Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015102
Report Date: 07/06/2016
Date Signed 07/06/2016 04:57:11 PM

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:NAVARRETE FAMILY CHILD CAREFACILITY NUMBER:
198015102
ADMINISTRATOR:NAVARRETE, ANA MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 908-4950
CITY:WHITTIERSTATE: CAZIP CODE:
90601
CAPACITY:14CENSUS: 8DATE:
07/06/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Ana Maria Navarrette, Licensee and Frank Navarrette, AssistantTIME COMPLETED:
05:25 PM
NARRATIVE
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Licensing Program Analyst (LPA) Ann Dumolt met with Ms. Navarrette and her adult son for the purpose of a Health and Safety Inspection. Home is a 4 bedroom, 2 bathroom, single level house. Most of the house is used for child care. There are two steps leading down into the main child care area. Licensee and her son observed to supervise use of steps, e.g., reminding children to walk not run and when using the restroom, only one child at a time may use the steps in order to prevent horse play. Front bedroom is used as napping area. Children have access to the kitchen. Knives are stored in a cupboard out of reach of children. Medications are stored in a pantry out of reach of children and with a latch on the door out of reach of children.

Restroom used by children is free of medications, toiletries, and sharp items. Licensee's bedroom and son's bedroom are off - limits to children and are made inaccessible to children (locked or have a pressure grip on doorknob). Per Licensee, there are no firearms stored in the home or garage. There is a carbon monoxide detector in the kitchen (combination plug in with battery back up).

Garage is detached from home. It is kept closed and there is a gated cinder block wall (about 40 inches high) to keep children from going into the driveway. Side door to garage is locked. Paints, aerosol cans, detergents, and other items not in use are stored in the garage. Patio is covered and is enclosed with a cinder block wall. A gate leads into the back yard. Back yard is spacious with a cement deck that is shaded with tarps supported by poles. There are fruit trees and a various vegetable gardens (tomatoes and zucchini). Fruit trees are barricaded to keep children from picking the fruit. There is a large shade tree in the yard with a shrine to the Virgin Mary. There is a small back house (indicated as "storage shed" on facility sketch") with a rest room directly accessible from the yard for children to use when outside playing. Per Licensee house is used for storage at this time. Door is locked to keep children out. Yard overall is fenced and gated. There are no bodies of water or pets.
SUPERVISOR'S NAME: Joan HayesTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: EAnn DumoltTELEPHONE: (323) 388-6283
LICENSING EVALUATOR SIGNATURE:

DATE: 07/06/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2016
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 4


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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: NAVARRETE FAMILY CHILD CARE
FACILITY NUMBER: 198015102
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/06/2016
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/05/2016
Section Cited
102418(a)
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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.
Child #5 is missing a copy of immunization record.
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Licensee states she will obtain a copy of the immunization. Send copy of the immunization record or a doctore's as proof of correction (keep the other copy on child's file).
Type B
08/05/2016
Section Cited
102417(g)(8)
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Operation of a Family Child Care Home. All homes shall have a current roster of the children.
Licensee needs to update Child Care Roster.
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Licensee states she will updated Child Care Roster to reflect all children currently in care.
Copy of Child Care Roster to be sent as proof of correction.
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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: Joan HayesTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: EAnn DumoltTELEPHONE: (323) 388-6283
LICENSING EVALUATOR SIGNATURE:

DATE: 07/06/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2016
LIC809 (FAS) - (06/04)
Page: 4 of 4


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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: NAVARRETE FAMILY CHILD CARE
FACILITY NUMBER: 198015102
VISIT DATE: 07/06/2016
NARRATIVE
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Files on children reviewed as Licensee stated that her Child Care Roster is not up to date. It was noted that two children in care are developmentally disabled. Both are still in high school and are over 18 years old. They are signed in and out by their parents. They generally come in the afternoons especially when school is in session and after attending a sheltered workshop. Licensee stated that she made inquiries with the Resource and Referral Agency and apparently to our Regional Child Care Office as the children were approaching their 18th birthdays but no one could offer an answer about what to do. LPA Dumolt will inquire with supervisor. It is possible that an exception could be requested as is done in Child Care Centers who serve the disabled.

Children's files reviewed and except for one child were found to be complete (the one child is missing a copy of immunization record). LPA Dumolt informed Licensee that a physical is not necessary for children in care. Also that children in elementary school do not need a copy of the immunization record on file. Licensee and her regular assistant (Gabriella Aldana--not here today) have current pediatric CPR and First Aid through the American Heart Association (expires 2/2018). Fire extinguisher (2A10BC) is serviced annually (last serviced 2/2016). Smoke detector is located in child care room and is operable. Licensee has documentation of fire and earthquake drills. On this visit there is one infant, 5 preschoolers, and two school aged adult children in care. Capacity is within licensed capacity of 14.

The following are deficiencies according to the CA Code of Regulations, Title 22, Division 12, Chapter 3 (see next page).

Exit interview conducted with Ms. Navarrette. Copy of report and appeal rights given.

Notice of Site Visit given.
SUPERVISOR'S NAME: Joan HayesTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: EAnn DumoltTELEPHONE: (323) 388-6283
LICENSING EVALUATOR SIGNATURE:

DATE: 07/06/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2016
LIC809 (FAS) - (06/04)
Page: 2 of 4


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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: NAVARRETE FAMILY CHILD CARE
FACILITY NUMBER: 198015102
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/06/2016
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/20/2016
Section Cited
102(d)(1)
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Criminal Record Clearance. All individuals subject to a criminal record review as specified in Section 1596.871 prior to working, residing or volunteering in a licensed home, shall obtain a California clearance or a criminal record exemption as required by the Department.
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Licensee will mail in a request for exception (which includes submitting a copy of the IEP for each child, to allow Child #7 and Child #8 to remain in care until they graduate from high school. This may waive the need for a criminal record clearance. But if the exception
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Licensee is caring for two children (Child #7 and #8) who are developmentally disabled. Due to being18 or older, they are considered adults however they are still in high school and do have IEP's. An exception could be granted allowing Child #7 and #8 to remain in care until they graduate from high school.
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request is denied, Child #7 and Child #8 will need to submit fingerprints for the criminal background clearance.
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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: Joan HayesTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: EAnn DumoltTELEPHONE: (323) 388-6283
LICENSING EVALUATOR SIGNATURE:

DATE: 07/06/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2016
LIC809 (FAS) - (06/04)
Page: 3 of 4