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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700230
Report Date: 08/22/2023
Date Signed: 08/22/2023 12:22:11 PM

Document Has Been Signed on 08/22/2023 12:22 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:RODRIGUEZ FAMILY CHILD CAREFACILITY NUMBER:
367700230
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
08/22/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:MARIA RODRIGUEZTIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Babatunde Ibitoye made unannounced visit to the Rodriguez Family Child Care Home to conduct an Increase in the Capacity inspection. LPA met with Licensee Maria Rodriguez. During the visit, LPA toured the home and grounds accessible to day-care children. Currently residing in the home is the Licensee, Husband, and Adult daughter. Main care is provided in living room (at entrance). Children use the bathroom adjacent to living room and Bedroom #2. Off limits areas include Bedroom #1,#3, #4, bathroom #2, and kitchen. There is a wood burning stove located in the living room which is inaccessible to children with a gate barrier .

Daycare equipment was evaluated.Per the licensee, there are weapons or firearms on the premises. There is swimming pool on the premises at the backyard , a fence measuring over 5 feet high, the gate opens away from the swimming pool, self-latches, and self closes, swimming pool fence meets Title 22 Regulations. The backyard is completely fenced. There is a swing/slide anchored to the ground. There are two dogs that stay in dog run, 15 chickens that stay in chicken coop, 2 parakeets .The facility has a tetherball and other age appropriate outdoor toys for children to use . Operable 2A10BC fire extinguisher, smoke alarm, and carbon monoxide detector are operable and in place. Central heat and air are available. LPA observed safe toys, safe indoor and outdoor play areas, and child safety plugs in unused electrical outlets. The home was inspected inside and out for safety, comfort, and cleanliness.

Licensee was informed that in the future if any other adult moves in and lives in this home they must be live scan cleared and TB cleared. The assistant providing care/supervisor also needed to be fingerprinted and cleared, TB cleared, immunized against influenza, pertussis, and measles, and complete the online mandated reporter training. Licensee has current CPR and First Aid Training with an expiration date of 6/17/2025. LPA discussed the practice of fire drills at least every 6 months, and documented the time and who was present. Licensee documented fire drill was conducted on 8/14/2023. Fire clearance was granted on 8/14/2023.

Planned hours of operation are Monday - Friday 23 hours.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE: DATE: 08/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/22/2023
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: RODRIGUEZ FAMILY CHILD CARE
FACILITY NUMBER: 367700230
VISIT DATE: 08/22/2023
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No Incidental Medical Services (IMS) are provided at this time. 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters, and other important information communication platforms.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication

This home meets the description of a safe and healthy environment for children as described in Chapter 3, Division 12, Title 22 of the California Code of Regulations.

An exit interview was conducted, and a copy of this report was reviewed and provided to the licensee Maria Rodguez.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023
LIC809 (FAS) - (06/04)
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