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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364814533
Report Date: 12/02/2024
Date Signed: 01/15/2025 10:18:43 AM

Document Has Been Signed on 01/15/2025 10:18 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:SALAZAR FAMILY CHILD CAREFACILITY NUMBER:
364814533
ADMINISTRATOR/
DIRECTOR:		SALAZAR, UNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(725) 300-5844
CITY:BARSTOWSTATE: CAZIP CODE:
92311
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
12/02/2024
TYPE OF VISIT:OfficeANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Licensee Un SalazarTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 1/15/2024, LPA Pittman amended the report to make a correction on Page 2 of the report. On 12/02/2024 at 11:00 AM, an Informal Office Meeting was conducted at the Palmdale Regional Office. Present during the meeting were Regional Manager (RM) George Mingle, Licensing Program Manager (LPM) Mariela Ramon, Licensing Program Analyst (LPA) Andrea Pittman, and Licensee Un Salazar was present with their Representatives: Ashenden Salazar and Seran Choe.

The goal of this meeting is for the Licensee to achieve and maintain facility compliance with Title 22 California Code of Regulations and to work collaboratively to promote the safety and well-being of the children in care. The Department strives to foster positive interactions to help achieve healthy relationships between the Department and Licensees.

The following Title 22 Regulations and policies were discussed: During this Informal Meeting, we addressed a substantiated complaint finding, a violation of criminal record clearance, definitions, revocation, penalties, operation of a family child care home, unlicensed care, and suspension of the license.

On October 23, 2024, the Department substantiated a violation of the license and on August 7, 2024, during a Case Management Inspection, the facility was cited for criminal record clearance.

The following issues were discussed:

· License- The license shall not be transferred to other individuals or locations.


· Criminal Record Clearance - All adults residing/working/volunteering in the home shall obtain a California Criminal record clearance or exemption prior to their presence in the facility.
· Penalties - Subsequent violations within a 12-month period will result in a civil penalty of $100.00 per violation per day for a maximum of 30 days.
· Reporting Requirements – the licensee shall report unusual incidents that occurred at the facility.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE: DATE: 12/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/02/2024
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: SALAZAR FAMILY CHILD CARE
FACILITY NUMBER: 364814533
VISIT DATE: 12/02/2024
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In response to these discussions, the licensee has stated the following:
The Licensee stated they moved back to the family child care home the same day the citation was received.
The Licensee shall ensure children are provided with a safe and healthful environment.
The Licensee shall operate the facility in compliance with Title 22, Division 12 Child Care Home Regulations always.

The Licensee will watch the following training videos and complete summaries for each video on CCLD website: https://ccld.childcarevideos.org/ and submit summaries for each video to LPA Pittman no later than 1/6/2025 via e-mail to LPA Pittman at andrea.pittman@dss.ca.gov and the LPM Ramon at mariela.ramon@dss.ca.gov.

- Background check for caregivers
-Supervising children in family childcare
-Reporting Requirements
-What is a civil penalty?
-Children's personal rights in child care

During this meeting, it was discussed the importance of maintaining the facility in substantial compliance. The department recognizes the potential for the licensee to rectify these issues and emphasizes the importance of adhering to Title 22 Regulations.

A copy of this report must be provided to the authorized representatives of all currently enrolled children and must also be provided to newly enrolled children for the next 12 months. The report shall be provided no later than the next business day or the next day the child is in care.

The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC 9224) shall be signed and kept in each of the children’s records. Web site address to obtain forms, review quarterly updates, review Title 22 & Health & Safety Codes is: https://www.cdss.ca.gov/inforesources/child-care-licensing

Copies of this report must be posted for 30 days in a visible location for the authorized representatives of children to review. Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2024
LIC809 (FAS) - (06/04)
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