily available to children they were stored inaccessible to children, none were observed during inspection.

According to facility representative, Maelynn Fletcher who spoke to the licensee over the phone, there is no fire arms in the house. There is a small dog (Shiba Inu Breed ) living in the house away from children. LPA verified there is a working telephone service (cellular service).
Back yard was inspected. There is enough cushioning under and around the falling zone of the structure with slide. (built in turf). Shade is provided. LPA observed inflatable pools which were empty of water on the side yard for water days. No hazardous items were observed. LPA reminded the facility representative, Maelynn Fletcher to make sure they are emptied of water after use.

The licensees doe have a current roster of children in care. Fire Drill was done and logged. The last fire drill done with children was logged as July 2024. Children’s records for children present during LPA’s inspection were reviewed for a copy of the emergency information card that contains all the information specified by regulation (LIC 700) and found to be in compliance. The log for every 15 minutes check on napping children under 24 months old were reviewed on the Smart Phone. LPA gave a sample of the manual log for another option reminded for future enrollment. Pediatric CPR/First Aid certifications is current for one assistant.
(Expires 11/2025).

Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at a family childcare home if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, measles for the two assistants were not within compliance.
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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MIRANOVICH, TATIANA	FACILITY NUMBER: 304313906
	VISIT DATE: 07/10/2024

NARRATIVE

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Beginning March 31, 2018, H&S Code 1596.8662 requires all licensed providers and employees to complete mandated reporting training, and to renew the training every two years. Incidental Medical Services (IMS) policy was discussed. For 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: https://www.ada.gov/resources/child-care-centers/.

The licensee understands they must be present in the facility and must ensure children in care are always supervised. Children are not to be left alone 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, Pediatric CPR/First Aid, and mandated reporter training.

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 clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance before working in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with facility representative, Maelynn Fletcher 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. A sample of every 15 minutes check on infant under 24 months old during nap time was given to facility representative, Maelynn Fletcher.

LPA also informed facility representative, Maelynn Fletcher of the importance of checking for recalled

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024

LIC809 (FAS) - (06/04)

Page: 3 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MIRANOVICH, TATIANA	FACILITY NUMBER: 304313906
	VISIT DATE: 07/10/2024

NARRATIVE

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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.

facility representative, Maelynn Fletcher was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California. 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 platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website athttps://www.cdss.ca.gov/inforesources/community-care- licensing/subscribe and select the Child Care option to receive email communication. (The licensee is already signed up for this purpose).

In the areas that were evaluated, the following deficiency was observed of the California Code of Regulations, Title 22, Division 12 on this inspection. Please see LIC 808D next page.

A notice of site visit was given to facility representative, Maelynn Fletcher and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to post will result in Civil Penalties of $100.00.

Exit interview conducted and report was reviewed with the facility representative, Maelynn Fletcher.

End of report

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/10/2024 02:05 PM - It Cannot Be Edited

Created By: Mahnaz Malek On 07/10/2024 at 01:54 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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MIRANOVICH, TATIANA	FACILITY NUMBER: 304313906
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/10/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. 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 two counts out of 2 staffs' files lacking verification of MMR and Pertussis Vaccines which poses a potential health, safety risk to persons in care. Staff # 1 and staff # 2 did not have immunization on file.
	POC Due Date: 07/17/2024
	Plan of Correction
1 2 3 4	The facility representative agreed to send the verification of immunization for staff # 1 and # 2 to LPA's email address by the due date of 7/17/2024.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Thuy Ho

LICENSING EVALUATOR NAME:

Mahnaz Malek

LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024

LIC809 (FAS) - (06/04)

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