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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157700025
Report Date: 04/30/2021
Date Signed: 04/30/2021 04:08:25 PM

Document Has Been Signed on 04/30/2021 04:08 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:CARDENAS FAMILY CHILD CAREFACILITY NUMBER:
157700025
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 7DATE:
04/30/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:39 PM
MET WITH:Rosa CardenasTIME COMPLETED:
03:59 PM
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On 4/30/2021 at 2:35 p.m., Licensing Program Analyst (LPA) Isabel Ortega was greeted virtually by above licensee Rosa and Camerian Cardenas, to conduct a case management licensee initiated inspection for the purpose to increase her Family Child Care Home(FCCH) Capacity. LPA disclosed the purpose of the inspection and was virtually guided on a tour of the Family Child Care Home. Upon entry LPA observed 7 children in care. Fire clearance for an increase of capacity large FCCH with a maximum capacity of 14 children in care was granted 4/01/2021. The operating hours are Monday - Sunday: varied depending on parent's need. This is a single story single family home. The home consist of a living room, dinning room, kitchen, 2 bedrooms, one bathrooms and attached garage. Primary care of children will continue to be conducted in room #1 and livening room referred to as the day care area. The back yard is used for outside play shade and water is provided. The off limits areas are bedroom #2(child proof knob observed), attached garage(locked and child proof knob observed). The inside and outside of the home was inspected. The LPA observed the home to be kept clean and orderly, with heating and ventilation for safety and comfort. LPA observed age appropriate safe toys and play equipment. The cleaning solutions, medications are stored in the locked garage inaccessible to children. The knives are kept in the kitchen underneath the sink and maintained locked with a child safety latch inaccessible to children in care. Per the licensee there are no weapons or firearms of any kind in the facility at this time. The LPA did not observe any weapons.
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE: DATE: 04/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/27/2021
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CARDENAS FAMILY CHILD CARE
FACILITY NUMBER: 157700025
VISIT DATE: 04/30/2021
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The smoke and carbon monoxide detectors are in operable condition meeting the Fire Marshals safety standards tested at 3:05 P.M. The licensee was reminded that fire and disaster drills are to be conducted at least once every six months and logged. The home had a fire extinguisher that meets State Fire Marshal standards(reading in green and serviced in March 2021).

The facility annual fees are current. The licensee had all the required licensing documents posted in the day care room visually accessible. The outside back yard is used by the children for outside play. The back yard is enclosed. The outdoor play area was inspected and was observed to be free of hazards, loose and sharp parts. There are no bodies of water at the family day care home.

The following were discussed: Smoking is not permitted in the licensed facility. Baby walkers, baby jumpers, baby exersaucers, baby bouncers/rockers and any other items that fall into that category are not permitted in the facility. The LPA also discussed earthquake safety and necessity of drills, required forms for children’s files, facility files and posting requirements.

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. Please advise your analyst of any person who will be visiting regularly or for longer than #1 week.
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2021
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CARDENAS FAMILY CHILD CARE
FACILITY NUMBER: 157700025
VISIT DATE: 04/30/2021
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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.

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 licensee was reminded it is her responsibility to visit the department's website to obtain licensing forms, Quarterly Updates, and Provider PINs.

A capacity for a large family child care home(FCCH) has been approved max 14 children in care effective today 4/30/2021. Copy of this report, appeal rights and notice of site visit will be via mailed to licensee.
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2021
LIC809 (FAS) - (06/04)
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