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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700097
Report Date: 02/11/2022
Date Signed: 02/11/2022 03:12:26 PM

Document Has Been Signed on 02/11/2022 03:12 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:RAMIREZ FAMILY CHILD CAREFACILITY NUMBER:
197700097
ADMINISTRATOR:RAMIREZ, RAQUELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 605-0539
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
02/11/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:41 PM
MET WITH:Raquel Ramirez LicenseeTIME COMPLETED:
03:20 PM
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Licensing Program Analyst (LPAs ) Justin Dorsey and Steven Montoya with licensee, Raquel Ramirez today for the purpose of conducting an annual inspection for a large family child care home. At the time of the inspection, there were 4 adult present: license and her assistant were caring for children, two adult daughter were present which all have been fingerprinted. There were 7 children in care. Home consists of 3 bedrooms, 2 bathrooms, kitchen, living room, dining area, gated front yard, backyard, and converted garage (child care area). Parents will enter child care room through side gate in the backyard. There is no pool, spa or other bodies of water on the premises. Fireplace is located in the living room. Family members residing in the home include 2 adults (Applicant and her husband) and 4 children.

Home was inspected inside and outside for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that are inaccessible to children. Child care is to be provided in the converted garage. LPA observed fire alarm, operable smoke detector/carbon monoxide detector and fire extinguisher in the child care area.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE: DATE: 02/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/11/2022
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: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 197700097
VISIT DATE: 02/11/2022
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Children will use the bathroom in hall (from the front door) which clean and neat..Door inside of the bathroom leads to off limits bedroom #1 and will be kept locked by key per licensee. Laundry area is in the garage behind key-locked doors. Off limits areas include all 3 bedrooms, master bathroom, kitchen, dining area and living room. Knives are kept in an upper cabinet in the kitchen above the oven. Medications are kept on a high,
inaccessible shelf above the kitchen sink. Cleaning compounds and detergents are kept in the locked shed beside converted garage/child care area. Requirements for fingerprint clearances and associations were discussed and verified with the licensee. LIcensee presented First Aid and CPR expires 09-2023.

Applicant 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. The "Notification of Parent's Rights" poster must be posted in an area of the home accessible to parents.

No citation were given for the license facilty.



Licensee was advised the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent and a copy of the Acknowledgment of receipt of licensing report (LIC9224) must be kept in each child's file. In addition, any child enrolled within the following 12 months must also receive a copy of the Type A Citation.

Exit interview was conducted a copy of this report was printed and given to applicant.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022
LIC809 (FAS) - (06/04)
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