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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364818951
Report Date: 04/11/2024
Date Signed: 04/11/2024 04:36:10 PM

Document Has Been Signed on 04/11/2024 04:36 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:GAMINO FAMILY CHILD CAREFACILITY NUMBER:
364818951
ADMINISTRATOR/
DIRECTOR:		GAMINO, MARIA A.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 241-4218
CITY:VICTORVILLESTATE: CAZIP CODE:
92395
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
04/11/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:46 AM
MET WITH:Maria GaminoTIME VISIT/
INSPECTION COMPLETED:
04:35 PM
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On April 11, 2024, Licensing Program Analysts (LPAs ) Kris Diaz and Sherell Braddock, conducted an unannounced Annual/Random Inspection. LPAs met with Licensee, Maria Gamino who partially guided LPAs on a tour of the home. Licensee’s main concern was being with and caring for the children. People who reside in the home are Licensee, her spouse, her mother, and her adult son who are live scanned and have TB skin test on file. LPA did not observe TB skin test for adult son. LPA advised licensee that all adults need TB skin test. The large family childcare home operates Monday-Friday, 7:30am-5:30pm. At the time of the visit there were 8 children present with 2 staff members.

This is a one-story home with 4 bedrooms, 3 bathrooms, kitchen/dining room, living room, and garage (converted for childcare). Children have access to the childcare room and the restroom in the hallway to the right of the entrance. Off-limit areas of the home are the bedrooms and part of the backyard that is made inaccessible with a short gate. There is also another section of the backyard that is made off limits with a chain link fence. There is no body of water or swimming pool on the premises. LPAs advised licensee that she is permitted to have water play including small kid sized pools as long as the children are visually supervised 100% of the time while in use and all water is discarded immediately after use. The bedrooms are made inaccessible with a safety gate in the hallway. LPAs observed two dogs in the facility and accessible to children. Per licensee, the dogs are current on vaccinations. LPAs advised licensee to place a copy of the dogs’ records in facility file. LPAs observed a bouncer in the childcare room. LPAs advised and observed licensee remove and place in inaccessible area. LPAs observed torn child sofa and advised licensee to remove today. LPAs observed washer and dryer in childcare room and advised licensee to place safety gate to make inaccessible. LPAs observed an accessible fireplace and advised licensee to place safety lock, gate, or screen to make it inaccessible. LPAs observed grill in the outside play area accessible to children. LPA advised licensee to place a cover and lock to make it inaccessible or move to off-limits area of the backyard.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kristina Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/11/2024
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: GAMINO FAMILY CHILD CARE
FACILITY NUMBER: 364818951
VISIT DATE: 04/11/2024
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LPAs observed unlocked shed in the backyard with the key in the lock. LPA observed fertilizers, insect poisons, and power equipment in the shed. LPA advised licensee to do a thorough walk-thru daily before childcare hours to ensure everything that should be inaccessible is made so before children arrive. LPA observed soaps and shampoos in shower of children’s restroom and advised licensee to remove. LPAs observed razors, melatonin, and toiletries in the mirror cabinet in the restroom and under the sink that are accessible to children in care. LPA advised licensee to place lock or safety latches on cabinets under restroom sink and mirror cabinet to make them inaccessible to children. LPA advised licensee to place safety lock on cabinets outside the restroom to make potentially hazardous materials inaccessible. LPA advised licensee to either place a safety gate to make kitchen completely inaccessible or place safety latches on all lower cabinets.

The home was inspected inside for comfort, cleanliness, telephone service, heating, and ventilation. Per licensee, medications are stored in an upper kitchen cabinet inaccessible to children in care. The kitchen knives are stored in the kitchen pantry on an upper kitchen cabinet. LPA advised licensee to place safety knob on door or place safety gate to make kitchen inaccessible. Cleaning compounds are stored in the hallway cabinet in off-limits area of the facility inaccessible to children.

