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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364843735
Report Date: 07/19/2023
Date Signed: 07/19/2023 01:04:06 PM

Document Has Been Signed on 07/19/2023 01:04 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:FIGUEROA DE GARCIA FAMILY CHILD CAREFACILITY NUMBER:
364843735
ADMINISTRATOR:IRMA FIGUEROA DE GARCIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 782-7959
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
07/19/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:29 AM
MET WITH:Irma Figueroa De Garcia, LicenseeTIME COMPLETED:
01:00 PM
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On July 19, 2023, Licensing Program Analyst (LPA), Calloway made an unannounced inspection visit to the above facility. The purpose of the inspection is to conduct an Annual/Random Inspection. LPA met with Licensee who granted access. LPA toured the facility with the Licensee. Care and supervision are provided as a Large Family Child Care for the capacity of 14 children. Upon arrival there was Licensee, spouse, three (3) day care children in care, and Licensee’s infant grandson. There are seven (7) children enrolled in the family childcare and 3 children were present during the time of this inspection. Licensee, spouse, 1 adult son reside in the home and have all Criminal Record Clearance. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, poisons, detergents/cleaning compounds, medicines and hazardous items that can pose a danger to children.
Physical Plant: This is a single-story house with 4 bedrooms, 3 bathrooms, kitchen/dining room, living room, and attached garage. Per Licensee the living room, 1 bathroom, 1 bedroom and backyard are accessible and utilized for the family childcare. LPA observed all items are made inaccessible to children during the time of this inspection. Child bathroom has an area being used as a storage area with items stacked up high. LPA asked for those items to be removed. Kitchen entry was gated (inaccessible). Per licensee meals and snacks are being provided to children. LPA observed age-appropriate safe toys and napping equipment (playpens and mats).
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE: DATE: 07/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/19/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: FIGUEROA DE GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 364843735
VISIT DATE: 07/19/2023
NARRATIVE
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Per licensee children nap in Bedroom #1. LPA observed all electrical outlets made inaccessible to children with safety covers. The roster is not complete with physician’s information. Per licensee, there are no weapons or firearms on the premises. LPA did not observe any weapons or firearms. Sharps/knives are kept up high in kitchen(gated) which could pose a danger to the children in care. Medication is stored (kitchen cabinet) Cleaning compounds are stored (under kitchen sink). LPA observed the required fire extinguisher (2A10BC) fully charged, smoke detectors and carbon monoxide devices tested operable. The First Aid Kit is complete with supplies and no first aid manual. The home has central heating and AC.

Outside: Backyard equipped with age-appropriate Little Tyke toys and a round play apparatus. There was grass and concreted area for play and a table and chairs with umbrella for shade. There is no spa/swimming pool, or bodies of water on the premises.

Off Limits: Per licensee off-limit areas of the home are Bedrooms 2, 3, and 4, Bathrooms 2 and 3, kitchen, living room, and garage.


