198014759-6-23-2023-12-CC-AVIA-CT3PJV-20230623112210

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198014759
Report Date: 06/23/2023
Date Signed: 06/23/2023 11:22:55 AM

Document Has Been Signed on 06/23/2023 11:22 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:	GARCIA FAMILY CHILD CARE		FACILITY NUMBER:	198014759
ADMINISTRATOR:	GARCIA, CARLOTA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 764-4376
CITY:	SUN VALLEY	STATE: CA	ZIP CODE:	91352
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	06/23/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:21 AM
MET WITH:	Carlota Garcia, Licensee		TIME COMPLETED:	12:15 PM

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On June 23, 2023, Licensing Program Analysts (LPA) Annelise Villa met with licensee, Carlota Garcia who guided analyst on a tour of the facility for the One Year Required inspection. Upon arrival LPA observed no children in care. The inspection was completed with the Licensee's son assisting with Spanish to English translation. Family members residing in the home include Licensee, and Licensee's adult son. Facility hours of operation are 6:00 am 11:00 pm. Incidental Medical Services (IMS) policy was discussed.

Physical Plant: This is a one story family home. The home consists of a kitchen, living room, family room, 3 bedrooms, 3 bathroom, garage, and front and back yards. The primary care for children is conducted in the living room. Bathroom #1 located in the back of the converted garage. The home was inspected inside and out for safety, comfort, cleanliness, orderliness, telephone service (land line), heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds under the kitchen sink with an operable safety latch, sharp knives are kept in the kitchen in a kitchen drawer and are inaccessible to children. Children nap on mats in family room. Licensee stated there are no medications in the home.

Safe and age-appropriate toys, play equipment and materials were observed. The smoke detector, carbon monoxide detector and Fire Extinguisher (2A10BC) are all in operable condition. Electrical outlets are inaccessible. No recalled and or prohibited toys or sleep/ play equipment were observed on the premises. There is a designated area for ill children as necessary in the living room. Per Licensee, there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (land line).

Bathroom: LPA observed toilet and faucet are clean and operable. There are no shampoos or cleaning products in bathroom #1. Water temperature is appropriate and toilet paper and paper towels are readily available.

Continued on LIC 809-C

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Annelise Villa
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2023

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: GARCIA FAMILY CHILD CARE	FACILITY NUMBER: 198014759
	VISIT DATE: 06/23/2023

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Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. The home has a clean and fully stocked refrigerator/freezer. Breakfast, lunch, dinner, and snacks are provided. Licensee stated she is not a participant in a food program.

Outdoor: The front yard is off limits. The front yard is made inaccessible by a door with a lock. The front yard is completely fenced in. Per licensee, there is one dog on the premises. LPAs observed age-appropriate toys, well secured and safe for children.

Pools/Spas/Bodies of Water: There are no bodies of water in the premises.

Advisory/Other: First Aid kit was observed in the family room with supplies readily available. CPR/First Aid expires 6/17/2025. Licensee does could locate mandated reporter training. Licensee will retake Mandated Reporter training and send proof of completion to LPA Villa no later than 6/26/2023. LPA reminded licensee mandated reporter training and CPR must be completed every 2 years.

The facility annual fees are current. Licensee had all the required posted documents: Facility License (LIC 203), Notice of Parent's Rights Poster (PUB 394), Emergency Disaster Plan (LIC 610A), and Earthquake Preparedness Checklist (LIC 9148). Children files were found to be complete. Last fire/disaster drill log is maintained current and last drill was completed on 4/11/2023.

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

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.

Continued on LIC 809-C

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Annelise Villa
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2023

LIC809 (FAS) - (06/04)

Page: 2 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: GARCIA FAMILY CHILD CARE	FACILITY NUMBER: 198014759
	VISIT DATE: 06/23/2023

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LPAs discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPAs 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.

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

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Annelise Villa
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2023

LIC809 (FAS) - (06/04)

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