The First Aid kit is located in the hallway cabinet on an upper shelf inaccessible to children. Per licensee, there are no weapons or firearms in the home. LPAs did not observe any weapons or firearms. Smoke detectors and carbon monoxide detectors are in operable condition. The Fire Extinguisher is green, fully charged, and meets the standards of the State Fire Marshal. LPA observed regular doorknobs on the entrances and exits of the facility. LPA advised licensee to replace knobs with single action handles (3 doors) and provided licensee with PIN 23-11-CCP. LPA did not observe fire-pull station in facility. Due to date of licensing the fire pull station was not required at the time. LPA advised licensee to get a wired fire pull station installed. LPA informed licensee that once station is installed and doorknobs are changed LPA will schedule new fire inspection. The licensee’s Pediatric CPR/First Aid expired March 2024. LPA advised licensee that she must have valid Pediatric First Aid/CPR and provide proof upon request from licensing. The licensee has the required immunizations against pertussis (TDAP) and measles (MMR) and Influenza. LPA provided blank Declination statements for licensee and all residents and employees of the facility to place in files and advised of the requirement to either get vaccinated against Influenza or provide statement of declination annually between August 1 and December 1.

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

DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2024
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: GAMINO FAMILY CHILD CARE
FACILITY NUMBER: 364818951
VISIT DATE: 04/11/2024
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The licensee stated she was unaware of the requirement to complete Mandated Reporter training every two years. LPA advised licensee that she and her staff must complete the training annually every two years and place proof of completion in files. Preventative Health and Safety Training was completed in 2007. LPA advised licensee to complete required training again due to the nutrition and lead components not being required at the time of her licensing. LPA observed 3 of 8 children’s files to be complete and contain required documents. LPA did not observe LIC 9227 or infant sleep log for 1 of 1 infant in care. Licensee stated, “I don’t do that.” LPA provided PIN 20-22-CCP and went over the bullet points with licensee. LPA explained the required forms and provided copies of LIC 9227 and an infant sleep log. LPA advised licensee to take another orientation class for FCCH to update self on pertinent information and regulations required to operate FCCH. Licensee stated she does not have time to read the emails she receives from CCLD and has not committed time to keeping up with regulations. LPA asked licensee if she would like to receive services from the Technical Support Program (TSP).

The required posted documents were posted and located in the childcare room: Notification of Parent's Rights Poster (PUB394), Emergency Disaster Plan (LIC610A), and Earthquake Preparedness Checklist (LIC9148) LPA provided licensee with a copy to post.

The following was discussed with the licensee:

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 licensee was reminded that 100% supervision is required at all times to children in care; Licensee was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care; 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.

LPAS discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as

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

DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2024
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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: GAMINO FAMILY CHILD CARE
FACILITY NUMBER: 364818951
VISIT DATE: 04/11/2024
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an additional resource. LPA also provided PIN 20-24-CCP and discussed with licensee. 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.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

The licensee 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 licensee was informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department.

Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, licensees, directors, and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Licensee 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: 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.

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

DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2024
LIC809 (FAS) - (06/04)
Page: 4 of 39
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: GAMINO FAMILY CHILD CARE
FACILITY NUMBER: 364818951
VISIT DATE: 04/11/2024
NARRATIVE
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 Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

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.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

The licensee 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

LPAS confirmed that there are no Registered Sex Offenders living in the facility and completed the RSO profile in FAS during the file review.

During this visit 5 type A violations, 4 type B violations, 1 technical violation and several technical assistances were issued. Licensee agreed to accept help from the TSP program. LPA will complete referral upon return to the Palmdale RO.

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

DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2024
LIC809 (FAS) - (06/04)
Page: 5 of 39
Document Has Been Signed on 04/11/2024 04:36 PM - It Cannot Be Edited


Created By: Kristina Diaz On 04/11/2024 at 03:51 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: GAMINO FAMILY CHILD CARE
FACILITY NUMBER: 364818951

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/11/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(1)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in 1 out of 1 places which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 04/15/2024
Plan of Correction
1
2
3
4
Licensee will place safety lock, safety screen, or cover over fireplace to make it inaccessible by POC due date.
Type A
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in 1 out of 1 places which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 04/12/2024
Plan of Correction
1
2
3
4
LPA observed licensee lock the shed containing poisons. Licensee will walk through the facility each morning before opening to ensure facility is safe and all inaccessible areas are made inaccessible.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claretta Yates
LICENSING EVALUATOR NAME:Kristina Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 04/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/11/2024