Other: Licensee has current Pediatric CPR and First Aid Training with expiration date (02/2025). Immunizations verified and mandated reporter training verified current. Transportation is being provided for children. Valid liability insurance and vehicle registration verified. Staff and children’s files were reviewed. Spouse is interacting with the children and does not have current TB or immunizations. LPA informed Licensee anyone living the home must have TB test and if they are interacting with the children, immunized against measles, mumps, pertussis, and rubella. Postings were not current with Disaster/Fire Drills nor was there a log.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2023
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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: FIGUEROA DE GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 364843735
VISIT DATE: 07/19/2023
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The following was discussed with the Licensee: Capacity requirements, IMS services, Notification of Parent's Rights (posted with updated address), Roster requirements (keep updated names and physician information), Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children’s files and provider’s files, updated Safe Sleep regulations were provided and discussed. The role and responsibilities of being a mandated reporter were reviewed. Everyone working in the home must renew mandated reporter training every two (2) years. www.mandatedreporterca.com. Licensee reminded that 100% supervision is always required to children in care. If food is brought in, it is properly labeled. Check food expiration dates periodically. Licensee was advised on how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov. Licensee was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care. Licensee advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Report Unusual Incidents to Licensing (LIC 624B) within 24 hours of incident occurring. Licensing must always have the facility’s phone number; if the phone number is changed, licensing must be notified. Regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare home and in those areas of the family day care home where children are present (24/7 ban). Type A citation: Type A citation(s) shall be posted for 30 consecutive days along with the Notice of Site Visit Letter (printed out after every visit) and posted during hours of operation, as there is/are immediate risk(s) to the health, safety, or personal rights of children in care. Licensee shall provide a copy any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2023
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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: FIGUEROA DE GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 364843735
VISIT DATE: 07/19/2023
NARRATIVE
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statement, must be placed in the child's file for verification. Failure to do so will result in a Civil Penalty being assessed. State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category. Licensee is advised visit www.shotsforschool.org for Immunization information.

--Licensee was informed of responsibility to report suspected Child Abuse, 1-800-827-8724/760-243-6640 --Family Child Care Providers (Disaster Planning information): https://cccld.childcarevideos.org/family-child-care-providers/disaster-planning-and-fire-safety/


--Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov
--Child Care Videos: https://ccld.childcarevideos.org
--Licensee advised to visit the CCL website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.

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
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2023
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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: FIGUEROA DE GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 364843735
VISIT DATE: 07/19/2023
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The On Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm. LPA provided consultation (Safe Sleep) during the inspection.

There are deficiencies cited during this inspection. See 809 D pages.

An exit interview was conducted, LPA read and provided a copy of this report and Notice of Site Visit were given to Irma Figueroa De Garcia, Licensee at the facility. Failure to maintain posting of Notice of Site Visit will result in a $100 Civil Penalty.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2023
LIC809 (FAS) - (06/04)
Page: 2 of 8
Document Has Been Signed on 07/19/2023 01:04 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 07/19/2023 at 12:44 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: FIGUEROA DE GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 364843735

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/19/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)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: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. 1. The licensee shall document the drills, including the date and time of each drill. This documentation shall kept at the family child care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation,interview, record review, the licensee did not comply with the section cited above in proof of Disaster/Fire Drill log and documentation which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/31/2023
Plan of Correction
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Licensee willl provide proof of Disaster/Fire log by POC date 0f 7/31/23 to Licensing.

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:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 07/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/19/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/19/2023 01:04 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 07/19/2023 at 12:44 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: FIGUEROA DE GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 364843735

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/19/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
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
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Based on observation interview record review, the licensee did not comply with the section cited above in one out of two staff S2 did not mandated reporter training which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/31/2023
Plan of Correction
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Licensee will provide proof of manadated reporter training to Licensing by POC date of 7/31/23 for spouse.
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 observation interview record review, the licensee did not comply with the section cited above in one out of two Staff S2 does not have CPR training which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/31/2023
Plan of Correction
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Licensee will provide proof of CPR training for spouse to Licensing by POC date of 7/31/23
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:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 07/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/19/2023


LIC809 (FAS) - (06/04)
Page: 7 of 8
Document Has Been Signed on 07/19/2023 01:04 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 07/19/2023 at 12:44 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: FIGUEROA DE GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 364843735

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/19/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation interview record review, the licensee did not comply with the section cited above in one out of two Staff S2 did not have current immunizations to interact with children which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/31/2023
Plan of Correction
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Licensee will provide proof of immunizations for spouse to Licensing by POC date of 7/31/23
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
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Based on observation interview record review, the licensee did not comply with the section cited above in the facility roster is not complete with the physician's information for each child in care which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/31/2023
Plan of Correction
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Licensee will provide a copy of a complete facility roster to Licensing by POC date of 7/31/23
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:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 07/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/19/2023


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