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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197412430
Report Date: 03/15/2022
Date Signed: 03/15/2022 11:06:34 AM

Document Has Been Signed on 03/15/2022 11:06 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:VELASCO FAMILY CHILD CAREFACILITY NUMBER:
197412430
ADMINISTRATOR:VELASCO, BERTHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 944-3066
CITY:LITTLEROCKSTATE: CAZIP CODE:
93543
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 2DATE:
03/15/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:04 AM
MET WITH:Bertha Velasco
TIME COMPLETED:
11:15 AM
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On 3/14/2022, Licensing Program Analyst (LPA) Carol Heath conducted an unannounced Required 1 Year inspection at the Velasco Family Child Care. Family members residing in the home are three adults (licensee, two adult renters who utilize the separate section of the house property-separated by a common wall which is the off-limits television room). Per LIS, facility annual fees are current. All adults living in the home have been background cleared. Per licensee, the hours of operation are Monday through Sunday 7:00 a.m. to 5:30 p.m. There were 5 daycare children (4 children and 1 infant) and 1 assistant present during this inspection. Incidental Medical Services (IMS) were discussed.

The Home is set up as follows:
This is a single-level home with 4 bedrooms and 3 bathrooms, laundry area (outside porch area), nap room, office, living room, dining, kitchen (no stove). The home was inspected for safety, comfort, cleanliness, telephone service, central air, and heat and ventilation. The home has central heating and air conditioning. All windows have screens and are free of cracks, bugs, and debris.

Ø Main Area: Main care is provided in the formal dining and living rooms (at the entrance), Bedroom #1 (infant nap room) Children use the bathroom located next to the dining room area. Children have access to the kitchen and backyard.

· Formal Dining / Living rooms: In the areas, LPA observed age-appropriate toys and furniture for the children. LPA observed: A small table was observed with a total of eight chairs. Several plastic storage bins were observed in which games and toys are stored for the children. A small play kitchen was located by the door with which children can play. There are games and books on the premises of this facility. There are mats on the floor that have educational/learning activities on them. The mats were observed to be in good condition.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 03/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/15/2022
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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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: VELASCO FAMILY CHILD CARE
FACILITY NUMBER: 197412430
VISIT DATE: 03/15/2022
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· Children Bathroom (#1): Children use the bathroom next to the Dining Room area The Bathroom was toured and inspected sink/toilet is in operable condition. 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. The bathroom was observed to be free and clear of hazardous items. The bathroom was clean, sanitized, and in good repair.
· Kitchen/Dining Room: The kitchen was inspected to ensure hazardous and dangerous items were inaccessible to children (Safety latches). In the kitchen, all sharp utensils, poisons, and medications are made inaccessible to children with child safety latches on cabinet doors and drawers. Sharp knives are and cleaning supplies are under the sink with magnet lock.
· Backyard: The backyard was inspected; The backyard (cement, dirt, grass artificial) is completely fenced. There are two swing sets (anchored), a gated area on the left and rear section - off-limits, Little Tikes play equipment, garden, marry-go-round, other age-appropriate toys, and a large shade-covered area. The play area is clear and clean of debris, the play area is fenced and gated all around, no body of water on the premises. Children wash hands outside the faucet area.

Ø Off-limit: Off-limit areas include licensee office, bedroom (#2,3 and 4), and bathroom (#2 and #3) which are located to the right of the child care bathroom (key lock). The private section of the property has one bedroom, one bathroom, living room, and kitchen.

