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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364843665
Report Date: 10/24/2023
Date Signed: 10/24/2023 02:23:00 PM

Document Has Been Signed on 10/24/2023 02:23 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:BECK-CHAVEZ FAMILY CHILD CAREFACILITY NUMBER:
364843665
ADMINISTRATOR:N. BECK-A. CHAVEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 792-8316
CITY:APPLE VALLEYSTATE: CAZIP CODE:
92308
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 14DATE:
10/24/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Natalie Beck-Chavez and Alfonso Chavez,Licensee's TIME COMPLETED:
02:45 PM
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On 10/24/2023 Licensing Program Analyst (LPA) Justeene Tamayo met with Licensee's Natalie Beck-Chavez and Alfonso Chavez, who guided analyst on a tour of the facility for the One Year Required inspection. This is one story, 4 bedroom, 3 bathroom home with kitchen/dining, family room, living room, laundry room and garage. There is no pool/spa or body of water on the premises. Upon arrival LPA observed 5 infants, 8 preschool children, and 1 school age child in care, along with both co-licensee's. Family members residing in the home include 3 adults (licensee, co-licensee, and licensee's daughter) and 1 minor child. Facility operation are Monday-Friday 7AM-5:30PM. Incidental Medical Services (IMS) policy was discussed.

Facility has been cited a Type A citation for being out of ratio. LPA observed 5 infants in care, which poses an immediate health and safety risk to children in care. Please see LIC809-D for deficiency page. This report cites a Type A violation and shall be provided to the parents/guardians of children currently enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 and must be kept in each child's file.

Physical Plant: Per Licensee, the garage converted room, separate playroom in the garage, 1 bathroom and the enclosed backyard play area specifically for children are utilized for the family child care activity area. Children use the bathroom in hallway on the left. Off-limit areas of the home living room, kitchen, 4 bedroom and 2 bathrooms on the inside of the house and extended fences off backyard area. The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (in laundry room off limits), medicines (master bedroom-off limits) and hazardous items (sharp knives in kitchen drawers) hat can pose a danger to children. LPA observed the kitchen area to be barricaded by a safety gate.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 10/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/24/2023
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: BECK-CHAVEZ FAMILY CHILD CARE
FACILITY NUMBER: 364843665
VISIT DATE: 10/24/2023
NARRATIVE
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LPA observed a fireplace in the the living room to be fully screened. Safe and age appropriate toys, play equipment and materials were observed. The smoke detector and carbon monoxide detector, Fire Extinguisher (2A10BC) are in operable condition. Per Licensee no one smokes in the home. Electrical outlets are inaccessible. LPA reminded licensee, no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/ play equipment are allowed. There is a designated area for ill children as necessary in family room. Per Licensee there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (cell).

Fire/Disaster Drill is complete and maintained current. Last Fire/Disaster Drill was completed on 10/20/2023

Roster complete and maintained current.

Bathroom: Shower/tub are free of hazards (child care bathroom). LPA did not observe any hazardous items in the children's bathroom. Toilet and faucet are clean and operable.

Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. If food is brought from the children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. The home has a clean and fully stocked refrigerator/freezer. Licensee currently has a food program. Breakfast, lunch, snacks and dinner are provided. Naps are provided on cots in the converted garage.

Outdoor: The backyard is safe for children. The backyard is completely fenced (with block cement). Per licensee, children only utilize the barricaded play area on the left hand side of the home. The rest of the backyard is fenced off and inaccessible to day care children in care. There is no body of water. LPA observed age appropriate toys. Per licensee, there are 5 pets on the premises (4 dogs and 1 cat).

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expired 03/31/2023. Licensee and Co-Licensee shall complete their CPR/First Aid and submit proof of completion to LPA Tamayo no later than 11/07/23. Mandated Reporter expires 01/08/2025 for both co-licensee's. There are no window cords accessible to children.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2023
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: BECK-CHAVEZ FAMILY CHILD CARE
FACILITY NUMBER: 364843665
VISIT DATE: 10/24/2023
NARRATIVE
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Documents Provided and or Discussed: Fire Drill Log, Roster, Postings, Safe Sleep PIN 20-24-CCP, Individual Sleeping Plan (LIC9227), and Safe Sleep Log. Licensee stated currently does not have child care insurance.

Licensee Beck-Chavez 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.

LPA discussed the safe sleep regulations with licensee Beck-Chavez and discussed the Child Care Licensing Safe Sleep webpage 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.

A notice of site visit was given to licensee and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Natalie Beck-Chavez, along with her appeal rights and Notice of Site Visit.

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

DATE: 10/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 10/24/2023 02:23 PM - It Cannot Be Edited


Created By: Justeene Tamayo On 10/24/2023 at 01:57 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: BECK-CHAVEZ FAMILY CHILD CARE
FACILITY NUMBER: 364843665

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.5(d)(2)
Staffing Ratio and Capacity
(d) For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either: (2) More than twelve and up to fourteen children only if the criteria in Section 1597.465 of the Health and Safety Code are met.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above. LPA Tamayo observed 5 infants in care, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/24/2023
Plan of Correction
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LPA observed two preschoolers and 1 infant leave the facility. Licensee is aware she can have no more than 3 infants with 14 children as long as two other children are ages 5 and 6 years of age. LPA provided licensee with a large ratio chart.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Mariela Ramon
LICENSING EVALUATOR NAME:Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:
DATE: 10/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/24/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/24/2023 02:23 PM - It Cannot Be Edited


Created By: Justeene Tamayo On 10/24/2023 at 01:57 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: BECK-CHAVEZ FAMILY CHILD CARE
FACILITY NUMBER: 364843665

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
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
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Based on record review, the licensee did not comply with the section cited above. Both licensee and co-licensee's CPR/First Aid expired on 03/21/23, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/07/2023
Plan of Correction
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Licensee and Co-Licensee will retake CPR/First Aid and send proof of completion cards to LPA Tamayo no later than 11/07/23.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Mariela Ramon
LICENSING EVALUATOR NAME:Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:
DATE: 10/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/24/2023


LIC809 (FAS) - (06/04)
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