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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700396
Report Date: 03/10/2022
Date Signed: 03/10/2022 03:28:06 PM

Document Has Been Signed on 03/10/2022 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:FLORES FAMILY CHILD CAREFACILITY NUMBER:
197700396
ADMINISTRATOR:VERONICA FLORESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 233-7754
CITY:PALMDALESTATE: CAZIP CODE:
93552
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 2DATE:
03/10/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:08 PM
MET WITH:Veronica FloresTIME COMPLETED:
03:42 PM
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Licensing Program Analyst (LPA's) Justin Dorsey and Justeene Tamayo met with Licensee Veronica Flores, who guided analyst on a tour of the facility for the One Year Required Inspection. This is a two story home with 5 bedrooms, 3 bathrooms, kitchen, dining area, living room, family room, laundry room and garage. The home has central heating and air conditioning. There is no pool on the premises. Upon arrival LPA observed 2 children.

Physical Plant: Main care is provided in the family room area. Children use the bathroom in the hallway near the laundry room. Children have access to the backyard. Off limit areas include: Upstairs area: LPA observed a gate to keep children from accessing the stairs. Living room: Per licensee the living room is only accessed when children arrive and leave the home. Laundry room: There is safety gate which makes this area inaccessible to children. Garage is accessed through the laundry room and no child care activities will be conducted there. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (locked under the sink), medicines (in upper kitchen cabinet ) and hazardous items (sharp knives inaccessible in upper kitchen cabinet) that can pose a danger to children. Fireplace is screened and locked. The home has safe and age appropriate toys, play equipment and materials. The smoke detector and carbon monoxide detector, and Fire Extinguisher (2A10BC) are in operable condition. Stairs have a gate. Per Licensee no one smokes in the home. Electrical outlets are inaccessible, no baby bouncers saucer chairs, or any 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 living room. Per Licensee there are no weapon/firearms in the home.

The last fire/earthquake drill was completed on 02/28/22 , LPA advised licensee to conduct a disaster drill every six months. Roster complete and maintained current.

Bathroom: Shower/tub are free of hazards (child care bathroom). Toilet and faucet is clean and operable.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE: DATE: 03/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/10/2022
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 3
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: FLORES FAMILY CHILD CARE
FACILITY NUMBER: 197700396
VISIT DATE: 03/10/2022
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Kitchen: Sharp utensils (in upper kitchen cabinet) and open bottles or alcohol (in off limits garage) are inaccessible to children. If food is brought from the children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. Cleaning supplies are locked under the sink. No chemicals in the kitchen were observed to be accessible. Per licensee, she serves the children breakfast, AM snack, lunch, PM snack and dinner are provided through Ventura Food Program.

Outdoor: The backyard is safe for children and is completely fenced. Children will play outside in the backyard. There is grass and concrete for children to play. LPA observed toys and play equipment in good condition. LPA observed a storage shed locked with a padlock in the back yard.

Advisory/Other: First Aid kit was readily available (in living room closet). CPR/First Aid expires on 01/18/24. Mandated Reporter was completed 12/16/21. Child nap on mats in the main care area (converted family room).

Documents discussed: Safe Sleep PIN 20-24-CCP and Large Family Child Care ratios.

Licensee Flores 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: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2022
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: FLORES FAMILY CHILD CARE
FACILITY NUMBER: 197700396
VISIT DATE: 03/10/2022
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LPA discussed the safe sleep regulations with licensee Flores 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 Flores 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.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted. Report and Appeal rights were reviewed with licensee Veronica Flores

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2022
LIC809 (FAS) - (06/04)
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