<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192004400
Report Date: 09/22/2021
Date Signed: 09/22/2021 12:43:21 PM

Document Has Been Signed on 09/22/2021 12:43 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:QUIROS FAMILY CHILD CAREFACILITY NUMBER:
192004400
ADMINISTRATOR:QUIROS, PATRICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 219-6887
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
09/22/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Ronald Quiros, Assistant &
Patricia Quiros, Licensee		TIME COMPLETED:
01:00 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
On Wednesday, September 22, 2021 at 10:30 AM, Licensing Program Analyst (LPA) Lucero conducted an unannounced Required One Year Inspection. LPA met with Assistant Ronald Quiros who guided LPA on a tour of the facility. A discussion was held with Assistant and Licensee where it was stated that the facility will be closing by the end of the month.

There were no children present at the time of inspection. Family members residing in the home has been discussed with licensee and are cleared. Present at time of inspection was licensee's brother Ronald Escalante and sister Ana Escalante. Assistant and both family members stated that they are visiting from out of the country and will be flying back at the end of this week. Both Ronald and Ana provided their passports and stated that they do not help with the caring of day care children. No children are present to interview to corroborate.

This facility is a one story home that consists of two bedrooms, two bathrooms, kitchen, living room, dining area, family room, attached garage, front and backyard. Per Assistant, areas accessible to children are the den, dining area, living room, and one bathroom located next to den. Per Assistant, areas off-limits to children are two bedroom, one bathroom, attached garage, and front yard, back yard, and detached apartment.

At approximately 10:45 AM LPA began the facility to inspect for safety, comfort, cleanliness, ventilation and working phone (land line). LPA observed a fireplace in the family room with a screen. LPA observed the furniture and children materials to be in good condition and age appropriate. LPA observed not observe the Children Roster, LIC 610A Emergency Disaster Plan, PUB 394 Parent’s Rights, emergency drills posted on the Parent Board as those documents were not posted.

At approximately 11;10 AM, LPA entered the restroom and observed the toilet, hand washing sink, running water, towel, and hand soap. LPA observed the restroom to be in good condition.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Armando J Lucero
LICENSING EVALUATOR SIGNATURE: DATE: 09/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/22/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 5
Document Has Been Signed on 09/22/2021 12:43 PM - It Cannot Be Edited


Created By: Armando J Lucero On 09/22/2021 at 11:45 AM
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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: QUIROS FAMILY CHILD CARE
FACILITY NUMBER: 192004400

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/22/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102391(d)
Inspection Authority of the Department
(d) The licensee shall permit the Department to inspect, audit, and copy children's records or other family child care home records upon demand during normal business hours. Records may be removed if necessary for copying.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview with licensee and assistant, it was stated that they did not have files at the facility. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/21/2021
Plan of Correction
1
2
3
4
Assistant stated that they will submit the files to LPA via mail; or the facility will close by the end of the month.
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview with licensee and assistant, it was stated that they did not have valid CPR/First Aid cards. None was provided at the time of records review. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/21/2021
Plan of Correction
1
2
3
4
Assistant stated that they will take the required CPR/First Aid courses and submit to LPA via mail; or the facility will close by the end of the month.
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:Valarie Cook
LICENSING EVALUATOR NAME:Armando J Lucero
LICENSING EVALUATOR SIGNATURE:
DATE: 09/22/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/22/2021


LIC809 (FAS) - (06/04)
Page: 2 of 5
Document Has Been Signed on 09/22/2021 12:43 PM - It Cannot Be Edited


Created By: Armando J Lucero On 09/22/2021 at 11:45 AM
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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: QUIROS FAMILY CHILD CARE
FACILITY NUMBER: 192004400

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/22/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.1(a)
Personnel Records
(a) Personnel records shall be maintained on each employee and shall contain the following information:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview with licensee and assistant, it was stated that they did not have files at the facility. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/21/2021
Plan of Correction
1
2
3
4
Assistant stated that they will submit the files to LPA via mail; or the facility will close by the end of the month.
Type B
Section Cited
CCR
102416.1(d)
Personnel Records
(d) All personnel records shall be maintained at the child care home and shall be available to the licensing agency for review.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview with licensee and assistant, it was stated that they did not have files at the facility. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/21/2021
Plan of Correction
1
2
3
4
Assistant stated that they will submit the files to LPA via mail; or the facility will close by the end of the month.
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:Valarie Cook
LICENSING EVALUATOR NAME:Armando J Lucero
LICENSING EVALUATOR SIGNATURE:
DATE: 09/22/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/22/2021


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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: QUIROS FAMILY CHILD CARE
FACILITY NUMBER: 192004400
VISIT DATE: 09/22/2021
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
26
27
28
29
30
31
32
LPA asked if there are any pets, poisons, firearms, weapons or bodies of water. Assistant stated that they have two, and no body of waters, firearms, weapons or poisons. LPA did not observe bodies of water on the premises. Assistant was advised that if any poisons (ex: Drano, rat poison or items with skull hazard symbol), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately.

LPA observed the smoke detector and carbon monoxide detector in the hallway of the second floor. Assistant tested both detectors until a beeping sound emanated from both devices. The smoke and carbon detectors appear to be in good condition. At approximately 11:20 AM, assistant stated that the children do not play outside. LPA observed from the windows that the the outdoor area appeared to be maintained.

At approximately 11:30 AM, LPA attempted to conduct records review. Licensee and Assistant stated during a conversation held that they do not have files for themselves or the children in care as their daughter took them with her to review. Assistant and Licensee could not provide Pediatric First Aid/ CPR card. Discussion was held with Licensee regarding the importance of maintaining current Pediatric CPR/First Aid certification. LPA determined that Licensee has not completed the Mandated Reporter Training (AB 1207). Licensee was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com and is also available in Spanish. Children's files were not reviewed as they facility does not have physical files present at the facility as licensee's daughter took them to review.

LPA discussed the safe sleep regulations with Assistant 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. LPA also informed Assistant Ronald Quiros of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at also explained to licensee that car seat, stroller are only and only for https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Armando J Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: QUIROS FAMILY CHILD CARE
FACILITY NUMBER: 192004400
VISIT DATE: 09/22/2021
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
26
27
28
29
30
31
32
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

Assistant Ronald Quiros 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to [email protected]. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

A notice of site visit was given and must remain posted for 30 days. See deficiencies page for deficiencies cited. Exit interview conducted and report was reviewed with the Assistant Ronald Quiros.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Armando J Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2021
LIC809 (FAS) - (06/04)
Page: 5 of 5