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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157700047
Report Date: 05/16/2022
Date Signed: 05/18/2022 08:53:50 AM

Document Has Been Signed on 05/18/2022 08:53 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:JAIME FAMILY CHILD CAREFACILITY NUMBER:
157700047
ADMINISTRATOR:AYDE JAIMEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 436-9414
CITY:ARVINSTATE: CAZIP CODE:
93203
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
05/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:39 AM
MET WITH:Ayde JaimeTIME COMPLETED:
03:39 PM
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 On 05/16/22 at 11:39 a..m. Licensing Program Analysts (LPA) Esequiel Rodriguez conducted an unannounced annual inspection at the Family Child Care Home to assess the Facility operation of their program and current physical plant status. Also, to evaluate the Facility's continuing ability to meet compliance with California Code of Regulations (CCR) Title 22, Health and Safety requirements, and other applicable State and Licensing Statutory requirements. LPA Rodriguez met with Licensee, Ayde Jaime and stated the reason for the inspection. The LPA provided a copy of the Entrance checklist form, LIC 126.

LPA Rodriguez told provider that to better assure and promote the health and safety of each individual being cared for in licensed setting, the Community Care Licensing Division's (CCLD) is focusing efforts on three priority areas: Prevention, compliance, and enforcement; Therefore, CCLD launched the Inspection Process Project (IPP) to meet these goals. As a result it developed the Compliance and Regulatory Enforcement (CARE) Tools for the Child Care Program which is being used during today's inspection. These does not impose any new requirement on the provider.

The Licensee. provided copy of the Child Care Center children rosters for each classroom (LIC 9040), At 12:05 p.m. LPA Rodriguez along with the Licensee conducted a walk trough of the inside and outside of the facility along with the entire operation of the Facility.

The Facility license is posted on a prominent place of the facility. The home is licensed to provide day care services to 14 children. The Facility is clean, safe, sanitary and well maintain. All utilities are operational and in good order. There is plenty parking space. The first aid kit is present and complete and is inaccessible to children/infants. The fire extinguishers, smoke alarms and carbon monoxide monitors are in compliance and
SUPERVISORS NAME: Scott Herring
LICENSING EVALUATOR NAME: Esequiel Rodriguez
LICENSING EVALUATOR SIGNATURE: DATE: 05/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2022
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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