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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157700067
Report Date: 12/07/2023
Date Signed: 01/09/2024 04:17:01 PM

Document Has Been Signed on 01/09/2024 04:17 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:GONZALEZ FAMILY CHILD CAREFACILITY NUMBER:
157700067
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
12/07/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Joanna Gonzalez TIME COMPLETED:
02:00 PM
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On 12/07/2023, Licensing Program Analyst (LPA) Beneroso conducted an unannounced Required 1-Year inspection at the Gonzalez Family Child Care Home. Upon arrival, the LPA met with licensee, Joanna Gonzalez who guided LPA on a tour of the facility. Family members residing in the home include 4 adults and 1 minor children. All adults living in the house have been background cleared. Per the Licensee, hours of operation are a day Monday through Sunday and is open for 23 hours a day. Per licensee, no overnight care is provided at the moment. Upon arrival, LPA observed 1 child in care. Licensee is within the ratio for a small facility. Incidental Medical Services (IMS) were discussed.

Physical Plant:
This is a single-story home with 4 bedrooms and 2 bathrooms, garage, front yard and backyard. Per licensee, care is provided primarily in room #1 (playroom). Children use bathroom located inside the playroom. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds, medication and hazardous items that can pose a danger to children. LPA observed age-appropriate safe toys and napping equipment on the premises.

Main Care Area: Main care is provided in room #1(playroom). LPA observed age-appropriate toys and furniture for the children. There are age-appropriate games and books on the premises. Per licensee, there is a designated area for ill/sick in a corner in the playroom. Children nap in the playroom in cots that are properly stored.

Children's bathroom: Children use the bathroom located in the hallway on the left-hand side. The bathroom was clean, sanitized, and in good repair. The bathroom was toured and inspected sink and toilet which is in operable condition.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE: DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/07/2023
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: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 157700067
VISIT DATE: 12/07/2023
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Kitchen/Dining Room: The kitchen is off limits by a door that remains locked. Sharp items are located in an upper cabinet. Cleaning compounds are located in a lower cabinet. Per licensee, she does currently have a food program. Meals offered: Breakfast, AM Snack, Lunch, PM Snack and Dinner as needed.

Backyard/Outdoor areas: The backyard is gated all around and made inaccessible to children with a locked gate. The backyard is not used for outside play. The front outdoor play area and driveway was inspected and was observed to be free of hazards, lose or sharp parts and tools. LPA observed appropriate and safe toys in the play area. Per licensee, there are two dogs in the property that are kept in the backyard (off-limits). Per licensee and LPA’s observations, there are no pools or bodies of water in the premises. There is one pet in the premises.

Off-limits: Per licensee, the off-limit areas of the home include all bedrooms, one bathroom, the front yard and the backyard is divided in 3. Only one of the divisions is used for daycare children, the rest of the backyard is locked with a metal gate to make it inaccessible to children in care.



Care and Supervision: Licensee is within the ratio for a small facility. The Licensee was reminded that supervision is always required for children in care.


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 was observed to be complete with supplies including thermometer, tweezers, scissors, gauze, bandages, cleansing pad/solution, and a first aid manual. LPA observed a required fire extinguisher (2A10BC) reading in Green and currently serviced. The facility currently does not have childcare insurance. Per licensee, she currently does not offer transportation.

Medications/ Hazardous Materials: Medications are stored in an upper cabinet, in the kitchen. Door that gives access to the kitchen has a safety doorknob cover.Cleaning compounds are stored in a lower cabinet in the kitchen, secured by a safety doorknob cover. There are no firearms in the home.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
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: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 157700067
VISIT DATE: 12/07/2023
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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 records were observed to be incomplete LIC627 was not found in the child’s file. A type B Citation was issued for this violation. Licensee’s CPR/First Aid is maintained current, it expires on 10/2024. Mandated Reporter Certificate is also maintained current, it expires on 10/01/2024. Per Licensee, fire and disaster drills are conducted every 6 months; the last drill was documented and conducted on 12/06/2023. Per LPA’s observations, the Facility License, Emergency Disaster plan, Earthquake Preparedness and Parents Rights Poster were posted.

Documents Provided and or Discussed: Safe Sleep PIN 20-24-CCP and LIC9227 (Individual Sleeping Plan) and Sleep Logs.

Child Care Advocates: You can now sign up for Quarterly Updates and PINs for one or more programs through our DSS website at www.ccld.ca.gov Click on “Receive Important Updates” located in the right middle part of the page, immediately above the Quick links. Put your email address and choose which program(s) you would like to subscribe to and click “subscribe. Applicant was advised that all LIC forms can be found at: www.cdss.ca.gov/inforesources/forms-brochures/forms-alphabetic-list/i-l

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

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: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
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: GONZALEZ FAMILY CHILD CARE
FACILITY NUMBER: 157700067
VISIT DATE: 12/07/2023
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Licensee Gonzalez 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 Gonzalez and discussed the Child Care Licensing Safe Sleep webpage at 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 www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

There was on Type B Violation cited during today’s inspection. Exit interview conducted and report was reviewed with the licensee Gonzalez, along with her appeal rights and Notice of Site Visit.

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

DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
LIC809 (FAS) - (06/04)
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