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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153907149
Report Date: 05/04/2023
Date Signed: 05/05/2023 08:18:50 AM

Document Has Been Signed on 05/05/2023 08:18 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:PAZ, MARIA FAMILY CHILD CAREFACILITY NUMBER:
153907149
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
05/04/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:57 AM
MET WITH:Maria PazTIME COMPLETED:
01:45 PM
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On 05/04/2023, Licensing Program Analyst (LPA) Beneroso conducted an unannounced Required 1-Year inspection at the Paz Family Child Care Home. Upon arrival, the LPA met with the Licensee, Maria Paz, who guided the LPA on a tour of the facility. Family members residing in the home include 4 adults (licensee, spouse, and two adult daughters). All adults living in the house have been background cleared.
Per the Licensee, the hours of operation are Monday through Friday, 5:30 AM to 5:30 PM. Per licensee, no overnight care is provided. Upon arrival, LPA observed 4 children in care and two adults providing care and supervision. Licensee is within the ratio for a small facility. Incidental Medical Services (IMS) were discussed.

Physical Plant:
This is a one-story, 3-bedroom, 2-bathroom home with a kitchen, living room, dining area, laundry room, and garage. The garage is off-limits. The home was inspected for safety, comfort, cleanliness, telephone service, central air, and heat and ventilation. The house has central heating and air conditioning. All windows are free of cracks, bugs, and debris.

Main Care Area: Main care is provided in the living groom. Children use the bathroom located down the hall to the right of the kitchen. Children do not have access to the kitchen and backyard. LPA observed age-appropriate toys and furniture for the children. There are age-appropriate games and books on the premises of this facility. Per licensee, there is a designated area for ill/sick children in
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE: DATE: 05/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/04/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PAZ, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 153907149
VISIT DATE: 05/04/2023
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Children's bathroom: Children use the bathroom located down the hall to the left of the kitchen. The bathroom was clean, sanitized, and in good repair. The bathroom was toured and inspected sink and toilet which is in operable condition. Toilet and faucets are clean, safe, and operable.

Kitchen/Dining Room: The kitchen has all its cabinets locked with a child safety latch. Sharp knives are inaccessible locked in an upper cabinet.

Backyard/Outdoor areas: Outdoor: The backyard is completely fenced (with chain linked fence). Per licensee, the backyard is currently off limits due to water damage from weather. Per licensee and LPA’s observations, there are no pools or bodies of water in the premises. There is a storage shed that remains locked and inaccessible to children.

Off-limits: Off-limit areas include the master bedroom and rooms #2 and 3 and bathroom made inaccessible by a safety doorknob cover. The backyard access to the backyard is currently made inaccessible with a safety doorknob cover.



Others:
Per licensee and LPA’s observations, there are no bodies of water. Electrical outlets are covered and made inaccessible to children. There are two pets in the facility.

Fire/Health/Safety: There is a cell phone kept charged and on the Licensee at all times.
Smoke Detectors and Carbon Monoxide were observed to be in operable conditions.
The First Aid kit is located in the daycare and was observed complete with supplies including thermometer, tweezers, scissors, gauze, bandages, cleansing pad/solution, and a first aid manual. Transportation is not currently offered.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PAZ, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 153907149
VISIT DATE: 05/04/2023
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LPA observed a required fire extinguisher (3A40BC) reading in Green and currently serviced. Per LPA’s observations, there were no hanging window blind cords.
Medications/ Hazardous Materials: Medications are located in an off-limit bedroom, made inaccessible by safety doorknob covers. Per licensee, there are No Firearms at the facility at this time. The facility currently does not have childcare insurance.

Incidental Medical Services (IMS): 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 Licensee will not be providing IMS to the children at this time.

Records: Children’s and infant’s records were observed to be complete and current.
Licensee’s CPR/First Aid is maintained current. It expires on 05/01/24. Mandated reporter is also maintained current, it expires on 04/15/2. Per Licensing Information System, facility annual fees were current. Per Licensee, fire and disaster drills are conducted every 6 months; the last drill was documented and conducted on 01/16/2023. Per LPA’s observations, the Facility License, Emergency Disaster plan, Earthquake Preparedness and Parents Rights Poster were posted.
Documents Provided and or Discussed: Fire Drill Log, Roster, Postings, Safe Sleep PIN 20-24-CCP and LIC 9227 (Individual Sleeping Plan). The Licensee was reminded that supervision is always required for children in care.

Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: PAZ, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 153907149
VISIT DATE: 05/04/2023
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Licensee Paz 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.

LPA discussed the safe sleep regulations with licensee Paz 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 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.

Inspection was conducted in Spanish, LPA is certified as bilingual by the department.

No deficiencies have been cited at this time.

A notice of site visit was given to licensee 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 and report was reviewed with the licensee Paz, along with her appeal rights and Notice of Site Visit.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023
LIC809 (FAS) - (06/04)
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