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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700491
Report Date: 08/15/2022
Date Signed: 08/15/2022 09:04:02 AM

Document Has Been Signed on 08/15/2022 09:04 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:MAJUAN FAMILY CHILD CAREFACILITY NUMBER:
197700491
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
08/15/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
08:05 AM
MET WITH:Maidelin MajuanTIME COMPLETED:
09:30 AM
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On 8/15/2022, Licensing Program Analyst (LPA) Carol Heath was greeted by Licensee, Maidelin Majuan. LPA was at the facility to conduct an announced case management licensee initiated inspection for an increase of capacity from a Small Family Child Care Home to a Large Family Child Care Home(FCCH) up to 14 children. LPA disclosed the purpose of the inspection and was granted entry by the licensee, who guided LPA on a tour of the Family Child Care Home. Upon entry, LPA observed 4 children in care.

Licensee was initially licensed on 4/1/2021 as a Small Family Child Care Home. The Fire Department has inspected the facility and a fire clearance for 14 children has been granted effective 07/29/2022. Family members residing in the home include 3 adults (licensee and her husband and adult friend). Per LIS, facility annual fees are current. All adults living in the home have been background cleared. Per licensee, the hours of operation are Monday through Friday 7:00 a.m. to 5:30 p.m. There were 4 daycare children (2 infant and 2 preschool children) present during this inspection. Incidental Medical Services (IMS) were discussed.

This is a Two story 4 bedroom, 3 bathroom home with an upstairs living room, downstairs living room, kitchen, backyard, attached garage, and laundry room. The garage is used for storage only and no childcare activities are conducted there. There is a pool and spa on the premises. The home was inspected for safety, comfort, cleanliness, telephone service, central air, and heat and ventilation. The home has central heating and air conditioning. All windows have screens and are free of cracks, bugs, and debris.


