336300674-3-27-2024-10-CC-JGAR-D3RTDK-20240327143828

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 336300674
Report Date: 03/27/2024
Date Signed: 03/27/2024 02:38:40 PM

Document Has Been Signed on 03/27/2024 02:38 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	CRUZ FAMILY CHILD CARE		FACILITY NUMBER:	336300674
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 5	DATE:	03/27/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:51 PM
MET WITH:	Angela Cruz, Licensee		TIME COMPLETED:	02:50 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) Jesse Gardner arrived at the facility to conduct an annual inspection as part of a compliance review. LPA was also at the facility to conduct an increase in capacity from 8 children to a NEW requested capacity of 14 children. The licensee is currently licensed at 10669 Mohave Ct. Moreno Valley, CA 92557, has applied to increase capacity to a large family childcare home and a fire clearance was granted on 03/13/2024. Present during this inspection were: five children, Licensee Angela Cruz and Assistant Darlene Cruz. The home is two-story with four bedrooms, three bathrooms, with attached garage. LPA toured the facility, inside and out with licensee and the following was observed and/or discussed: · Per licensee, off-limit areas include: Second floor, Kitchen, and garage · Normal hours of operation will be: Monday-Friday, 7:00 am – 5:00 pm · Smoke detectors and Carbon Monoxide detectors were tested by licensee during this inspection and were in working order. · The fire extinguisher met standards established by the State Fire Marshal. · All hazardous items were observed to be inaccessible. Storage of poisons and toxins are inaccessible to children. Sharp items including kitchen knives, are inaccessible and stored in the kitchen. · Firearms are secured with cable locks inside a locked safe containing ammunition upstairs in a bedroom in an off-limit area. The stairs leading to the bedroom containing the firearms are barricaded. Licensee understands all guns, weapons and ammunition must continue to be key locked separately and made inaccessible per Title 22 Regulations.

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024

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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 336300674
	VISIT DATE: 03/27/2024

NARRATIVE

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· The fireplace is properly screened
· Clean, safe and age appropriate toys were observed
· Verification of control of property is on file.

· Licensee’s Mandated Reporter Training expires on 5/1/2025.

· Licensee’s Pediatric CPR and First Aid Card expires on 4/2024.

· Preventive Health and Safety training, including nutrition and lead components have been completed by applicant on 01/26/2023.

· Resident and/or staff records were reviewed and all adults who require caregiver background checks have received all required clearances and/or exemptions. Licensee understands all bodies of water including ponds, above ground pools and spas, in-ground pools and spas, and some fountains must be properly covered or fenced per title 22 regulations. The Department must be notified before and after installation of the bodies of water described. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.

LPA reviewed with licensee, the LIC311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

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 licensed 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.

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024

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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 336300674
	VISIT DATE: 03/27/2024

NARRATIVE

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The following reminders were reviewed with licensee during inspection:

- Title 22 Reporting Requirements and the Regional Office Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov
-Fingerprint transfer forms to associate new individuals or to disassociate someone from the facility at: Associations_Disassociations858@dss.ca.gov
- The Duty Officer is available to answer questions Monday – Friday 8:00am to 5:00pm at:
1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200.

Licensee was informed of the MyChildCarePlan.org website; 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.

The Licensee was informed of their reporting requirements and was provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov

The Licensee can submit transfer forms to associate new individuals or to disassociate someone from the facility at: Associations_Disassociations858@dss.ca.gov

On-line Licensing forms & regulations for a Child Care Center can be obtained on the Department’s website: www.ccld.ca.gov. Additionally, there is a link to “Receive Important Updates” located on the right side of the page, immediately above Quick Links. One can add their email address and choose which program(s) they wish to receive Provider Information Notices (PIN) for.

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024

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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 336300674
	VISIT DATE: 03/27/2024

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The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at: 951-782-4200.

During the exit interview, the Licensee Angela Cruz, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
The increase for a Large Family Child Care Home will be submitted for approval with a maximum capacity of 12, or 14 with parent notification.

During the inspection, referring to the walkway leading to the bathroom that the children utilize, LPA observed loose and uneven flooring that could pose a potential trip hazard if traversed by children. LPA issued a technical violation as a result of the observation. Licensee stated that the flooring would be repaired as soon as possible.

An exit interview was conducted, and a copy of this report along with the LIC9102 (technical violation), and Appeal Rights were provided.

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2024

LIC809 (FAS) - (06/04)

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