197700448-6-5-2023-12-CC-JDMO-CSHUGL-20230605153432

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700448
Report Date: 06/05/2023
Date Signed: 06/05/2023 03:34:42 PM

Document Has Been Signed on 06/05/2023 03:34 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:	GOMEZ-CASTILLEJOS FAMILY CHILD CARE		FACILITY NUMBER:	197700448
ADMINISTRATOR:	MONICA GOMEZ-CASTILLEJOS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 236-9978
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93535
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 2	DATE:	06/05/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:37 PM
MET WITH:	Monica Gomez-Castiilejos		TIME COMPLETED:	03:40 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 06/05/2023, at 1:37 P.M., Licensing Program Analyst (LPA) Joselito L. Del Mundo conducted an unannounced annual inspection at Gomez-Castilljos Family Child Care Home to assess its ability to meet compliance with California Code of Regulations (CCR) Title 22, Health, and Safety requirements. LPA Del Mundo met with Licensee, Monica Gomez-Castillejos and stated the reason for the inspection. The LPA provided copies of the LIC 126 Entrance Checklist Form, LIC 311D Forms/Records to Keep in the Family Child Care Home, and all records/forms that need to be maintain in the facility. Licensee guided the analyst on a tour of the day care areas. The day care take place in the following area of the home: living room play area #1), family room (play area #2), bedroom #1, bathroom #1 (nap time room), and backyard (outdoor play area). Licensee states the day care hours of operation is Monday to Sunday from 4:00 A.M. to 9:00 P.M. Currently living in the home is licensee and licensee’s fiancé. Licensee is providing transportation to children in care. During this visit, LPA observed two children present in the facility. Physical Plant: The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds, medicines and hazardous items that can pose a danger to children. All poisons, cleaning products and detergents are stored underneath the kitchen sink (off limits) where they are locked and inaccessible to children. Knives, cutleries, and other sharp items are stored in the upper cabinet of the kitchen. Licensee has household medications stored inside the closet of the licensee’s room. Per licensee, zero medications are currently being provided for the current children in care. Licensee stated that she is a member of the food program and she is providing breakfast, morning snacks, lunch, and afternoon snacks to children in care. The facility is a one-story house. The fireplace is covered with a metal screen and is inaccessible to children

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2023

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: GOMEZ-CASTILLEJOS FAMILY CHILD CARE	FACILITY NUMBER: 197700448
	VISIT DATE: 06/05/2023

NARRATIVE

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in care. The home has heating and air conditioning units.

Licensee stated that fire/earthquake drills were last conducted on February 26, 2023. The facility has a fully charge fire extinguisher with a 2-A:10-B:C (reading in green, checked at 2:26 P.M.) classification and the last service date was February 14, 2023. Safe and age-appropriate toys for different ages, children’s books, puzzles, cooking set toys, supermarket set toys, building blocks, cubbies, tables and chairs were observed during this visit.

Licensee three napping equipment like cots in bedroom #1 (napping room). LPA also observed 2 cribs in bedroom #1.

Licensee has two first aid kit boxes located above the fireplace mantel. The smoke detector and carbon monoxide detector were in operable conditions. LPA observed electrical outlets are covered with a plastic cover to prevent access to children in care.Licensee also stated that she has two dogs which are inside a dog kennel and are inside the licensee’s room.

Licensee is advised that baby bouncers, saucer chairs, or any recalled and or banned toys or sleep/ play equipment are prohibited on the premises. Licensee is advised to check for fixture, furniture and equipment that have been banned or recalled by the United States Consumer Product Safety Commission.

Bathroom: Toilet, sink and faucet were clean and operable. During the inspection, LPA did not observed razors and/or sharp objects, mouthwash, medications, perfumes, air freshener, nail polish and nail remover that will pose a health and safety risk to children in care.

Currently, the licensee has two children enrolled in the facility. When a child shows signs of illness, he/she is separated from other children in bedroom #1 of the facility.

Outdoor: The facility has no body of water on the premises. The outdoor play area has age-appropriate toys and play equipment. LPA observed toy house, swing set, two slides for little and big children. Per licensee, she supervised children while playing outside, but currently, the outdoor play area is not being used by the licensee.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2023

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: GOMEZ-CASTILLEJOS FAMILY CHILD CARE	FACILITY NUMBER: 197700448
	VISIT DATE: 06/05/2023

NARRATIVE

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At the time of inspection, Licensee is aware of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing on the day of the incident and/or 24 hours of incident by telephone, fax and/or in writing to the Department. Licensee is familiar with the Unusual Incident Report form, LIC624B. The report on unusual incident/injuries can also be mailed to unusualIncidentreport@dss.ca.gov

Review of records to be maintained: LPA reviewed with licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. LPA reviewed two children’s file and the Licensee files. Based on records review, children’s files are complete; licensee has current mandated reporter training and CPR/First aid training certicate. Licensee has proof of immunization against influenza, pertussis, and measles. Licensee has TB skin test on file.

Licensee and other adults living in the home have received criminal record clearance.

The following was discussed with the licensee:

Licensee reminded that 100% supervision is required at all times to children in care. Licensee was made aware that it is he/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.

Licensee 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: GOMEZ-CASTILLEJOS FAMILY CHILD CARE	FACILITY NUMBER: 197700448
	VISIT DATE: 06/05/2023

NARRATIVE

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https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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.

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

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

The facility is in compliance per Title 22 regulations. During today's inspection, LPA Del Mundo did not observe deficiencies that may hinder the health and safety of the children in care. No deficiencies were cited during this inspection. An exit Interview and discussion of observations were conducted with the licensee.

A copy of this Report was reviewed, Notice of Site Visit (LIC 9213) and Appeal Rights were provided to Licensee, Monica Gomez-Castillejos

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2023

LIC809 (FAS) - (06/04)

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