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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197400197
Report Date: 12/04/2023
Date Signed: 12/04/2023 11:01:20 AM

Document Has Been Signed on 12/04/2023 11:01 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:ROBLES FAMILY DAY CAREFACILITY NUMBER:
197400197
ADMINISTRATOR:ROBLES, AMPAROFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 944-4851
CITY:LITTLEROCKSTATE: CAZIP CODE:
93543
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
12/04/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:42 AM
MET WITH:Amparo RoblesTIME COMPLETED:
11:30 AM
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On 12/4/2023, Licensing Program Analyst (LPA) Carol Heath conducted an unannounced Required annual inspection at the Robles Family Child Care Home. Upon arrival, the LPA met with the licensee, Amparo Robles and her daughter (assistant: Nancy Robles), who guided the LPA on a tour of the facility. Individuals that reside in the home include 4 adults (licensee, licensee’s daughter and her husband, granddaughter). Per Guardian, all adults in this facility obtain a criminal record clearance.
This is a large family childcare facility. The hours of operation are Monday through Friday, 5 a.m. to 6 p.m. During the inspection, LPA observed 0 childcare children. During today’s inspection, the grandson (Age: 19 years old) see LIC 811 for name. The grandson does not have fingerprint clearance and associated with the facility. Per the Licensing Information System, annual facility fees were Not current. The licensee will pay online by 12/8/2023. Incidental Medical Services (IMS) were discussed. Per the licensee, she does not have children who need IMS at this time.
The home is set up as follows: This is a single-story home with 6 bedrooms, 4 bathrooms, a kitchen, a living room, formal dining, a family room, enclosed patio area, and No garage. The following areas are used for daycare:
Daycare is provided in the living room, hallway, bathroom, dining room, kitchen, and front yard, which are utilized for the family's childcare. Off-limit areas are the six bedrooms, three bathrooms (does not include hallway bathroom for childcare), laundry room, and storage room.
· Living room/ Dining Room: In the designated playroom, LPA observed adequate age-appropriate toys, books, games. The carpets and other materials were observed to be in good condition.
· Children's bathroom: Children use the bathroom next to the Dining Room area. The Bathroom was toured and inspected, and the sink/toilet is in operable condition. The bathtub and shower are free of hazards. Toilet and faucets are clean, safe, and operable. All poison and medications are made inaccessible to children with child safety latches on the sink cabinet and drawers.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 12/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/04/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: ROBLES FAMILY DAY CARE
FACILITY NUMBER: 197400197
VISIT DATE: 12/04/2023
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· Kitchen/Dining Room: The kitchen was inspected to ensure dangerous items were inaccessible to children. Sharp knives are kept in a butcher block in the kitchen cabinet without a safety latch. LPA observed medications are in the refrigerator. LPA asked the licensee to make the medications inaccessible to the children. The dishwasher, stove, microwave, etc., are clean. No chemicals in the kitchen were observed to be accessible.
· Front yard: The Front yard was inspected; The Front yard is gated all around. The outdoor play area was observed with BBQ, broken toys, and water fountain with water. There is a grass area for active play. There is a covered barbecue grill. The left and right-side yards have a gate. The right-side gate has a shed (padlocked).
Other:
· AC/Heating Unit / Swamp Cooler unit was observed. The AC/Heating Unit is located on the right side of the home and is inaccessible to children via barrels blocking access to the AC unit. / The swamp cooler unit is inaccessible to children.
· Bodies of water: Pre the licensee, there were bodies of water (Decorative water fountain with water) in the front yard.
· Electrical outlets: All unused electrical outlets are plugged in and made inaccessible to children.
· Food: The licensee is enrolled in the Food program. The licensee will provide Breakfast, lunch, and snacks.
· Fire extinguisher (2A10BC): LPA observed a required fire extinguisher (2A10BC) reading in Green and located in the kitchen, which is inaccessible to children. It meets standards established by the State Fire Marshall.
· Fireplace: The fireplace was observed in the living room and is screened to make it inaccessible to the children.
· Hanging window blind cords: The cords are inaccessible to children.
· Isolation area (Illness): Per the licensee, if the child shows signs of illness, they will be separated from other children and stay in Living room.
· Medications and cleaning solutions: Detergents/cleaning compounds are in the upper kitchen cabinet, inaccessible to the children. Medications are in the off-limits bedroom.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2023
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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: ROBLES FAMILY DAY CARE
FACILITY NUMBER: 197400197
VISIT DATE: 12/04/2023
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· Napping: Children are school age. No nap
· Pets: No pets in the facility.
· Phone service: There is a working cell phone.
· Smoke Detectors and Carbon Monoxide: The smoke detectors and carbon monoxide devices tested operable.
· The First Aid kit is in the closet, inaccessible to children. The First Aid Kit was observed to be complete with supplies and No a first aid manual.
· Transportation: The licensee does provide transportation for children. The licensee has a valid California driver's license, valid vehicle insurance, and vehicle registration.
· Weapons or Firearms: Per the licensee, there are No Firearms at the facility at this time. LPA does not observe any firearms in the childcare area.
LPA reviewed the following Documentation:
· Child files: LPA observed 3 children's files, and the records were found to be in order with the required forms.
· CPR/First Aid: LPA observed that the licensee has current Pediatric CPR and First Aid Training with an expiration date of 07/2024.
· Fire Drill and Disaster Drill: Per the licensee, fire and disaster drills are conducted every 6 months; the last drill was documented and performed on 10/13/23.
· Immunization: The licensee and her assistant have the required immunizations (MMR and DTaP). The licensee and her assistant provided a written statement declining the influenza vaccination.
· Infant Sleeping Plan (LIC 9227) and Sleeping Log: Per the licensee, NO infant (0-12 months) is enrolled in the facility.
· The licensee posted all required information.
· Mandated Reporter Training: The licensee has completed and renewed the online mandated reporter training on 7/24/2022 (needs to be renewed in 2 years).
· Staff Personnel File: LPA observed 1 staff information. The assistant will need to complete the mandated reporter training
The following information was discussed with the licensee:
o A baby walker shall not be allowed on the premises of a family childcare home in accordance with Health and Safety code sections 1596.848(b) and (c). State law prohibits baby walkers, bouncy seats, exersaucers, and other items that fall into that category.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2023
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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: ROBLES FAMILY DAY CARE
FACILITY NUMBER: 197400197
VISIT DATE: 12/04/2023
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o Capacity, Roster requirements, and Documentation requirements for disaster drills (fire and earthquake).
o Licensee [or facility representative] 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.
o Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates on courses and updates/changes to the regulations.
o Licensee was made aware that it is their responsibility to know the regulations and anyone who assists in providing care. The licensee was advised that the inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility's phone number; if the phone number is changed, licensing must be notified.
o Licenses were advised of the requirement to report unusual incidents and injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on form LIC624B.
o LPA discussed the safe sleep regulations with the licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the licensee [facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
o Mandatory Forms for the children's and assistant files.
o Our Quarterly updates come out every 3 months. They are also now in Spanish. Please log in to the CCLD website, or you can email our advocates to have the quarterly updates sent directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov
o Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
o The licensee is reminded that 100% supervision is required for children at all times.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2023
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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: ROBLES FAMILY DAY CARE
FACILITY NUMBER: 197400197
VISIT DATE: 12/04/2023
NARRATIVE
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o The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also, call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).
o The regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare home and in those areas of the family day care home where children are present (24/7 ban).
o The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 a.m. - 5:00 p.m.

