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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700298
Report Date: 01/26/2023
Date Signed: 01/26/2023 04:22:10 PM

Document Has Been Signed on 01/26/2023 04:22 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:GARCIA FAMILY CHILD CAREFACILITY NUMBER:
367700298
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
01/26/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Mirna GarciaTIME COMPLETED:
04:30 PM
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On January 26, 2023, Licensing Program Analyst (LPA) Kuliema Calloway, met with Licensee for the purpose of conducting a Pre-Licensing Inspection. Applicant is requesting to provide care and supervision for a Small/Large Family Child Care Home for the capacity of 8 children. Currently residing in the home is the applicant and their three children only. Per applicant, family members residing in the home include Licensee as one (1) adult and three (3) children. All adults residing in the home has a Criminal Record Clearance (DOJ/FBI and Child Abuse Index Clearance. Applicant and LPA toured the home indoor and outdoor to ensure the home meets licensing requirements. Applicant is requesting the days and hours of operation will be: 7:00 Am to 5:00 AM. Monday through Friday for the Family Child Care.

The Home is set up as follows:
This is a single story home with four (4) bedrooms and two (2) bathrooms with a kitchen, living room, laundry room, garage, and family room. Per the Applicant the following areas of the home will be utilized for the Family Child Care: The living room, which is located on the right hand side once you enter the front door. There is a fireplace located in the family room which is made inaccessible to children with a screen/glass barrier and a gate around. The home was inspected for safety, comfort, cleanliness, telephone service, central air, and heat and ventilation. The home has central heating and air conditioning. All windows have screens and are free of cracks, bugs, and debris.

· Main Area: Childcare is provided in the living room. Children have access to the kitchen and not backyard at this time. LPA observed age-appropriate toys,books, and furniture for the children that is in good repair. The area is neat and clean. All unused electrical outlets are covered and made inaccessible to the children.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE: DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/26/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 367700298
VISIT DATE: 01/26/2023
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· Children's Bathroom (#1): Children use the bathroom down the hallway next to the laundry room. The Bathroom was toured and inspected sink/toilet is in operable condition. Toilet and faucets are clean, safe, and operable. There were no poisons or medications stored in the cabinets and drawers. The bathroom was observed to be free and clear of hazardous items. The bathroom was clean, sanitized, and in good repair.
· Kitchen/Dining Room: The kitchen was inspected there were no hazardous dangerous items observed in the upper drawers. The lower cabinets had pots and plastic containers secured with magnetic safety latches. In the kitchen, all sharp utensils were stored in a plastic container and inside the lower cabinets inaccessible to children with magnetic child safety latches on the cabinet doors. Eating, dining area for the children was located to the right of the kitchen with seating for at least seven and was clean and in good repair.
· Backyard: The backyard was inspected and off limits for now. The backyard is gated all around. Children do not play in the backyard. The left side has a small gate that accesses the side of the house and will be secured with a pad or combination lock. The right side of the backyard is not used for child care and is off-limits for children in care. There is dirt and no concreted area for active play. There are no swings or slides. There is debris in the yard that needs to be removed.
  • Off-Limit Areas: All four Bedrooms, the Garage, the Laundry Room, and Bathroom # 2. There are safety knobs, on the laundry room door that accesses the garage (enter from the laundry room). These areas are made inaccessible to children with safety knobs. LPA observed key locks on all the bedroom doors.
Other:

· AC/Heating Unit was observed. AC/Heating Unit is located in the back yard of the home. It is not covered. LPA informed licensee it needs to have a cover and made inaccessible to the children.

Electrical outlets: All unused electrical outlets are plugged with safety plugs and made inaccessible to children.

· Fire extinguisher (2A10BC): LPA observed there is a required fire extinguisher (2A10BC) that is reading in Green and located on the wall to the left of the kitchen it is not inaccessible to children. It meets standards established by the State Fire Marshall.