LIC809 (FAS) - (06/04)
Page: 6 of 39
Document Has Been Signed on 04/11/2024 04:36 PM - It Cannot Be Edited


Created By: Kristina Diaz On 04/11/2024 at 03:51 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: GAMINO FAMILY CHILD CARE
FACILITY NUMBER: 364818951

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/11/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102425(j)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview, and record review, the licensee did not comply with the section cited above in 1 out of 1 persons which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 04/12/2024
Plan of Correction
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2
3
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LPA provided licensee with infant sleep log and LIC 9227. Licensee began logging infant sleep during visit and will maintain log going forward.
Type A
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, interview, and record review, the licensee did not comply with the section cited above in 2 out of 2 persons which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 04/15/2024
Plan of Correction
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2
3
4
Licensee and staff will complete and provide proof by COB on POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claretta Yates
LICENSING EVALUATOR NAME:Kristina Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 04/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/11/2024


LIC809 (FAS) - (06/04)
Page: 7 of 39
Document Has Been Signed on 04/11/2024 04:36 PM - It Cannot Be Edited


Created By: Kristina Diaz On 04/11/2024 at 03:51 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: GAMINO FAMILY CHILD CARE
FACILITY NUMBER: 364818951

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/11/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and record review, the licensee did not comply with the section cited above in 1 out of 1 persons which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 04/15/2024
Plan of Correction
1
2
3
4
Licensee will provide proof of registration for EMSA approved or American Heart Association or American Red Cross class by COB on POC due date.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claretta Yates
LICENSING EVALUATOR NAME:Kristina Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 04/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/11/2024


LIC809 (FAS) - (06/04)
Page: 8 of 39
Document Has Been Signed on 04/11/2024 04:36 PM - It Cannot Be Edited


Created By: Kristina Diaz On 04/11/2024 at 03:51 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: GAMINO FAMILY CHILD CARE
FACILITY NUMBER: 364818951

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/11/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(b)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in 1 out of 1 persons which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/12/2024
Plan of Correction
1
2
3
4
LPA observed licensee remove toys from pack n play. LPA provided licensee with PIN 20-24-CCP Licensee will follow safe sleep regulations for infants.
Type B
Section Cited
CCR
102416.1(a)
Personnel Records
(a) Personnel records shall be maintained on each employee and shall contain the following information:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review and interview, the licensee did not comply with the section cited above in 2 out of 2 persons, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/11/2024
Plan of Correction
1
2
3
4
Licensee wiil create and maintain staff files by POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claretta Yates
LICENSING EVALUATOR NAME:Kristina Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 04/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/11/2024


LIC809 (FAS) - (06/04)
Page: 9 of 39
Document Has Been Signed on 04/11/2024 04:36 PM - It Cannot Be Edited


Created By: Kristina Diaz On 04/11/2024 at 03:51 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: GAMINO FAMILY CHILD CARE
FACILITY NUMBER: 364818951

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/11/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and record review, the licensee did not comply with the section cited above in 1 out of 1 requirements which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/15/2024
Plan of Correction
1
2
3
4
Licensee will create and maintain facility roster by COB on POC due date
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the licensee did not comply with the section cited above in 1 out of 1 persons which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/15/2024
Plan of Correction
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Licensee will have parents fill out and place in infants file by COB on POC due date
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claretta Yates
LICENSING EVALUATOR NAME:Kristina Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 04/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/11/2024


LIC809 (FAS) - (06/04)
Page: 10 of 39
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: GAMINO FAMILY CHILD CARE
FACILITY NUMBER: 364818951
VISIT DATE: 04/11/2024
NARRATIVE
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LPA advised licensee that LIC 9224 must be signed by all parents of enrolled children and report must be shown to the parents as well as any new families enrolled within 12 months. Violations could result in civil penalties.

This inspection visit was conducted in person. The report was read, and a copy was provided to the licensee, Maria Gamino. Notice of Site Visit was given and must remain posted for 30 days. Exit interview was conducted.

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

DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2024
LIC809 (FAS) - (06/04)
Page: 39 of 39