197700457-7-13-2022-12-CC-IORA-CGB4MG-20220713191332

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700457
Report Date: 07/13/2022
Date Signed: 07/13/2022 07:13:43 PM

Document Has Been Signed on 07/13/2022 07:13 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 CARE		FACILITY NUMBER:	197700457
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 9	CENSUS: 0	DATE:	07/13/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	06:31 PM
MET WITH:	Ana Flores		TIME COMPLETED:	07:30 PM

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On 7/6/2022 Licensing Program Analysts (LPA) Isabel Ortega conducted an unannounced Case management other inspection as Licensee is requesting to increase her capacity from 8 children to 14 children. The LPA disclosed the purpose of the inspection and was granted entry by Licensee who guided the LPA on a tour of the facility. Upon entry to the facility the LPA did not observe any children in care.

Licensee was initially licensed on 2/17/2021 as a Small Family Child Care Home. The Fire Department has inspected the home and granted a fire clearance for 14 children effective 6/01/2022. Family Child Care Home operates Monday through Sunday varied 23 hours depending on family's need. The facility provides breakfast, morning snack, lunch, afternoon snack and dinner as needed dinner.

This is a single story with three-bedrooms, two restrooms and a detached garage. Main care is provided in the living room and dining room referred to as the child care area. Children use the restroom located in the middle of the hallway to the left of the entrance. The off-limit areas include the kitchen, two bedrooms, one restroom and the detached garage. The kitchen is inaccessible to children in care as licensee has placed a secure child proof gate at the entrance of the kitchen.

SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022

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: FLORES FAMILY CHILD CARE	FACILITY NUMBER: 197700457
	VISIT DATE: 07/13/2022

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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, medicines, and hazardous items that can pose a danger to children. There are age appropriate toys and equipment on the premises. LPA did not observe a fireplace or any bodies of water. Per the licensee there are no weapons or firearms of any kind in the facility at this time, nor did the LPA observe any weapons.

The backyard is utilized by the children for outside play and is fenced all around. The outdoor play area was inspected and play equipment was observed to be free of hazards, loose and sharp parts. LPA observed age appropriate toys both inside and outside of the home.

The facility’s fire extinguisher (2A10BC) met the State Fire Marshal standards. The fire extinguisher (2A10BC) was serviced 3/15/2022 and is reading in green. the smoke and carbon monoxide are found to be in operable condition. The facility annual fees are current. The parent board was reviewed and had all the required forms posted and accessible to parents.

Licensee is reminded with a capacity increase she must have a qualified assistant present whenever she has more than 8 children in care. Licensee was provided with a capacity and ratio handout pertaining to large Family Child Care Homes and the various age groups that can be under care at one given time.

SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022

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: 197700457
	VISIT DATE: 07/13/2022

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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
The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation were inspected, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. There are age appropriate toys and equipment on the premises. LPA did not observe a fireplace or any bodies of water at the above facility. LPA observed cots and mats for napping (room #1 will also be used for napping).
Licensee was reminded with a capacity increase she must have a qualified assistant present whenever she has more than 8 children in care. Licensee was provided with a capacity and ratio handout pertaining to large Family Child Care Homes and the various age groups that can be under care at one given time. Licensee has met Title 22 regulations; Fire clearance was granted 6/01/2022, therefore, a Large Family Child Care Home License capacity of 14 children has been granted effective today 7/14/2022. An exit interview was conducted, and a copy of this report, appeal and notice of site visit was provided to Licensee on this day. All Licensing reports are recommended to be kept on file for minimum three years.

SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022

LIC809 (FAS) - (06/04)

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