304313939-10-6-2021-06-CC-KDEI-C7JTUB-20211006150204

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304313939
Report Date: 10/06/2021
Date Signed: 10/06/2021 03:02:17 PM

Document Has Been Signed on 10/06/2021 03:02 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:	VANEGAS, KENIA		FACILITY NUMBER:	304313939
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	10/06/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Licensee Ms. Vanegas, Kenia & Mr. Roberto Jose		TIME COMPLETED:	03:15 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	Licensing Program Analyst (LPA) Ketki Desai conducted an announced in-person Pre-Licensing inspection (Relocation) for a new Small Family Child Care home. LPA met with Licensee Ms. Vanegas,Kenia and Mr. Roberto Jose , who guided analyst on a tour of the new home. The home is a single story with no stairway or fireplace. Adults residing in the home, including the Licensee, are two more adults in the home. The licensee is requesting a Small family childcare home license. Operation hours will be Monday to Friday, 6.00 AM to 6.00 PM, care and supervision shall be provided to children ages Infant to School age. (3 months to 12 years of age). At the time of inspection today, there were no children present. All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a single story home, that consists of 5 bedrooms, 2 restrooms, living room, kitchen, front porch, two side yards and the back yard. A review of the Facility Personnel Report Summary indicates all the three adults residing in the home are cleared, who require caregiver background check clearances exemptions. Licensee stated is not registered with any Foster Care agency or holds a foster parent license. Licensee was reminded if changes to notify the licensing office. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service (cell phone), ventilation and heating. The home has a central Air and Heating system, and A/C unit is installed in the side yard with a safe barrier covering. There is a child safety gate installed making the bedrooms of the home inaccessible to children. Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible in areas designated for children. The licensee states (that there are no poisons on the premises). Licensee was advised that any poisons must be locked with a key or combination lock. (1)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021

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: VANEGAS, KENIA	FACILITY NUMBER: 304313939
	VISIT DATE: 10/06/2021

NARRATIVE

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Based on the Facility Sketch submitted, areas off limits to children and parents are: Four bedrooms, one bathroom, kitchen area, one right side yard are inaccessible. The off limits areas are made inaccessible by installation of child safety gate at the end of the kitchen making the other side of the home inaccessible. Kitchen is open and safety latches are installed on the cabinet where cleaning supplies are stored. Living area is open, it shall be used as a walkway to access the bathroom only. Licensee has installed safety knobs on the bedroom doors making them inaccessible. Licensee understands that licensing staff may have access to off-limit areas during inspection visit if necessary.

Areas Designated for Day care activities: Children shall enter the home through the main door of the home, entering into the designated childcare area. (One bedroom is converted into the Day care room) The day care area is spacious with toys and educational items for the children. Living area shall be used for additional activities, especially if the Licensee has an infant care. The designated bathroom is on the right hand side of the hallway, children shall walk through the living area to gain access to the designated bathroom. It was observed to be safe and free of hazardous items. There is a cabinet under the sink, has paper products, no hazardous items were observed, and bathroom was clean.

Children shall use cots during napping time, all linens and blankets shall be provided by the parents and additional linens are available if needed. Licensee also shall provide infant care age 3 months and up, Licensee has changing table with pad, crib and small cubbies for infant storage. All infant needs shall be provided by the parents.

Licensee shall provide transportation services to the enrolled school age children. Adult member of the home who is live scanned and cleared shall transport the children, while Licensee shall supervise the other children at home.

OUTDOOR PLAY AREA: Per Licensee, children shall use the front porch area and the back yard. Front porch area has a fenced rolling gate including a shaded area, with concrete flooring and small grass area, outdoor toys are arranged here and it was safe for outdoor activities. The rolling fenced gate shall be locked during operating hours. Licensee understands Adult supervision is needed during outdoor play. Licensee also use the open back yard for additional activities, it has direct access from the room , this area is fenced, there is a shaded area where children can engage in outdoor play and it has concrete and glass flooring. Licensee has age appropriate outdoor toys. (Page-2)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021

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: VANEGAS, KENIA	FACILITY NUMBER: 304313939
	VISIT DATE: 10/06/2021

NARRATIVE

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Licensee is enrolled in the food program and shall continue to provide AM/PM Snacks with Lunch to the enrolled children, if food is brought from home, it shall be labelled and stored accordingly.

Licensee have completed the required Health and Safety with Nutrition and Lead Poisoning component Training and Pediatric First Aid and CPR which expires on 6/2022 and have provided the new enrollment receipts. There are first aid supplies available.

There are no pets / Bodies of water or weapons in the home.

The following was discussed with the applicant:
Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Civil Penalties will be assessed if not in compliance.

·In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR certification and a valid criminal record clearance associated to the facility license.
·Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License may be terminated.

·The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.

Licensee was also made aware of the Child Advocacy program so she could receive the updated Quarterly reports and other information in a timely manner. ChildCareAdvocatesProgram@dss.ca.gov

Reporting Requirements: Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.

Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.
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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021

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: VANEGAS, KENIA	FACILITY NUMBER: 304313939
	VISIT DATE: 10/06/2021

NARRATIVE

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Fire and safety drills must be performed every six months and documented for review by the Department.
Children and Staff records must be maintained and updated as needed and must be available for review by the Department.

No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility.

All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.

Licensees shall reveal each facility license number in all advertisements, publications or announcements with the intent to attract clients.

Infant Care: Applicant states that she will care for infants. LPA advised the Licensee to sleep infants where they can always be directly supervised and advised against sleeping infants in a separate room. The Licensee states the following as a supervision plan for infants: The infants will sleep where she will be providing supervision and they shall not be left unattended. LPA provided a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. Online copy can be downloaded at: https://www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials
LPA reviewed with applicant 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 (Page-4)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: VANEGAS, KENIA	FACILITY NUMBER: 304313939
	VISIT DATE: 10/06/2021

NARRATIVE

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Incidental Medical Services (IMS):
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.

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

LPA advised the Licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.
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OTHER INFORMATION AND FORMS PROVIDED: (Posters were emailed to the Licensee)
 Handouts provided for Never Shake a Baby, Sudden Infant Death Syndrome (SIDS) and Safe Sleeping practices. Capacity Handout for a Small Family Child Care Home and Large Family Child Care Home was provided.

Per applicant, there are no dual licenses at this address. Applicant’s email address was obtained during this inspection. The applicant was advised that email may be public information.

Once licensed, the applicant is required to adhere to the terms and limitations stated on the license. A copy of this report and all other Licensing reports must be made available to the public for 3 years.

On today’s inspection the new relocation site was observed to have a safe, healthful and comfortable accommodation furnishing and equipment’s for the new enrollees. The facility was in compliance for a (Small Family Child Care Home) with Title 22 Regulations at the time of inspection. A license will be issued after final review, in the event additional requirements are needed, the applicant will be notified

Appeal rights were presented and Exit interview was conducted with the Licensee Ms. Vanegas Kenia

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021

LIC809 (FAS) - (06/04)

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