197493200-5-10-2024-12-CC-AALH-D55QQD-20240510122211

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197493200
Report Date: 05/10/2024
Date Signed: 05/10/2024 12:23:02 PM

Document Has Been Signed on 05/10/2024 12:23 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:	JAQUEZ FAMILY CHILD CARE		FACILITY NUMBER:	197493200
ADMINISTRATOR/ DIRECTOR:	JAQUEZ, REBEKKAH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 298-1029
CITY:	CANYON COUNTRY	STATE: CA	ZIP CODE:	91351
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 8	DATE:	05/10/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Licensee Rebekkah Jaquez		TIME VISIT/ INSPECTION COMPLETED:	12:50 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 05/10/2024 Licensing Program Analyst (LPA) Alemoh conducted an unannounced annual random inspection. The LPA disclosed the purpose of the inspection and was granted entry by Licensee who guided LPA on a tour of the home. Upon entry to the facility LPA observed 8 children in care and one staff along with the licensee providing care and supervision. There are no bodies of water on the premise. This is a one-story family home with 3 bedrooms 2 restrooms along with a detached garage. There is a living room, dining room, kitchen, three bedrooms, two restrooms, laundry room, a den and a back yard for outdoor play. Main care is provided in the den referred to as the children’s play area. Children are provided with cots during nap time. Children utilize the restroom on the first door down the hall from the main entrance of the home. The off-limits areas are the three bedroom (child safety gate observed), one restroom, the detached garage and the laundry room. The operational childcare hours are Monday through Friday from 7:00 a.m. to 5:30 p.m. Overnight care is not provided. Licensee provides children with breakfast, lunch, and afternoon snack.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2024

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: JAQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 197493200
	VISIT DATE: 05/10/2024

NARRATIVE

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The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds(locked underneath kitchen/bathroom sink with safety latch), medicines(vitamins stored in the top kitchen cabinet), and hazardous items that can pose a danger to children. Knives (stored in kitchen cabinet w/ safety latch), medication, cleaning supplies(locked underneath kitchen/bathroom sink with safety latch) and chemicals are kept inaccessible to children.

There are educational age-appropriate toys and equipment on the premises such as arts and crafts, blocks, and learning materials. Cubbies observed for children to place their belongings. Infant changing table observed to be clean and orderly, along with extra diapers and cleaning wipes. Air purifier was observed in the playroom area. Water dispenser is provided for children to fill up water bottles. The First Aid kit with a temperature thermometer was observed in the playroom area to be complete.

The required fire extinguisher (2A10BC) is reading in green. Smoke and carbon monoxide detector tested and found to be in operating condition according to the Fire Marshal standards. Fire and disaster drills are conducted every six-month. At this time licensee states last drill was conducted last month in April but no documentation was provided. A technical violation will be issued. LPA informed licensee to conduct a fire drill as soon as possible and to document the date and time, and to send proof to LPA as soon as possible. The fireplace was observed in the living room area to be screen and barricaded.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2024

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: JAQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 197493200
	VISIT DATE: 05/10/2024

NARRATIVE

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Outdoor: The front yard is off limits. The backyard is completely fenced in with a brick wall. There is a gate separating a dog run There is a dog and a turtle on the premises. Per licensee, the dog does not come in contact when children are present. LPA observed age appropriate toys, well secured and safe for children. AC unit observed to be screened and barricaded. At the time of this visit there are renovations ongoing in the play yard area(see 812). Areas of the renovations in the outside play yard area were observed to be barricaded by a safety gate making the areas of the outside play yard inaccessible to children. Left side of the home was observed to be off-limits barricaded by an iron fence. Cameras around the premises and inside the playroom area.

Licensee had all the required posted documents: Facility License (LIC 203, Notice of Parent's Rights Poster (PUB 394), Emergency Disaster Plan (LIC 610A), and Earthquake Preparedness Checklist (LIC 9148)The licensee maintains proof of immunization against pertussis (TDAP), measles (MMR), TB and influenza.

Licensee provided a valid CPR/First Aid training certificate card which does not expire until 4/15/2025. Child Care Provider Mandated Reporter training (AB1207) expires on 04/29/2025. Licensee was not able to provide the Child Care Provider training certificate (AB1207) for the assistant. A technical violation was issued. Children’s file were reviewed and are complete (provided updated immunization card).

Safe Sleep regulations (under 24 months) were discussed with Licensee and referred to the CCL web site for additional information and PINS. Provided licensee with an infant sleep plan form LIC 9227 (infants under one year of age) and sleep log for 15-minute checks for infants under two years of age. LPA Alemoh observed safe sleep logs stored in the infant files.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2024

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: JAQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 197493200
	VISIT DATE: 05/10/2024

NARRATIVE

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Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. New employees shall have 90 days from date of employment to complete training as required. The
training may be conducted at the following website www.mandatedreporterca.com

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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at http://www.ada.gov/childqanda.htm

Child Care Advocates:
To sign up for our Quarterly Updates please email the Child Care Advocates at chilcareadvocatesprogram@dss.ca.gov & (916) 654-154.The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot line at 1-800-540-4000.

An exit interview was conducted, a copy of this Report, a Notice of Site visit and Appeal rights were provided and discussed with licensee. Notice of Site visit is to be posted visible to parents for 30 days.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2024

LIC809 (FAS) - (06/04)

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