197700147-10-22-2024-12-CC-AALH-DAAQV4-20241022122944

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700147
Report Date: 10/22/2024
Date Signed: 10/22/2024 12:30:36 PM

Document Has Been Signed on 10/22/2024 12:30 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:	RODRIGUEZ FAMILY CHILD CARE		FACILITY NUMBER:	197700147
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 5	DATE:	10/22/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Licensee Ruth Rodriguez		TIME VISIT/ INSPECTION COMPLETED:	01:20 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 10/22/2024, Licensing Program Analyst (LPA) Alemoh conducted an Capacity Increase Pre-Licensing inspection with Licensee, Ruth Rodriguez to ensure the facility meets basic licensing requirements set forth by Title 22, Health and Safety requirements. The requested capacity is 14. The fire department has granted a fire clearance. Licensee is advised that as a family childcare home operating at full capacity, she must adhere to the following: Operate with a Maximum of 14 children in care with no more than 3 Infants, also must have 2 school age children enrolled. Or Max. 12 Capacity with no more than 4 infants. A Qualified Assistant must be present when more than 8 children are in care.

The Licensee is requesting to provide care for a Large family childcare home for the capacity of 14 children. Currently, there are 2 adults (Licensee and licensee spouse) living in the home. LPA toured the home indoor and out to ensure it meets FCCH requirements. The Licensee is requesting the days and hours of operation will be Monday through Friday 06:00am - 6:00pm.

There is a pool on the premises.

The home is described as follows:

This facility is a single-story home that consists of 3 bedrooms, 3 bathrooms, kitchen(barricaded by a safety gate), living area, dining room, family room, play rooms(1/2), an attached garage, and front yard and backyard fenced.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 5

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: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 197700147
	VISIT DATE: 10/22/2024

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
26
27
28
29
30
31
32

Indoor:
Main area: Main care is provided in the playroom areas. Both rooms were observed to be safe and age appropriate. Tables, chairs and a couch were observed to meet the children's needs. Toys, play equipment and learning materials such as books, coloring materials, blocks etc., were observed. Wet wipes and cleaning supplies stored on the corner desk high enough making them inaccessible to children. Children use the bathroom in the playroom and in the hallway on the left. Children have access to the main care areas(playroom #1/2), living room area, nap room, and the backyard.
Bathroom #1: Children use the bathroom #1 in the play room area. The bathroom #1 was toured, and inspected, toilets are in clean and operable condition. Toilet and faucets are clean, safe, and operable; shower area is free of hazard. Underneath the bathroom sink is extra toilet paper and towels locked with a safety latch. Cleaning wipes and supplies stored on the top shelf high enough making it inaccessible to children. Bathroom #2 located in the hallway area was toured and observed to be free of hazardous materials. Shower area was free of hazards and made inaccessible with a safety gate. A shower tub was observed in the bathroom area to be made inaccessible to children and covered.

Kitchen: Off-limits barricaded by a safety gate. Sharp utensils, cleaning supplies made inaccessible, (per licensee no children at the time of this visit are taking medications); drawers and cabinets with plastic bags, and sharp things(knives stored in the top cabinet) or small things children can swallow; are inaccessible to children. The refrigerator dishwasher, stove, microwave, etc., are clean. The kitchen was clean, orderly, and free of hazardous items.

Outside: The outdoor play areas (back and front yard fenced) were observed. Children will play outside in the backyard. The backyard was observed to be divided into 2 sections, the back section of the backyard is gated with a tall chain linked fence with pad lock to prevent access to that part of the backyard.In the off-limits area of the backyard, there is a horse stable (no horses) and a large storage shed that is also off limits to the children. The remainder of the backyard is accessible to the children and fenced. One side of the home (left) is not accessible to the children and are prevented access by a chain linked fence with a latch to prevent access. LPA observed toys and play equipment in good condition. There is a sandbox and concrete for children to play.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 197700147
	VISIT DATE: 10/22/2024

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
26
27
28
29
30
31
32

There is a swimming pool and an empty pond in the backyard. The bodies of water are completely enclosed by a 5 ft mesh fence. The fence runs all the way down to the concrete on which it sits, leaving no room between the bottom of the fence and the concrete. The pool gate was tested and observed to be self-closing and self-latching. The gate has an installed mechanism containing a key to lock the gate and it is located within 6 inches from the top of the gate. The lever to open the gate is located at the top of the gate. The pool gate opens away from the body of water. The pond was observed to have a netting covering all around the pound. All items rendering the fence climbable are moved away from the fence. The mesh fencing is sturdy and capable of withstanding the impact of children's toys including bicycles. LPA took photos to document in the file.