Ø Others:
· AC/Heating Unit was observed. AC/Heating Unit is located on the right side of the home is inaccessible to children via barrels blocking access to the unit.
· Bodies of water: Per licensee, there is bodies of water in the home. However, it is located at off-limit area.
· Electrical outlets: All unused electrical outlets are plugged in and made inaccessible to children.
· Fire extinguisher (2A10BC): LPA observed there is a required fire extinguisher (2A10BC) fully charged Date: 3/3/22 and located in the kitchen near the front door inaccessible to children. It meets standards established by the State Fire Marshall.
· Fireplace: No fireplace
· Hanging window blind cords: The cords are inaccessible to children.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: VELASCO FAMILY CHILD CARE
FACILITY NUMBER: 197412430
VISIT DATE: 03/15/2022
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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 following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. The Licensee will not be providing IMS to the children at this time.
· Isolation area (Illness): Per licensee, if the child shows signs of illness, he/she will be separated from other children and stay in Bedroom #1
· Medications and cleaning solutions: Detergents/cleaning compounds are under the children bathroom #1 with a child locked. Medications are in the off-limits bedroom.
· Napping: Children will nap in the designated nap areas with adult supervision. LPA observed 14 cots and playpens.
· Phone service: There is a working landline and cell phone
· Smoke Detectors and Carbon Monoxide: The smoke detectors and carbon monoxide devices tested operable.
· The First Aid kit is located in the children Bathroom #1 inaccessible to children. The First Aid Kit was observed complete with supplies and a first aid manual.
· Transportation: The licensee does provide transportation for children. The licensee has a valid California driver's license with an expiration date of 02/10/2023. Licensee has valid vehicle insurance with the expiration date of 05/09/22 and vehicle registration.
· Weapons or Firearms: Per licensee, there are no firearms at the facility. LPA does not observe any firearms.

Ø Documentation:

· Child files: LPA reviewed 8 children's records, the records are incomplete and missing forms.
· CPR/First Aid: LPA observed licensee has current Pediatric CPR and First Aid Training with expiration date (06/22/23) 1 hour of nutrition training, (8) hours of Preventive Health and Safety Training.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: VELASCO FAMILY CHILD CARE
FACILITY NUMBER: 197412430
VISIT DATE: 03/15/2022
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· Facility Roster: LPA observed Child Care, Facility Roster. Per Licensing Information System, facility annual fees were current.
· Fire Drill and Disaster Drill: Per the licensee, fire and disaster drills are conducted every 6 months; the last drill was documented and conducted on 02/4/2022.
· Immunization: The licensee has the required immunizations. The licensee provided a written statement declining the influenza vaccination.
· Infant Sleeping Plan (LIC 9227): LPA shared the information with the licensee. Per Licensee, there is 1 infant (2 months) enrolled in the facility. LPA observed
· Licensee has posted as required the Facility License, Emergency Disaster plan, and Parents Rights Poster. The facility roster is current.
· Mandated Reporter Training: The licensee has completed the online mandated reporter training at www.mandatedreporterca.com, and will renew on 6/18/23
· Staff Personnel File: LPA observed 1 staff information. The file contained all required licensing documents

Ø The following information was discussed with the licensee:
ü Mandatory Forms for the children’s files and provider’s files.
ü Requirements for fire drills, earthquake drills, and documentation for both.
ü The role and responsibilities of being a mandated reporter were discussed.
ü The licensee is reminded that 100% supervision is required for children at all times.
ü Capacity requirements, Roster requirements, Posting requirements, Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children’s files and provider’s files, and Safe Sleep Awareness. The role and responsibilities of being a mandated reporter were reviewed. The licensee was reminded that supervision is always required for children in care.
ü Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. Licensee was advised that 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.
ü Licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: VELASCO FAMILY CHILD CARE
FACILITY NUMBER: 197412430
VISIT DATE: 03/15/2022
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ü The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot-line at 1-800-540-4000. Also, call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).
ü Criminal Record Statement: 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 the 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.
ü Safe Sleep: LPA discussed the safe sleep regulations with 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 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.
ü Notice of Site Visit: A notice of site visit was given and must remain posted for 30 days.
ü Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
ü Type A citation: LPA (name of analyst) informed licensee [or facility representative] (include name) that this report dated (insert visit date) document(s) (number of Type A citation) Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.
Also, LPA (name of analyst) informed the licensee [or facility representative] to provide a copy of this licensing report dated (insert visit date) that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
ü 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). State law prohibits baby walkers, bouncy seats, exersaucers, and any other items that fall into that category.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: VELASCO FAMILY CHILD CARE
FACILITY NUMBER: 197412430
VISIT DATE: 03/15/2022
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ü --Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.
n 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

ü The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 AM - 5:00 PM.

ü A copy of the Safe Sleep Proposed Regulations was provided to Licensee.

ü LPA provided consultation during the inspection.


No deficiencies are being cited at this time, the facility complies with Title 22


Exit interview conducted and the report was reviewed with the licensee Bertha Velasco.

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

DATE: 03/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2022
LIC809 (FAS) - (06/04)
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