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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157700087
Report Date: 07/03/2024
Date Signed: 07/03/2024 03:57:00 PM

Document Has Been Signed on 07/03/2024 03:57 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:MARIN FAMILY CHILD CAREFACILITY NUMBER:
157700087
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
07/03/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:40 AM
MET WITH:Maria MarinTIME VISIT/
INSPECTION COMPLETED:
12:10 PM
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On 07/03/2024, Licensing Program Analyst (LPA) Beneroso conducted an unannounced Annual Random inspection at the Marin Family Child Care Home. Upon arrival, the LPA met with licensee, Maria Marin who guided LPA on a tour of the facility. Family members residing in the home include 1 adult and 4 minor children. All adults living in the house have been background cleared. Per the Licensee, hours of operation are Monday through Friday 5AM to 5PM. Per licensee, no overnight care is provided at the moment. Upon arrival, LPA observed 3 children present. Incidental Medical Services (IMS) were discussed.

Physical Plant:
This is a single-story home with 3 bedrooms and 2 bathrooms. Per licensee, care is primarily in the living room. 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: Per licensee, care is primarily in the living room. 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 children in the living room in a corner. Children in cots and mats in the living room. LPA observed nap equipment to be 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.



Kitchen/Dining Room: The kitchen has a physical barrier. LPA observed a child safety gate. Sharp items are located in an upper cabinet. Per licensee, she does currently have a food program. Meals offered: Breakfast, AM Snack, Lunch, PM Snack and Dinner
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE: DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/03/2024
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: MARIN FAMILY CHILD CARE
FACILITY NUMBER: 157700087
VISIT DATE: 07/03/2024
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Backyard/Outdoor areas: The side yard is all fenced in. Per licensee, she wishes to open the backyard for access to the children. LPA observed backyard and advised licensee to obtain sandbags or an anchor system for the canopies she has installed in the backyard. Approval will take place in another visit. Per licensee and LPA’s observations, there are no pools or bodies of water in the premises.

Off-limits: Per licensee, the off-limit areas of the home include the 3 bedrooms, and one bathroom and garage. Rooms and garage are made inaccessible by a safety door knobs.



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 offer transportation, LPA observed insurance to be current.

Medications/ Hazardous Materials: Medications are stored in an upper cabinet in the kitchen. Cleaning compounds are stored in an upper cabinet as well. There are no firearms in the home.

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

DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024
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: MARIN FAMILY CHILD CARE
FACILITY NUMBER: 157700087
VISIT DATE: 07/03/2024
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Records: Children’s records were observed to be complete as well as the staff’s files. Licensee’s CPR/First Aid is maintained current, it expires on 04/2026. Mandated Reporter Certificate is also maintained current, it expires on 01/30/2026. Per Licensee, fire and disaster drills are conducted every 6 months; the last drill was documented and conducted on 03/2026. 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. LPA discussed the safe sleep regulations with licensee Marin 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.

Provider Information Notices (PINs) & Child Care Advocates: You can now sign up for Quarterly Updates on Rules, Regulations, Policies and PINs for one or more programs through our DSS website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe Applicant was informed all forms pertaining to Child Care Licensing can be found at https://www.cdss.ca.gov/inforesources/forms-brochures/forms-alphabetic-list/i-l

Child Care Advocates Program: Provides information and resources about licensed childcare. www.childcareadvocatesprogram@cdss.ca.gov

Megan’s Law - On this date, 07/03/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

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

DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024
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: MARIN FAMILY CHILD CARE
FACILITY NUMBER: 157700087
VISIT DATE: 07/03/2024
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MyChildCarePlan.org: Family Child Care Home Licensee was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Criminal Record Clearance: Licensee [or facility representative] was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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.

Applicant was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within 24 hours of incident by telephone and in writing within 7 days of incident to the department. Applicant was informed all suspected Child Abuse should be reported to the Child Abuse Hot-line at 1-800-540-4000. The above incident should be reported on the form LIC624B per the regulation. The form should be email to unusualincidentreport@dss.ca.gov

There are no deficiencies cited during today’s inspection. Exit interview conducted and report was reviewed with the licensee Marin, along with her appeal rights and Notice of Site Visit.

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

DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024
LIC809 (FAS) - (06/04)
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