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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153907149
Report Date: 09/13/2023
Date Signed: 09/13/2023 03:26:53 PM

Document Has Been Signed on 09/13/2023 03:26 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
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: 5DATE:
09/13/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Maria PazTIME COMPLETED:
12:50 PM
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On 09/13/2023 Licensing Program Analysts (LPA) Beneroso conducted an announced Case management - Licensee Initiated inspection as Licensee is requesting to increase her capacity from 8 children to 14 children. The LPA disclosed the purpose of the inspection and was granted entry by Licensee who guided the LPA on a tour of the facility. Upon entry to the facility the LPA observed five children in care.

Licensee was initially licensed on 09/01/2010 as a Small Family Child Care Home. The Fire Department has inspected the home and granted a fire clearance for 14 children effective 08/04/2023. Family Child Care Home operates Monday through Friday 4:30am to 6pm. The facility provides breakfast, morning snack, lunch, afternoon snack and dinner as needed.

This is a one-story, 3-bedroom, 2-bathroom home with a kitchen, living room, dining area, laundry room, and garage. Currently, the children do not have access to the backyard due to weather. The outdoor areas are completely fenced in with chain linked fence. No bodies of water were observed. There is a garage in the premises that remains locked and with a safety door knob.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE: DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/13/2023
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: 09/13/2023
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The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation were inspected, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. There are age-appropriate toys and equipment on the premises. LPA observed mats and cots provided for nap time. Children nap in the day care area.

The First Aid kit was observed to be complete, including a thermometer. The required fire extinguisher (2A10BC) reading in green, smoke and carbon monoxide detectors were found to be in operable condition. Fire and disaster drills are conducted every six-month last drill was conducted in September 13, 2023. The facility’s annual fees are current. The parent board was reviewed and had all the required forms posted and accessible to parents. Licensee’s Mandated Reporter certification is current, it expires on 04/15/2024 and CPR/First Aid is current expires 05/01/2024.

Incidental Medical Services (IMS) policy was discussed

The following were discussed: No smoking, infant walkers, Johnny jumpers, exersaucers and any other item that falls into that category are permitted in the facility.


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

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
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: 09/13/2023
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Licensee was reminded with a capacity increase she must have a qualified assistant present whenever she has more than 8 children in care. Licensee was provided with a capacity and ratio handout pertaining to large Family Child Care Homes and the various age groups that can be under care at one given time.

The licensee was informed that all adults living in or having access to the home are required to have fingerprint clearances with Department of Justice, FBI and Child Abuse Index prior to having contact with children. If the aforementioned is not adhered to, a Civil Penalty of up to $500, per non-cleared adult will be assessed immediately.


The Licensee was reminded to report Unusual Incidents. A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. The applicant was informed to utilize the Unusual Incident Report/Injury Report form LIC624B when submitting the report to the department.

Safe Sleep regulations (under 24 months) were discussed with Licensee and referred to the CCL web site for additional information and PINS. Provided licensee with an infant sleep plan form LIC 9227.

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

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
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: 09/13/2023
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Beginning on January 1, 2018, Assembly Bill 1207 (2015) 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. Applicants must meet requirements as a precondition to licensure. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com

Facility meets the requirements for a capacity 14 license effective 09/13/2023. No citations were issued during this inspection.

Inspection was conducted in Spanish.

Exit interview conducted and report was reviewed with licensee, Maria Paz. A copy of this report was provided electronically along with her appeal rights and Notice of Site Visit. A notice of site visit must remain posted for 30 days

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

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

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
LIC809 (FAS) - (06/04)
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