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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197405687
Report Date: 03/13/2024
Date Signed: 03/13/2024 03:28:06 PM

Document Has Been Signed on 03/13/2024 03:28 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:KEZIOS FAMILY CHILD CAREFACILITY NUMBER:
197405687
ADMINISTRATOR:FAY KEZIOSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 295-0247
CITY:CASTAICSTATE: CAZIP CODE:
91384
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
03/13/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Licensee Fay KeziosTIME COMPLETED:
04:00 PM
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On 03/13/2024 Licensing Program Analyst (LPA) Alemoh, met with licensee, Fay Kezios who guided analyst on a tour of the facility for the One Year Required inspection. Upon arrival LPA observed 3 children in care and the licensee providing caring for them. Family members residing in the home include 2 adults (licensee, licensee's husband). Facility hours of operation are Monday - Friday 7AM- 5:30 PM. Incidental Medical Services (IMS) policy was discussed.

There are no bodies of water in the premises.

Physical Plant: Main care is provided in the family room, master bedroom and the converted garage. The converted garage was observed to be safe, orderly and clean. Soft carpet floors, couches and chairs for children to sit, along with 3 storage cabinets with safety latches. Safe and age appropriate toys, play equipment and materials were observed. Washer and dryer was observed in the converted garage and made inaccessible by a sliding door. The children use the bathroom located in the hallway home to the left. The off-limits areas are: two bedrooms, second restroom and the living room area. (There is a safety gate barricading the living room area.) Laundry room is also off limits and are kept locked during business hours.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE: DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2024
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: KEZIOS FAMILY CHILD CARE
FACILITY NUMBER: 197405687
VISIT DATE: 03/13/2024
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The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds which are kept in the top cabinet above the washer and dryer, medicines are kept in the locked top kitchen cabinet and hazardous items (sharp knives are kept in plastic container in the top kitchen cabinet high enough that they are inaccessible to children.)

The smoke detector, carbon monoxide detector and Fire Extinguisher (2A10BC) are all in operable condition. Electrical outlets are inaccessible. No recalled and or prohibited toys or sleep/ play equipment were observed on the premises. There is a designated area for ill children as necessary in the converted garage. Per Licensee, there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (cell).

Fire/Disaster drills are maintained current. Last fire disaster drill was completed on 02/15/2024. A fireplace was located in the family room and was observed to be barricaded and made inaccessible to the children by a safety gate.

Bathroom: LPA observed the toilet and faucet are clean and operable. The shower/tub are free of prohibited items such as shampoo and body washes. Safety latches were observed on all the bathroom cabinets.

Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. The home has a clean and fully stocked refrigerator/freezer. Cleaning supplies are in the laundry room cabinets which is locked during business hours. Breakfast, lunch, snacks are provided. Licensee stated she currently does not have a food program. Naps are provided on cribs/beds in the master bedroom.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2024
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: KEZIOS FAMILY CHILD CARE
FACILITY NUMBER: 197405687
VISIT DATE: 03/13/2024
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Outdoor: The front yard is off limits. The backyard is completely fenced in with a brick wall. Per licensee there are no animals on the premises. LPA observed age appropriate toys, well secured and safe for children. The left side of the backyard the BBQ grill is stored and was observed to be off-limits by a locked iron gate making it inaccessible to children. The right side of the backyard there is a gate that gives access to the front yard and was observed to be locked. Security cameras are on the premises.

Advisory/Other: First Aid kit was observed with supplies readily available located in the kitchen area. CPR/First Aid expires 11/28/2025. Mandated Reporter expires on 03/05/2025. LPA reminded licensee; mandated reporter training must be completed every 2 years.

Documents Provided and or Discussed: Fire Drill Log, Postings, Employee's and Children's records, Safe Sleep PIN 20-24-CCP and Individual Sleeping Plan (LIC9227). Licensee currently does have child care insurance.

Licensee Fay 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.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2024
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: KEZIOS FAMILY CHILD CARE
FACILITY NUMBER: 197405687
VISIT DATE: 03/13/2024
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LPA discussed the safe sleep regulations with licensee Fay and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPAs also informed licensee 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.

Licensee Fay is unaware of the safe sleep regulations. LPA Alemoh discussed and provided licensee a copy of the safe sleep regulations, safe sleep chart, and ISP( Individual Sleep Plan form) .

An exit interview was conducted, a copy of this report was reviewed and provided to licensee along with the appeal rights.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2024
LIC809 (FAS) - (06/04)
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