334817967-10-11-2023-09-CC-SLOZ-CWHV44-20231011160543

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334817967
Report Date: 10/11/2023
Date Signed: 10/11/2023 04:05:59 PM

Document Has Been Signed on 10/11/2023 04:05 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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	LOPEZ FAMILY CHILD CARE		FACILITY NUMBER:	334817967
ADMINISTRATOR:	LOPEZ, SOPHIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 880-5011
CITY:	CATHEDRAL CITY	STATE: CA	ZIP CODE:	92234
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 8	CENSUS: 3	DATE:	10/11/2023
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	03:25 PM
MET WITH:	Licensee Sophia Lopez		TIME COMPLETED:	04:15 PM

NARRATIVE

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Licensing Program Analyst (LPA) Samuel Lopez arrived at the facility to conduct a case management visit in response to the receipt of an unusual incident report (UIR). The UIR was received by the licensing agency on 10/3/2023. The UIR documented an incident involving a child having a blow out in their diaper and somehow, 3 days later, the parent/legal guardian claiming that the blowout may have caused bruising.

Upon arrival this date on 10/11/2023, LPA Lopez met with the Licensee Sophia Lopez and stated the purpose of the visit. LPA reviewed records, video footage, and conducted interview(s).

On 9/29/2023, a child was picked up from the facility by their parent/legal guardian. The licensee explained that the child had a blow out on their diaper and beyond, which reached the child's back. The child also had a bit of redness or possible rash in the diaper area. The parent/legal guardian left the facility without any further incident. On 10/2/2023, the child was not dropped off for care and, so the licensee inquired with the parent/legal guardian, as to the reason for the child not attending. At the end of the day, the licensee was informed that the child had develop bruises as a result of the blow out from 9/29/2023. There was no additional communication between the licensee and the child's parent/legal guardian from the moment the child was picked up on 9/29/2023, until late in the day on 10/2/2023. Video footage obtained and reviewed showed the child being picked up on 9/29/2023, the licensee explaining the incident to the parent/legal guardian, at the front door. The parent/legal guardian checked the child, did not make claim of any bruising, nor could bruises be seen in the video.

Based on the information gathered, facility complied with reporting requirements, and other regulation requirements. No violations of Title 22 were identified.

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. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Sophia Lopez.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2023

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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