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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700475
Report Date: 10/29/2022
Date Signed: 10/29/2022 10:08:31 AM

Document Has Been Signed on 10/29/2022 10:08 AM - 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:SERRANO FAMILY CHILD CAREFACILITY NUMBER:
197700475
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
10/29/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:47 AM
MET WITH:Edna Serrano TIME COMPLETED:
10:23 AM
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On 10/29/2022, Licensing Program Analyst (LPA) Justin Dorsey conducted a Capacity Increase Pre-Licensing inspection with Licensee, Edna Serrano to ensure the facility meets basic licensing requirements set forth by Title 22, Health and Safety requirements. The Licensee is requesting to provide care for a Large family childcare home for the capacity of 14 children. Currently, there is 1 adult (Licensee) and 2 family members 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 Sunday 4:00am - 3:00am.

The home is described as follows:

This is a one story home with 4 bedrooms, 2 bathrooms, kitchen, dining room, living room, family room, and garage. The home has central heating and air conditioning.



Indoor:
Main area: Main care is provided in the living room and 1 bedroom. The on-limits bedroom is an infant room which can be accessed from the family room. Children use the bathroom in the hallway near the living room. Children have access to the backyard.
Bathroom #1: Children will use the bathroom #1 near the family room. Bathroom #1 was toured, and inspected, toilets are in operable condition. Toilet and faucets are clean, safe, and operable; bathtub and shower area free of hazard. There are no medications or items stored in the medicine cabinet.
Kitchen: The kitchen is made inaccessible to children by gate. Sharp utensils, cleaning supplies, medicines; drawers and cabinets with plastic bags, and sharp things 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. All lower and upper cabinets in the kitchen have child locks. Medications and knives are stored locked high in a kitchen cabinet. Cleaning supplies are locked under the sink.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE: DATE: 10/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/29/2022
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: SERRANO FAMILY CHILD CARE
FACILITY NUMBER: 197700475
VISIT DATE: 10/29/2022
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Outside: The backyard was inspected. The backyard is completely fenced, children will play outside only in the backyard. Per Licensee the children only have access to the inner concrete area of the backyard. LPA Dorsey observed a fence which restricts children from accessing the outer dirt parts of the yard. LPA Dorsey observed a shed and trampoline in the off-limits area off the backyard. Per licensee the children do not have access to this area of the backyard. There is a concrete area and a sandbox for children to play. LPA observed toys and play equipment in good condition.

Kitchen: Sharp utensils and medications (in upper kitchen cabinet) are inaccessible to children. LPA reminded licensee 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.

Advisory/Other: First Aid kit was readily available (in living room). CPR/First Aid expires on 03/16/23. Mandated Reporter was completed 03/29/21. Children nap on mats and in cribs in the living room. During the visit LPA Dorsey observed the homes carbon monoxide detector, smoke detector and 2A10BC fire extinguisher were in operable condition.

Documents discussed: Personnel Records 102416.1, Safe Sleep PIN 20-24-CCP, LIC 9227, Infant Safe Sleep Log and Large Family Child Capacity Worksheet.

Licensee Serrano 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 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.

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

DATE: 10/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2022
LIC809 (FAS) - (06/04)
Page: 2 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: SERRANO FAMILY CHILD CARE
FACILITY NUMBER: 197700475
VISIT DATE: 10/29/2022
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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 Edna Serrano.

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

DATE: 10/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2022
LIC809 (FAS) - (06/04)
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