· Fireplace: The fireplace was observed in the family room and is screen/glass barrier and with a gate around it to make it inaccessible to the children.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 367700298
VISIT DATE: 01/26/2023
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  • Hanging window blind cords: The cords are tied and up high so that they are inaccessible to children.
· Incidental Medical Services (IMS): 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. The Licensee will not be providing IMS to the children at this time.
· Isolation area (Illness): Per the licensee, if the child shows signs of illness, he/she will be separated from other children and stay in the hallway leading to the off limits laundry room on a cot until parent(s) can pick up the child.
· Medications and cleaning solutions: Detergents/cleaning compounds are in kept in off limits Bathroom# 2.
· Napping: Children will nap in the designated nap areas with adult supervision. LPA observed four mats in the cubby shelf.
· Overnight Care: Pre-licensee, overnight care will be provided. Licensee is aware it can only be for 23 hours.
· Pets: LPA observed one (1) small kitten kept in off limit garage. They have current vaccinations and will not interact with the children.
· Phone service: There is a no working land line. Licensee does have a working cell phone.
· Smoke Detectors and Carbon Monoxide: There were four (4) smoke detectors and one (1) carbon monoxide devices tested and operable.
· The First Aid kit is located in the kitchen in a lower cabinets secured with the magnetic safety latches and made inaccessible to children. The First Aid Kit was observed complete with supplies and a first aid manual.
· Transportation: The licensee does not provide transportation for the children.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023
LIC809 (FAS) - (06/04)
Page: 3 of 7
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: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 367700298
VISIT DATE: 01/26/2023
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·Weapons or Firearms: Per Licensee, there are No Firearms at the facility at this time. LPA did not observe any firearms.
Hot Water: Was tested at a safe temperature between 105-120 degrees.
vDocumentation:
ü CPR/First Aid: LPA observed licensee has current Pediatric CPR and First Aid Training with expiration date 01/21/2025, a (1) hour of Nutrition Assessment Training on 8/31/2021, (8) hours of Preventive Health and Safety Training including (1) hour Nutrition and Lead Poisoning Prevention on July 31, 2022.
ü Mandated Reporter Training: Applicant completed the required training on 8/1/2022.
ü Criminal Record: Per Guardian, all adults who live in this facility obtained a criminal record clearance.
ü Facility fees: Per Licensing Information System, facility fees were current.
ü Emergency Disaster Plan: LIC 610 A was submitted and received by CCLD on 8/7/2022.
ü Immunization: The licensee has the required immunizations: Negative TB skin test, MMR and DTaP) and Influenza.
ü Valid Driver License: Applicant has a valid California Driver License with an expiration date of May 24, 2023.
ü Infant Sleeping Plan (LIC 9227) and Sleeping Log: LPA shared the Safe Sleeping Regulation with the licensee.
ü LPA observed necessary postings as required: Emergency Disaster Plan, Earthquake Preparedness, and Parent's Rights Poster.
Ø The following information was discussed with the Licensee:
ü Mandatory Forms for the children’s files and provider’s files.
ü Requirements for fire drills, earthquake drills, and documentation for both.
ü The licensee is reminded that 100% supervision is required for children at all times.
ü Capacity requirements, Roster requirements, Posting requirements, and Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children’s files and provider’s files, and Safe Sleep Awareness. The role and responsibilities of being a mandated reporter were reviewed. The licensee was reminded that supervision is always required for children in care.
ü Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility’s phone number; if the phone number is changed, licensing must be notified.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023
LIC809 (FAS) - (06/04)
Page: 4 of 7
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: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 367700298
VISIT DATE: 01/26/2023
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ü A licensed child care provider, administrator, or employee of the licensed child day car facility shall complete an on-line Mandated Reporter Training and shall renew the training every two (2) year at: www.mandatedreporter.com
ü 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 (LIC 624B).
ü The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot-line at 1-800-540-4000. Also, call the CCLD office and follow up with a written Unusual Incident/Injury Report (LIC 624B).
ü Criminal Record Statement: Licensee 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 the 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.
ü Safe Sleep: LPA discussed the safe sleep regulations with licensee 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.
ü Notice of Site Visit: A notice of site visit must remain posted for 30 days.
ü Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
ü Parent Notifications Requirements: Per the Health and Safety Code (HSC) 1596.859, 1596.8895, and 1597.05 to improve transparency of licensing records and to ensure that the parents/guardians using the licensed childcare facility are aware of situations that present danger to the children.
ü Employees or volunteers at family day care home; immunization requirements; records; exemptions (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.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023
LIC809 (FAS) - (06/04)
Page: 5 of 7
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: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 367700298
VISIT DATE: 01/26/2023
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ü 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 that 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 statement, must be placed in the child's file for verification. Failure to do so will result in a Civil Penalty being assessed.
ü The 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). State law prohibits baby walkers, bouncy seats, exersaucers, and any other items that fall into that category.
ü Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.
Our Quarterly updates come out every 3 months they are also now in Spanish please log in to the CCLD website or you can email our advocates to have the quarterly updates sent directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

ü The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 AM - 5:00 PM.

ü A copy of the Safe Sleep Proposed Regulations was provided to Licensee.

**Incidental medical Services (IMS) policy was discussed. Applicant will wait until facility opens to determine IMS needs. 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.htmSafe Sleep in Child Care: Resources can be found on our website at http://www.cdss.ga.gov/inforesources/Child-Care-Licensing/Public-Information-and-Resources/Safe-Sleep

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

DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023
LIC809 (FAS) - (06/04)
Page: 6 of 7
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: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 367700298
VISIT DATE: 01/26/2023
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Lead Poisoning: For more information, go to the California Childhood Lead Poisoning Prevention Branch’s website at www.cdph.ca.gov/programs/clppb,or call them at (510) 620-5600.

Applicant advised visit www.shotsforschool.org for Immunization information.

Child Care Advocates: You can now sign up for Quarterly Updates and PINs for one or more programs through our DSS website at www.ccld.ca.gov. Click on “Receive Important Updates” located in the right middle part of the page, immediately above the Quick links. Put your email address and choose which program(s) you would like to subscribe to and click “subscribe”.

Prior to being licensed the follow is required by: February 27, 2023.

· Copy of Husband's Driver License and contact phone number.

· AC Unit must be covered.


· Unused vehicle must have a car cover.
· LIC 279 B listing all children in the home.
· Declaration from Licensee, no other adults are living in the home.
Fire extinguisher must have a gated cover or made inaccessible to children.

**Applicant was given the pre-licensing application packet with licensing forms included.

**As a result of this inspection, the home does not meet Title 22 Regulations. Corrections are required.

Exit interview conducted: A copy of this report, Notice of Site inspection was discussed and left with Mirna Garcia.

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

DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023
LIC809 (FAS) - (06/04)
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