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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017720
Report Date: 03/17/2023
Date Signed: 03/17/2023 01:01:04 PM

Document Has Been Signed on 03/17/2023 01:01 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:OROZCO FAMILY CHILD CAREFACILITY NUMBER:
198017720
ADMINISTRATOR:OROZCO, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 774-5157
CITY:DOWNEYSTATE: CAZIP CODE:
90240
CAPACITY: 14TOTAL ENROLLED CHILDREN: 3CENSUS: DATE:
03/17/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Licensee - Maria OrozcoTIME COMPLETED:
01:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) R. Derraco conducted a case management visit to the above mentioned address on 03/17/23. LPA began case management visit at 11:30 PM with licensee, Maria Orozco. The purpose of this visit is to issue a citation regarding LPA's observations during a complaint inspection. LPA observed 1 assistant and 1 child in care. The home was observed to be clean and in good repair.

LPA observed S2 placing C1 into a Pack n Play Playpen, swaddled in two blankets. LPA advised licensee that infants are not allowed to be swaddled or sleep with any objects such as blankets in the playpen or crib.. Licensee states she forgot what was included in the safe sleep regulations. LPA provided PIN 20-24-CCP - Recently Approved Safe Sleep Regulations in Effect to licensee. LPA also advised licensee to sign up for PIN notifications through the Department of Social Services Child Care Licensing website at www.cdss.ca.gov . LPA advised licensee that a citation under California Code of Regulations (CCR) section 102425(f) will be issued. LPA observed licensee taking C1 out of swaddle and placing C1 into the Play Pen to sleep.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted, appeal rights provided and report was reviewed with the licensee Maria Orozco

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2023
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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Document Has Been Signed on 03/17/2023 01:01 PM - It Cannot Be Edited


Created By: Randy Derraco On 03/17/2023 at 12:11 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: OROZCO FAMILY CHILD CARE
FACILITY NUMBER: 198017720

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/27/2023
Section Cited
CCR
102425(f)

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102425 Infant Safe Sleep (f) an infant shall not be swaddled while in care. This requirement is not met as evidenced by:
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Licensee states she will review PIN 20-24-CCP and review resources for infant safe sleep on the Departement website and provide LPA a summary of material reviewed.
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Based on observation, interview and record review, the licensee swaddled the infant which poses a potential Health, safety and/or personal rights risk to persons in care.
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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:Karen Chambers
LICENSING EVALUATOR NAME:Randy Derraco
LICENSING EVALUATOR SIGNATURE:
DATE: 03/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/17/2023


LIC809 (FAS) - (06/04)
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