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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700491
Report Date: 07/10/2024
Date Signed: 07/10/2024 02:41:37 PM

Document Has Been Signed on 07/10/2024 02:41 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:MAJUAN FAMILY CHILD CAREFACILITY NUMBER:
197700491
ADMINISTRATOR/
DIRECTOR:
MAIDELIN MAJUANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 747-1470
CITY:PALMDALESTATE: CAZIP CODE:
93550
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
07/10/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:02 PM
MET WITH:Maidelin Majuan, Licensee TIME VISIT/
INSPECTION COMPLETED:
03:32 PM
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On 07/10/2024, Licensing Program Analyst (LPA) Justeene Tamayo met with Licensee Maidelin Majuan, who guided analyst on a tour of the facility for the One Year Required inspection. Upon arrival, LPA observed 1 infant, 8 preschool age children, and 3 school age children, along with assistant #1. Adults living in the home are Licensee, Licensee's spouse, and 2 minor children. Hours of operation are Monday-Friday, 7:00am-5:45pm. Incidental Medical Services (IMS) policy was discussed.

Physical Plant: This 2 story, 4-bed, 2.5-bath with living room, family room, kitchen, back and front yards, and garage. Main care is provided in the living room, and family room areas. Children use the bathroom #1 behind the kitchen area. Children have access to the main care areas, bathroom #1, kitchen, and the back yard. Off limit areas include all bedrooms, upstairs area, bathrooms #2-3, front yard, and garage. There is a wooden baby gate barricading the stairs. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons(under kitchen sink with safety latch) and sharp knives(upper kitchen cabinet unreachable to children in care). Per licensee, there are no medications in the home.

Safe and age-appropriate toys, play equipment and materials were observed. LPA Tamayo tested the smoke detector and carbon monoxide detector and observed both to be in operable condition. Fire extinguisher was found to be in operable condition and located near the entrance of the home. Electrical outlets were inaccessible. No recalled and or prohibited toys or play equipment were observed on the premises. There is a designated area for ill children as necessary.

Bathroom: Children use the bathroom located on the right of the home. Bathroom #1 is a half bathroom with no shower or tub. LPA observed toilet and faucet to be clean and operable. No hazardous materials or items were observed in bathroom #1. LPA reminded applicant the children's bathroom must be free of accessible shampoos, mouthwash, medication, perfumes, razor, air freshener, nail polish and polish remover.

Continued on LIC 809-

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 07/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/10/2024
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: 07/10/2024
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Kitchen: Sharp utensils are stored in an upper kitchen cabinet and inaccessible to children in care. The home has a clean and fully stocked refrigerator/freezer. Breakfast, lunch, dinner and snacks are provided. Licensee stated she is participant in a food program. Cleaning supplies and chemicals are stored under the kitchen sink with a safety latch. LPA observed the safety latch to be in operable condition.

Outdoor: Children play in the back yard. LPA toured the back yard and observed it to be free of garden tools, poisonous plants, thorn trees, cactus, or lawn mower inaccessible to children. The play area is clear and clean of debris, play area is fenced and gated all around. LPA observed age-appropriate play equipment for children. LPA also observed a self-latching wrought iron black fence barricading the right side of the home, where children also participate in outdoor activities.

Pools/Spas/Bodies of Water: There is an in ground swimming pool and a spa in the backyard. LPA observed three property walls barricading the in ground swimming pool, the rest of the swimming pool is completely enclosed by a 5 ft metal fence. The fence runs all the way down to the concrete on which it sits, leaving approximately 2 inches between the bottom of the fence and the concrete. The pool gate was tested and observed to be self-closing and self-latching. The gate has an installed mechanism containing a key to lock the gate and it is located within 6 inches from the top of the gate. The lever to open the gate is located at the top of the gate. The pool gate opens away from the body of water. All items rendering the fence climbable are moved away from the fence.

Advisory/Other: First Aid kit was observed in the reception area with supplies readily available. Licensee’s First Aid/CPR certification is valid and expires on 04/22/2025. Mandated reporter training's for licensee expires on 05/01/2026. LPA reminded licensee, mandated reporter training and CPR must be completed every 2 years. Per Licensee, there are no guns, weapons, or firearms in the home. Per Licensee, there is no smoking in the home. There are no pets on the premises. Last fire/disaster drill was completed on 07/10/2024

Licensee’s annual fees are current. LPA observed all required facility postings on premises. Licensee had the following required posted documents: Notice of Parent's Rights Poster (PUB 394), Facility License (LIC 203) and Emergency Disaster Plan (LIC 610A), Earthquake Preparedness Checklist (LIC 9148) and Fire/Disaster Log.

Documents Provided and or Discussed: Fire Drill Log, required postings, Employee's and Children's records, Safe Sleep PIN 20-24-CCP and Individual Sleeping Plan (LIC9227). Licensee currently does not have childcare insurance.

Continued on LIC 809-C

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024
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: 07/10/2024
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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.

Prior to making alterations or additions to a family child care home or grounds, the Licensee shall notify the Department of the proposed changed, including, but not limited to, the following: Conversion of a garage (either attached or detached) into a "child care" room; Room additions to the family child care home. Any change from an area of the family childcare home previously identified as "off limits" to an area where care and supervision will be provided to children in care. Licensee shall provide the Department with a copy of an inspection report when an inspection is required by the local building inspector as a result of the alteration, addition or construction.

Licensee advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department (email address on the website: www.unusualincidentreport@dss.ca.gov. A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep. More information on Infant Safe Sleep procedures can be found online on the CDSS web page 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.

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

No deficiencies have been cited at this time.

An exit interview was conducted, a copy of this report was reviewed and provided to licensee, along with a copy of her appeal rights, and Notice of Site Visit.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024
LIC809 (FAS) - (06/04)
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