Ø Main Area: Main care is provided in the Downstairs area, living room, kitchen, and bathroom located near the kitchen and backyard.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 08/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/15/2022
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: MAJUAN FAMILY CHILD CARE
FACILITY NUMBER: 197700491
VISIT DATE: 08/15/2022
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· Dining / Living rooms: In the areas, LPA observed a fireplace that was properly screened via a mirror glass barrier which made it inaccessible to children. LPA observed age-appropriate toys and furniture for the children. LPA observed: A small table was observed with children size chairs. Several plastic storage bins were observed in which games and toys are stored for the children. There are games and books on the premises of this facility. There are mats on the floor that have educational/learning activities on them. The mats were observed to be in good condition.
· Children Bathroom (#1): Children use the bathroom next to the Dining Room area The Bathroom was toured and inspected sink/toilet is in operable condition. The toilets and faucets are clean, safe, and operable. All poison and medications are made inaccessible to children with child safety latches on the sink cabinet and drawers. The bathroom was observed to be free and clear of hazardous items. The bathroom was clean, sanitized, and in good repair.
· Backyard: The backyard is used 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. There is a gated pool and spa in the backyard. Gate was observed to be of appropriate height with a self-latching/self-closing opening, demonstrated by the licensee. The Key is kept out of reach of children. A padlock was observed on the gate opening. LPAs observed a locked gate on the right side of the home for storage. There is another gated section on the left side.
· Kitchen: The kitchen was inspected to ensure hazardous and dangerous items were inaccessible to children (Safety latches). In the kitchen, all sharp utensils, poisons, and medications are made inaccessible to children with child safety latches on cabinet doors and drawers. Sharp knives are kept in a butcher block in the gated kitchen.
Ø Off-limit: Off-limit areas include the Entire upstairs area, 4 bedrooms, 2 bathrooms, an attached garage that remains locked at all times and has a safety doorknob, and a laundry room that has a safety door knob.
· Upstairs area (4 bedrooms and 2 bathrooms): There is a safety gate for stairs to make the second floor inaccessible to the daycare children.
· Attached garage: There is a safety doorknob on the door
· Laundry room: There is a safety doorknob on the door.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2022
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: MAJUAN FAMILY CHILD CARE
FACILITY NUMBER: 197700491
VISIT DATE: 08/15/2022
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Ø Others:
· AC/Heating Unit was observed. AC/Heating Unit is located on the right side of the home and is inaccessible to children via barrels blocking access to the unit.
· Bodies of water: Per the licensee, there is a pool and spa on the premises. There is a gated pool and spa in the backyard. Gate was observed to be of appropriate height with a self-latching/self-closing opening, demonstrated by the licensee. The Key is kept out of reach of children.
· Electrical outlets: All unused electrical outlets are plugged in and made inaccessible to children.
· Fire extinguisher (2A10BC): LPA observed there is a required fire extinguisher (2A10BC) fully charged Date: 5/2022 and located in the classroom inaccessible to children. It meets standards established by the State Fire Marshall.
· Fireplace: A fireplace that was properly screened via a mirror glass barrier which made it inaccessible to children
· Hanging window blind cords: The cords are inaccessible to children.
· Incidental Medical Services (IMS): The Licensee will not be providing IMS to the children at this time.
· Isolation area (Illness): Per the licensee, if the child shows signs of illness, he/she will be separated from other children and stay in Dining Room.
· Medications and cleaning solutions: Detergents/cleaning compounds are in the laundry room with a safety gate. Medications are in the upper kitchen cabinet and master bathroom medicine cabinet.
· Meal: The daycare home provides breakfast, am snack, lunch, pm snack, and dinner as needed. According to Licensee, she is currently participating in a Food Nutrition Program.
· Napping: Children will nap in the designated nap areas with adult supervision. LPA observed 6 cots and 3 cribs.
· Phone service: There is a working landline or cell phone
· Smoke Detectors and Carbon Monoxide: The smoke detectors and carbon monoxide devices tested operable.
· The First Aid kit is located in a classroom inaccessible to children. The First Aid Kit was observed complete with supplies and a first aid manual.
· Transportation: The licensee will not transport daycare children at this time.
· Weapons or Firearms: Per Licensee, there are no Firearms at the facility at this time. LPA does not observe any firearms.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2022
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: MAJUAN FAMILY CHILD CARE
FACILITY NUMBER: 197700491
VISIT DATE: 08/15/2022
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Ø Documentation:
· CPR/First Aid: LPA observed licensee has current Pediatric CPR and First Aid Training with expiration date (01/2023) 1 hour of nutrition training, (8) hours of Preventive Health and Safety Training.
· Facility Roster: LPA observed Child Care, Facility Roster. Per Licensing Information System, facility annual fees were current.
· Fire Drill and Disaster Drill: Per the licensee, fire and disaster drills are conducted every 6 months; the last drill was documented and conducted on 05/18/2022.
· Immunization: The licensee has the required immunizations. The licensee provided a written statement declining the influenza vaccination.
· Infant Sleeping Plan (LIC 9227): LPA shared the information with the licensee. Per Licensee, there is 2 infant (0-12 months) enrolled in the facility.
· The licensee has posted as required the Facility License, Emergency Disaster plan, and Parents Rights Poster. The facility roster is current.

· Mandated Reporter Training: The licensee has completed the online mandated reporter training at www.mandatedreporterca.com, and will renew on 4/12/2024


· Staff Personnel File: Licensee was informed with a capacity increase a qualified Assistant is required to be present whenever more than 8 children are in care. Licensee has 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. Pre licensee, she already has Elaine Prieto Garcia as her assistant. Her fingerpring is cleared and she has all the require tainings and documentation.

Ø The following information was discussed with the licensee:

· Criminal Record Statement: Licensee [or facility representative] 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: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2022
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MAJUAN FAMILY CHILD CARE
FACILITY NUMBER: 197700491
VISIT DATE: 08/15/2022
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· Safe Sleep: LPA discussed the safe sleep regulations with the licensee [or facility representative] 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 the licensee [facility representative] 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.
· Notice of Site Visit: A notice of site visit was given and must remain posted for 30 days.
· Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
· Type A citation: LPA Carol Heath informed licensee [or facility representative] (include name) that this report dated (insert visit date) document(s) (number of Type A citation) Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.
Also, LPA (name of analyst) informed the licensee [or facility representative] to provide a copy of this licensing report dated (insert visit date) that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

**As a result of this inspection, the home does not meet Title 22 Regulations. The Palmdale is waiting for 7/22/2022 UIR report/CPS report finding.

· Waiting for child #1 (See LIC811 confidential names) medical report from 7/25/22



Exit interview conducted and report was reviewed with the licensee Maidelin Majuan


SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2022
LIC809 (FAS) - (06/04)
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