Off-limit area:
Master bedroom
Kitchen
Living room #2: Per licensee the living room is off-limits to children.
Laundry room: There is a door which makes this area inaccessible to children.
Garage: Garage is accessed through the kitchen area and no child care activities will be conducted there.

Other:
Napping equipment (4 cots, 2 mats, 3 sleeping bags): Per licensee children nap in the nap room, LPA reminded licensee that children must be supervised when sleeping. LPA observed the nap room to contain two play pens along with an extra play pen stored in the play room area. There is a cabinet that contains extra play materials along with a closet contains extra supplies and equipment. Safe Sleep charts were observed next to the children sign in and out sheet.

Electrical outlets: All unused electrical outlets are made inaccessible to children.
There is a First Aid kit located in the play room area on top of the cabinet.
Weapons or Firearms: Per The Licensee, there are no weapons or firearms. LPA did not observe any weapons or firearms.Cleaning compounds are stored in bathroom #1 on the top shelf. Smoke detector and a carbon monoxide detector tested operable.
Fire extinguisher (2A10BC) There is a fully charged fire extinguisher (2A10BC); which meets fire marshal standards. A fireplace was observed in the living room area to be barricaded by a safety gate.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 197700147
	VISIT DATE: 10/22/2024

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
26
27
28
29
30
31
32

Documentation:
The Licensee has current CPR, First Aid Training with the expiration dates of 05/2026. Prevented Health Safety and Nutrition Training were reviewed and completed on 01/21/2018. The Licensee has her fingerprint clearance and TB exam. The Licensee has proof of being immunized against pertussis, and measles. The Licensee has proof of Mandated Reporting Training dated 10/18/2024. Per Licensee breakfast, AM snack, Lunch and PM snack are provided for children. Per licensee she is on a food program.

The following was discussed with The Licensee:
Mandatory Forms for the children’s files and provider’s files, Requirements for fire drills, earthquake drills, and documentation for both. Role and responsibilities of being a mandated reporter.

The Licensee reminded that 100% supervision is required at all times to children in care. The Licensee was advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov. The Licensee was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified

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.
On January 1, 2018, or before March 30, 2018, a person who is a licensed childcare provider, administrator, or employee of a licensed child day care facility shall complete the online mandated reporter training and shall complete renewal mandated reporter training every two years. @www.mandatereporterca.com

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 197700147
	VISIT DATE: 10/22/2024

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
26
27
28
29
30
31
32

Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). Family childcare homes shall post during hours of operation. Failure to meet the posting requirements shall result in an immediate $100.00 civil penalty In addition; all parents of currently enrolled children and any newly enrolled child for the following 12 months shall receive a copy of report and sign the LIC 9224 acknowledging receipt. Civil Penalty assessments will be assessed if all above requirements are not adhered to.

§1597.622 Employees or volunteers at family day care home; immunization requirements; records; exemptions (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year

Incidental medical Services (IMS) policy was discussed. The Licensee will wait until facility opens to determine IMS needs. 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

Safe Sleep in Child Care: Resources can be found on our website at http://www.cdss.ca.gov/inforesources/Child-Care-Licensing/Public-Information-and-Resources/Safe-Sleep. Safe sleep charts, and individual sleep plan was observed and filled out.

An exit interview was conducted, Appeal Rights and Notice of Site Visit were given and the report was reviewed with Licensee Rodriguez.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024

LIC809 (FAS) - (06/04)

Page: 5 of 5