367700237-9-18-2023-12-CC-KDIZ-CVSUXT-20230918155851

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 367700237
Report Date: 09/18/2023
Date Signed: 09/18/2023 03:59:09 PM

Document Has Been Signed on 09/18/2023 03:59 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:	RODRIGUEZ FAMILY CHILD CARE		FACILITY NUMBER:	367700237
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 6	DATE:	09/18/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:05 PM
MET WITH:	Cindy Rodriguez		TIME COMPLETED:	04:05 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 9.18.23, Licensing Program Analyst (LPA) Kris Diaz met with the Licensee, Cindy Rodriguez for an unannounced annual/random inspection. The licensee gave access to the home and guided LPA on tour. People who reside in the home are the licensee, her spouse, and her two minor children (11, 14). Both adults have fingerprint clearance and TB Test. The licensee has the required immunizations against pertussis (TDAP), measles (MMR) and provided a statement declining the flu vaccine. At the time of the visit licensee had 6 children in care (2 infants, 4 3-4yo). LPA reminded licensee that 100% supervision required at all times when children in care. Per the licensee, the small family childcare home operates 24 hours/day 7days/week. LPA reminded licensee that someone should always be awake when the children are awake. Incidental Medical Services (IMS) were discussed. Per the licensee, she does not have childcare children who need IMS currently. This is a one-story home with 4 bedrooms, 3 bathrooms, kitchen, dining room, family room, living room, laundry room, and attached garage. There is no pool/or body of water on the premises. The children have access to the living room where the main childcare is provided, the kitchen, dining room, family room, and backyard. Children have access to bathroom down the hallway to the right. LPA advised licensee to place safety latches on all lower cabinets in the kitchen. LPA observed several age-appropriate toys, books, play structures, and activities in the childcare area and backyard. Off-limit areas include the laundry room, bedrooms, and garage. Per licensee, older children are present Fri.-Sat. LPA advised licensee to place a safety gate or locks on cabinets in kitchen when older children are present to make inaccessible. The family room has a fireplace. LPA observed licensee place cover in front during visit. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds (kept in upper kitchen cabinet inaccessible to children), medicines (kept in kitchen cabinet above refrigerator inaccessible to children), and hazardous items that can pose a danger to children.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kristina Diaz
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

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: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 367700237
	VISIT DATE: 09/18/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Sharp knives are kept in upper kitchen cabinet inaccessible to children. The facility roster is complete and maintained current. LPA observed fire/earthquake drills log is kept current. The licensee has two small dogs, a large dog, and a cat. The animals are accessible to children, and LPA observed all current immunizations.
Per licensee, there are no weapons or firearms of any kind in the facility. The LPA did not observe any weapons. Children nap in the childcare room and the infants nap in cribs in the family room. Mats and blankets are provided for napping. The required fire extinguisher (2A10BC), smoke detector and carbon monoxide detector are in operable condition. Home has central air and heat. LPA observed current Pediatric CPR/First for licensee and her assistant that expires 4/2025 and 2/2025. The licensee has a first aid kit in an upper kitchen cabinet that is inaccessible to children. LPA observed the parent board and required documents are posted. LPA observed current mandated reporter training completed on 1/12/23.

The following was discussed with the licensee:
Mandatory Forms for the children’s files and provider’s files, Requirements for fire drills, earthquake drills and documentation for both. Role and responsibilities of being a mandated reporter were reviewed. Licensee reminded that 100% supervision is required at all times to children in care. The licensee was advised 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. The licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in 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 tobacco in a private residence that is licensed as a family childcare home and in those areas of the family childcare home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category.

Requirements for fingerprint clearances and associations were discussed with the licensee. Licensee can be cited a civil penalty of $100 per day, up to $500.00 for the 1st offense and up to $3000.00 for the 2nd offense within a 12-month period, PER PERSON.

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. Licensees must meet requirements as a precondition to licensure.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kristina Diaz
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 367700237
	VISIT DATE: 09/18/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

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.

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

Licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B. Handout of Safe Sleep Concepts was given to the licensee.

Licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent and a copy of the Acknowledgment of receipt of licensing report (LIC9224) must be kept in each child's file. In addition, any child enrolled within the following 12 months must also receive a copy of the Type A Citation.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email to:
inspectionprocess@dss.ca.gov

For additional information regarding the inspection and its tools and methods, please visit the CCLD website
at: https://www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

This inspection was conducted in person. The report was read with the licensee. A copy of this report and the Notice of Site Visit was provided to licensee, Cindy Rodriguez. Exit interview was conducted.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kristina Diaz
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3