Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016385
Report Date: 08/08/2018
Date Signed 08/08/2018 11:36:31 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:ROBLES FAMILY CHILD CAREFACILITY NUMBER:
198016385
ADMINISTRATOR:ROBLES, SHANIAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 589-8271
CITY:LOS ANGELES,STATE: CAZIP CODE:
90001
CAPACITY:14CENSUS: 14DATE:
08/08/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:24 AM
MET WITH:Shaniah RoblesTIME COMPLETED:
11:55 AM
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ANNUAL INSPECTION COMPLETED IN SPANISH
Helen Estrella, Licensing Program Analyst (LPA) conducted an unannounced annual random inspection to ensure the health & safety standards as required by regulations governing family child care homes are being met. Upon arrival, LPA met with licensee Shaniah Robles. LPA informed licensee of nature of the visit and was guided on a tour (inside and outside) of the home. Per the licensee, the individuals residing in the premises are licensee, spouse, adult son, and mother. LPA confirmed with licensee that all adults residing/working in the home have criminal record/TB clearances.

The facility is a 3-bed, 1-bath home with side yard and backyard. The home is located in a duplex home and the licensee home is in the rear. The following areas accessible for care are: family room, bathroom, front bedroom used for napping, rear right bedroom used for activities and fenced-in side yard for outdoor play. The off limits areas include: rear left bedroom that is maintained locked, kitchen with secured child's safety gate and backyard that also has a gate and is where vehicles are parked.

There was 14 children in care at the time of inspection with licensee, her spouse and her mother, however, 3 children were picked up by her mother during the observation. At 11:16AM, children's records and observed that licensee is operating within capacity limits. Licensee states currently does not have any children in care at this time that require Incidental Medical Services (IMS). There are NO bodies of water in the premises.

SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3073
LICENSING EVALUATOR NAME: Helen EstrellaTELEPHONE: (424) 301-3073
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2018
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ROBLES FAMILY CHILD CARE
FACILITY NUMBER: 198016385
VISIT DATE: 08/08/2018
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At 10:31AM, LPA observed a working smoke and carbon monoxide detector, required 2A10BC fire extinguisher, changing table located in the bathroom, napping equipment, firsst aid kit. LPA observed current CPR/Pediatric certification for licensee, spouse and mother valid through 01/20/20 and last fire disaster drill log completed 07/10/18. Sharp objects, toxins, and hazardous materials are inaccessible to children in the kitchen and bathroom. Licensee states there are no weapons/firearms in the home and none observed by the LPA. Telephone service, heating, lighting and ventilation were evaluated and in good condition.

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

The following was discussed with the licensee:


Licensee informed fire drill to be completed every month and to keep a log and to ensure records for staff and children as well as a roster are kept for 3 years. Licensee informed all adults living and residing in the home must be fingerprinted and cleared prior to entering the facility and $100.00 civil penalty may be assessed for failure to comply to have adults fingerprinted and cleared prior to entering facility. Licensee informed no smoking in the premises during child care hours of operation and was made aware that state law prohibits baby walkers, bouncy seats, exer-saucers and any other items that fall into that category.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3073
LICENSING EVALUATOR NAME: Helen EstrellaTELEPHONE: (424) 301-3073
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2018
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: ROBLES FAMILY CHILD CARE
FACILITY NUMBER: 198016385
VISIT DATE: 08/08/2018
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Licensee was reminded that all infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome), and that the Provider is required to wash hands after every diaper change and to never shake a baby to prevent the Shaken Baby Syndrome. Licensee was also reminded that only children eating may be in high chairs and that car seats are utilized only for transportation.

Mandated Reporter: Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Website: :http://www.mandatedreporterca.com/.

Applicant was made aware of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541. Email Address: childcareadvocatesprogram@dss.ca.gov

The licensee was advised that, once licensed, the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, (Type A violation), a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. The applicant was made aware that a licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment.

The facility was in substantial compliance at the time of inspection. An exit interview was conducted and copy of this report was given to licensee Shaniah Robles.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3073
LICENSING EVALUATOR NAME: Helen EstrellaTELEPHONE: (424) 301-3073
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2018
LIC809 (FAS) - (06/04)
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