Deficiencies cited: (See LIC 809D). The following Type A and B deficiencies are being cited in accordance with Title 22 of the California Code of Regulations and Health & Safety codes.

Exit interview conducted and report was reviewed with the licensee, Amparo Robles.


SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2023
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Document Has Been Signed on 12/04/2023 11:01 AM - It Cannot Be Edited


Created By: Carol Heath On 12/04/2023 at 10:09 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ROBLES FAMILY DAY CARE
FACILITY NUMBER: 197400197

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/04/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102370(d)(1)
Criminal Record Clearance. All individuals subject to a criminal record review as specified in Section 1596.871 prior to
working...btain a California clearance or a criminal record exemption as required by the Department.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above. During today's inspection, the licensee's 19 years old grandson does not have fingerpring clearn and associate with the facility, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 12/04/2023
Plan of Correction
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The grandson left the house and will not return to the house until his fingerpring is clearn and assoicate with the facility
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claretta Yates
LICENSING EVALUATOR NAME:Carol Heath
LICENSING EVALUATOR SIGNATURE:
DATE: 12/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/04/2023


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Document Has Been Signed on 12/04/2023 11:01 AM - It Cannot Be Edited


Created By: Carol Heath On 12/04/2023 at 10:30 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ROBLES FAMILY DAY CARE
FACILITY NUMBER: 197400197

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/04/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)

(b) (1)   On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee's assistant did not comply with the section cited above. The assistant's Mandated reporter trainng expired 2022,which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/11/2023
Plan of Correction
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The assistant will complete the training on line and email the certification to LPA by 12/11,
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claretta Yates
LICENSING EVALUATOR NAME:Carol Heath
LICENSING EVALUATOR SIGNATURE:
DATE: 12/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/04/2023


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