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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700123
Report Date: 05/23/2022
Date Signed: 05/23/2022 12:02:07 PM

Document Has Been Signed on 05/23/2022 12:02 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:SASIS FAMILY CHILD CAREFACILITY NUMBER:
367700123
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 7DATE:
05/23/2022
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Celinna Sasis, LicenseeTIME COMPLETED:
12:15 PM
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LPA Maddox met with Licensee, Celinna Sasis today for the purpose of conducting capacity increase inspection. Upon arrival LPA counted 7 PS age children alone with Licensee. This is a 2 story Townhouse with 3 bedrooms, 3 bathrooms. Family members residing in the home include 2 adults (Licensee and her spouse). All adults in the home have fingerprint clearances and exams for T.B., LPA verified Licensee has required immunization's. **There are no pools, spas or any other bodies of water observed on the premises. Main area of care is conducted in the family room (located next to kitchen) and loft (upstairs). Children will have access to 2 bathrooms (1 upstairs and 1 downstairs). Off limit areas include all bedrooms # 1-3, master bathroom, and garage. The hours of operation will are from 8:30am - 11:30 am. LPA explained to Licensee to notify the Department if her hours change. Licensee states she does not care for infants at this time.

The kitchen and bathroom were toured and inspected for proper storage of chemicals, detergents, cleaning compounds, medications and sharp pointed objects, all items were made inaccessible to children. All unused electrical outlets are plugged and play equipment and toys are available.
The backyard is completely fenced. There are 2 dogs on the premises (vaccinations verified).
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE: DATE: 05/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/23/2022
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: SASIS FAMILY CHILD CARE
FACILITY NUMBER: 367700123
VISIT DATE: 05/23/2022
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Licensee has current CPR and First Aid training (exp 1/22/24) Health and Safety Training verified (dated 12/8/19). Per Licensee, there are weapons in the home stored according to Regulations. The required fire extinguisher (2A 10BC), smoke detector, and carbon monoxide devises were are present and in operable condition. Licensee has maintained a current roster and has documented Emergency Disaster drills no less than twice a year.

The Licensee is reminded of the requirement to report and unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC 624B.

******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 o 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 - Not at this time

Fire Clearance has been received for a large capacity. The On Duty Worker is available for questions at 661-202-3318 Monday through Friday 8am-5pm. Exit Interview conducted a copy of this report is discussed and left at the facility.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2022
LIC809 (FAS) - (06/04)
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