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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700788
Report Date: 01/24/2024
Date Signed: 01/24/2024 11:23:20 AM

Document Has Been Signed on 01/24/2024 11:23 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:CUNIAL FAMILY CHILD CAREFACILITY NUMBER:
197700788
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
01/24/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:17 AM
MET WITH:Maria CunialTIME COMPLETED:
11:23 AM
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On January 24, 2024, Licensing Program Analyst (LPA) Kris Diaz and Licensing Program Manager (LPM) Claretta Yates, conducted an announced Pre-Licensing inspection. LPA/LPM met with applicant, Maria Cunial, who guided LPA/LPM on a tour of the home. People who reside in the home are the applicant and her spouse who are both live scanned and have TB skin tests on file and their minor child (15). The applicant is requesting to operate as a small family childcare home. Days and hours of operation are Monday through Friday 6:00am to 6:00pm. Incidental Medical Services (IMS) were discussed with the applicant.

This is a two-story family home. The home consists of three bedrooms, three in a half-bathrooms, kitchen, dining room, great room, den, laundry room and garage. The primary care will be conducted in the den. Children will have access to the great room, den, bathroom in the den, and side yard. The off-limit areas of the home include the entire upstairs area made inaccessible with a safety gate at the bottom of the stairs, the kitchen and dining room made inaccessible with safety gates, the garage with entry from the kitchen and inaccessible outside area on the right side of the home, and the pool area located directly in the backyard. The backyard is completely enclosed by a fiberglass fence. The accessible outside play area contains a shed that is made inaccessible with key padlock. The children access the left side yard area by a door at the left of the front entrance. Per Applicant, children will only access outside area from side door. LPA observed a dog in the left side yard that is made inaccessible with a temporary gate with mesh lining. LPA advised applicant to heighten mesh fence to top of temporary gate. Per applicant, dog will be placed in off-limits upstairs prior to operating hours and transported to outside during naptime keeping inaccessible to children. LPA obtained declaration from applicant stating such.

There is a swimming pool on the premises. The gate leading to the pool area from the side yard allows visibility to the pool area at all times. The swimming pool has a gate with self-closing, self-latching mechanism and key lock that meets the department’s regulations and makes the area inaccessible to children. LPA reminded applicant to check the area each morning prior to operating hours to ensure the area is completely inaccessible to children.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kristina Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/24/2024
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CUNIAL FAMILY CHILD CARE
FACILITY NUMBER: 197700788
VISIT DATE: 01/24/2024
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LPA observed an alarm on the sliding door leading from the kitchen to the outside area where the pool is located. LPA observed three windows leading directly to the pool area with operating alarms to alert if windows are opened. LPA observed several age-appropriate toys and activities in the play area and in the side yard. LPA reminded applicant to provide 100% supervision.

The home was inspected inside for comfort, cleanliness, telephone service, heating and ventilation. Medications are stored in the master bedroom inaccessible to children. Children's medications are stored in upper kitchen cabinet made inaccessible with safety latch. The kitchen knives are stored in a knife block in the pantry in the kitchen on a high shelf made inaccessible to children with safety knob. Cleaning compounds are stored in the upstairs laundry area.

The First Aid kit is located in bathroom cabinet in the den made inaccessible with safety lock. Per applicant, there are no weapons or firearms in the home. LPA did not observe any weapons or firearms. Per applicant, her spouse has service weapon that remains at work site. LPA reminded applicant of the storage requirements for weapons, firing pins, and ammunition. Smoke detectors and carbon monoxide detectors are in operable condition. The fire extinguisher (2A10BC) was green and fully charged and meets the standards of the State Fire Marshal. The applicant’s Pediatric CPR/First Aid expires 7/2025. The applicant has the required immunization against pertussis (TDAP) and measles (MMR), and the flu. The applicant completed the required Mandated Reporter training on 8/10/2022. Preventive Health Practices including lead training was completed 7/2023.

The documents required to be posted were located in the entrance area accessible to parents: Notification of Parent's Rights Poster (PUB394), Emergency Disaster Plan (LIC610A), and Earthquake Preparedness Checklist (LIC9148).

The following was discussed with the applicant:

Mandatory licensing forms for the children’s files, facility forms/records, and information to be posted in the family child care home; Requirements to conduct fire and disaster drills once every six months and record it; Role and responsibilities of being a mandated reporter were reviewed; The applicant was reminded that 100% supervision is required at all times to children in care; Applicant was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care;

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kristina Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CUNIAL FAMILY CHILD CARE
FACILITY NUMBER: 197700788
VISIT DATE: 01/24/2024
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Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified; Regulation prohibits the smoking of any kind during the operation of the day care.

The applicant was informed that all adults living in or having access to the home, or are employees are required to have fingerprint clearances with Department of Justice, FBI and Child Abuse Central Index prior to having contact or working with children. If this is not adhered to, a Civil Penalty of up to $500, per non-cleared adult will be assessed immediately. Please advise your analyst of any person who will be visiting regularly or for longer than one week. The applicant was advised to utilize the Request for Live scan Service LIC9163 to have adults fingerprinted and associated to the home.

The applicant was advised of the requirement to report Unusual Incidents. 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. The applicant was informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department.

The applicant was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days whenever a licensing inspection is conducted. If a Type A deficiency is cited, a copy of the licensing report must also be posted for 30 days. The same report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months & licensee must obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file. Copies of the reports must be provided to each parent when a Type A violation is cited along with Acknowledgment of Receipt of Licensing Reports LIC 9224. If these requirements are not met civil penalties per violation will be assessed.

Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors, and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com.

Prior to making alterations or additions to a family childcare home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following:

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kristina Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CUNIAL FAMILY CHILD CARE
FACILITY NUMBER: 197700788
VISIT DATE: 01/24/2024
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Conversion of a garage (either attached or detached) into a "childcare" room; Room additions to the family childcare 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. The 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.

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.

Lead Flyer Requirement Health and Safety Code 1596.7996 mandated that effective January 1, 2019, CCC's and FCCH's are required to provide parents and guardians of children enrolling or reenrolling in care with written information on the risks and effects of lead exposure, blood lead testing requirements and recommendations, and options for locations of affordable blood lead tests as specified. A Lead Poisoning Facts Flyer was created, in partnership with the California Department of Public Health (CDPH), to satisfy this requirement.

The applicant was advised it is her responsibility to visit the department's website to access licensing forms, Quarterly Updates and Provider Information Notices (PINs): www.ccld.ca.gov

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 CCLD website at: https://www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Prior to being licensed the following corrections are required by: Wednesday, January 31, 2024
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kristina Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CUNIAL FAMILY CHILD CARE
FACILITY NUMBER: 197700788
VISIT DATE: 01/24/2024
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Planter in side yard needs to be filled and made inaccessible

Wire mesh on dog gate needs to be heightened to the top of the gate.

This inspection was conducted in person. The report was read with the applicant. A copy of this report and the Notice of Site Visit was provided to applicant, Maria Cunial. Exit interview was conducted

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kristina Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
LIC809 (FAS) - (06/04)
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