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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400363
Report Date: 04/12/2023
Date Signed: 04/12/2023 01:44:29 PM

Document Has Been Signed on 04/12/2023 01:44 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:QUINTERO FAMILY CHILD CAREFACILITY NUMBER:
198400363
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 4DATE:
04/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Olga Quintero, LicenseeTIME COMPLETED:
02:00 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
Licensing Program Analyst (LPA) Alicia Mooberry conducted a Required Annual Inspection in Spanish on this date. Upon arrival at 10:00am LPA met with Olga Quintero, Licensee, who provided tour of facility. LPA explained the purpose of inspection and provided the inspection Entrance Checklist, LIC 126. Upon arrival, LPA observed that Child #1, Infant of 14 months, was sleeping in a car seat with a blanket covering child which poses an immediate risk to the health and safety of children in care.

LPA inspected rooms/areas on the facility sketch in which child-care services are provided and to which children have access. Per licensee the hours of operation are Monday-Friday 6:00am - 6:00pm. There were four (4) children present, including two (2) infant. Also present was Elmer Quintero, Adult who lives in the home. All adults present have been cleared and associated to the facility license. Individuals residing in the home were discussed and noted. Licensee was reminded that annual fees must be paid timely.

This is facility is a single-story home that consists of 3 bedrooms, 2 restrooms, living room, kitchen, dining area, laundry area and detached garage.

Areas used by children include: Living room (main childcare area), dining room, bathroom (in the hallway), back, front and side yard.


Areas off limits include: All three (3) bedrooms, kitchen, laundry room, small bathroom at rear of home, detached garage and garden area behind garage.

LPA observed off-limits bedrooms to be closed and locked. Licensee does understand that licensing staff may have access to off-limit areas during inspection visit if necessary.

LPA observed the facility license posted in the living room. Licensee was advised to post the required posted documentation in a location visible to parent/guardians of children in care. Including Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form.


Page 1 – Report Continues
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE: DATE: 04/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/12/2023
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
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: QUINTERO FAMILY CHILD CARE
FACILITY NUMBER: 198400363
VISIT DATE: 04/12/2023
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 observed completed, LIC 610- Facility Disaster Plan. Smoke and carbon monoxide detectors were tested and are operable, Fire extinguisher indicated fully charged, No service tag was observed, Licensee was reminded that fire extinguisher needs to be serviced yearly. LPA provided a copy of the LIC 9040- Children Facility Roster, and advised licensee to maintain completed and keep on file for 3 years after children are present in the facility.
The home maintains telephone service via cell phone. The home is observed to be clean and orderly. There are toys and other age appropriate material available for children. LPA observed that cleaning compounds are in kitchen inaccessible to children. The bathroom that children use is located in the observed to be clean and free of hazards.
Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, not only inaccessible to children.
Per Licensee there are no firearms or weapons stored in the home. There is dog in the home that is kept in the off-limit bedroom away from children in care.

Isolation area for sick children waiting to be picked up is in living room, away from the other children.


LPA informed licensee of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months, and provided PIN 20-24-CCP in Spanish. LPA observed a play yard available for Child #1 (14 month old infant), infants sleep in the living room. Staff supervise infant for the duration of the nap and will document 15 minute checks.

As an additional resource.LPA discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep LPA also informed licensee of the importance of checking for recalled 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.

Currently, children are using the back and front yard for outdoor play (Licensee was reminded to always supervise the children when in the front yard since the yard is not completely fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. Facility does not have a pool or similar bodies of water.



Children’s records were reviewed, Child #1 and Child #4 were not available for review, this poses a potential risk to the health and safety of children in care. -------------------Page 2 – Report Continues
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2023
LIC809 (FAS) - (06/04)
Page: 2 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: QUINTERO FAMILY CHILD CARE
FACILITY NUMBER: 198400363
VISIT DATE: 04/12/2023
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
Licensee records were reviewed for approved Pediatric First Aid and CPR certification, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate.

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

Licensee 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/inspection-process.

Based on the LPA's observations and records review the following deficiencies will be cited today in accordance with California Title 22 Regulations.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form (LIC 9224) must be maintained in each child’s file immediately upon receipt from parent.

A notice of site visit was given and must remain posted for 30 days.


Exit interview conducted and report was reviewed with the Licensee, Olga Quintero. Appeal Rights were discussed and provided.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 04/12/2023 01:44 PM - It Cannot Be Edited


Created By: Alicia Mooberry On 04/12/2023 at 12:13 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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: QUINTERO FAMILY CHILD CARE
FACILITY NUMBER: 198400363

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102425(h)
Infant Safe Sleep
Car seats shall only be used for transportation purposes and shall not be used for sleeping.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation the licensee did not comply with the section cited above in 1 out of 2 infants in care was sleeping is a carseat covered with a blanket which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 04/12/2023
Plan of Correction
1
2
3
4
Licensee removed Child #1 from the carseat and placed child in the play yard to sleep. Per licensee, the carseat will returned to the parent at drop off and the Safe sleep regulations (PIN 20-24-CCP) will be given the parents.
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:Valarie Cook
LICENSING EVALUATOR NAME:Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:
DATE: 04/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/12/2023


LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 04/12/2023 01:44 PM - It Cannot Be Edited


Created By: Alicia Mooberry On 04/12/2023 at 12:13 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
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: QUINTERO FAMILY CHILD CARE
FACILITY NUMBER: 198400363

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/12/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102418(a)
Immunizations
(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.

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 2 out of 4 children present did not have the facility file including immunizations which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/21/2023
Plan of Correction
1
2
3
4
Per licensee, the facility records for Child #1 and Child #4 willbe completed by POC due date, proof of correction will be sent to LPA via email.
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

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 due to facility chidlren's roster was not availabel for feview which posesd a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/21/2023
Plan of Correction
1
2
3
4
Per licensee, the facility records for Child #1 and Child #4 willbe completed by POC due date, proof of correction will be sent to LPA via email.
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:Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:
DATE: 04/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/12/2023


LIC809 (FAS) - (06/04)
Page: 5 of 5