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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700328
Report Date: 03/02/2023
Date Signed: 03/02/2023 12:37:00 PM

Document Has Been Signed on 03/02/2023 12:37 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:BRAVO & HERNANDEZ FAMILY CHILD CAREFACILITY NUMBER:
367700328
ADMINISTRATOR:ANA BRAVO & HUGO HERNANDEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 648-7218
CITY:VICTORVILLESTATE: CAZIP CODE:
92394
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
03/02/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:01 AM
MET WITH:Hugo Hernanzez & Ana Bravo, LicenseesTIME COMPLETED:
12:36 PM
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On March 2, 2023, Licensing Program Analyst (LPA) Kuliema Calloway, met with Licensee(s) for the purpose of conducting a Pre-Licensing Inspection. Applicants are requesting to provide care and supervision for a Large Family Child Care Home for the capacity of 12 to 14 children. Currently residing in the home is applicant, their spouse, and three (3) foster children. All adults residing in the home have a Criminal Record Clearance (DOJ/FBI and Child Abuse Index Clearance. Applicants and LPA toured the home indoors and outdoors to ensure the home meets licensing requirements. Applicants are requesting the days and hours of operation will be: 6:00 AM to 5:00 AM for overnight, twenty three hours care. Monday through Sunday for the Family Child Care Home.

The Home is set up as follows:
This is a two-story home with four (4) bedrooms and three (3) bathrooms, a kitchen, living room, dining room, laundry room, family room, upper family room, and garage. The home was inspected for safety, comfort, cleanliness, telephone service, central air, heat, and ventilation. The home has central heating and air conditioning. All windows have screens and are free of cracks, bugs, and debris.

· Main Care Area: Child Care is provided in the family room (upon entry it is down the walkway and on the left side) and Bedroom #1 (to the right of the childcare area). Children will have access to the backyard. LPA observed age-appropriate furniture for the children that is in good repair. There are toys and books on the premises of this facility. The area is neat and clean. There is a closet in the hallway used for the childcare for storage and supplies it is secured with a safety knob. All unused electrical outlets are covered and made inaccessible to the children.
· Children's Bathroom (#1): Children will use Bathroom #1 which is downstairs off the child- care area, near the garage (off limits). The bathroom was toured and inspected sink/toilet are in operable condition. Toilet and faucets are clean, safe, and operable. There were no shampoos, mouthwash, razors, poisons or medications stored in the cabinets and drawers. The bathroom was clean, sanitized, and in good repair.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE: DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/02/2023
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: BRAVO & HERNANDEZ FAMILY CHILD CARE
FACILITY NUMBER: 367700328
VISIT DATE: 03/02/2023
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·Kitchen: The kitchen is not gated and made accessible. The kitchen has a stove, sink, microwave, refrigerator/freezer, and pantry. The upper drawers were inspected and there were no hazardous or dangerous items observed the drawers. They do not have safety latches making them accessible to the children. The lower cabinets had pots, pans, dishes and plastic containers were not secured with safety latches. In the kitchen, all sharp utensils were stored inside the upper kitchen drawer which has a magnetic safety lock. The upper cabinets have glasses, food, and dishes, which are accessible to children. The eating area for the smaller children is in the childcare area for at least five (5) kids. Eating for the school aged children is at a larger table in the childcare area. Dining seating for at least six (6) school aged children were observed. The refrigerator and freezer were inspected, and both were clean and in good repair.
· Backyard: The backyard is accessible; it was inspected and is fenced all around. Children will play in the backyard. The left side and right side have a gate that accesses the side of the house without a lock. Per licensee and fire inspection, the Fire Department recommendations were to not lock the gates for emergency exit in the event of a fire. Both areas are accessible to the children. There is grass and concreted area for active play. There is no swing or slide set, but age appropriate toys for play.
· Off Limit’s Areas: The entire upstairs floor. The stairs leading to the second floor are gated. Upstairs is: The Master Bedroom, Bedroom #2, Bedroom #3, and Bathroom # 2, Bathroom #3, the Laundry Room, Upper Family Room (Office), and Downstairs: The Garage. LPA observed a safety knob on the garage door (enter from the hallway near Bathroom #1) which makes it inaccessible to children.
· AC/Heating Unit: There were two (2) AC/Heating Units in the back yard of the home. They were not covered and were made accessible to the children.
· Electrical outlets: All unused electrical outlets have safety plugs and are made inaccessible to children.
· Fire extinguisher (2A10BC): LPA observed there is a required fire extinguisher (2A10BC) that is FULL and reading in Green and located inside the locked pantry and made inaccessible to children. It meets standards established by the State Fire Marshall.
· Fire Alarm: Is located on a wall in the kitchen near the refrigerator. On 3/1/2023, it was inspected by the Fire Department and approved. It is accessible to the children until gate is installed.
· Fireplace: The fireplace was observed in the family room (childcare area) it is a brick fireplace and has a screen/glass barrier with a gate in front of the family room to make it inaccessible to the children. LPA suggested an additional safety gate to assist with preventing injuries.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
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: BRAVO & HERNANDEZ FAMILY CHILD CARE
FACILITY NUMBER: 367700328
VISIT DATE: 03/02/2023
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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 on a cot near the stairs (off limits) until the parent(s) can pick up the child.
· Medications and cleaning solutions: Detergents/cleaning compounds are in kept in the off-limits Garage; the medications are kept upstairs in the Master Bedroom (off limits).
· Napping: Children will nap in the designated nap areas (Bedroom #1) with adult supervision. LPA observed six (6) cots inside a closet with a safety knob on the door in the hallway near the childcare area.
· Overnight Care: Per licensee, overnight care will be provided if needed for twenty-three (23) hours.
· Pets: LPA observed two (2) pets in the backyard. They are currently vaccinated. Per Licensee, during day care childcare hours the dogs will stay inside the garage and during evening child care hours the dogs will be outside.
· Phone service: There is no working landline. Licensee’s both have a working cell phone. · Smoke Detectors and Carbon Monoxide Detectors: There were two (2) smoke detectors combine with carbon monoxide downstairs and four (4) smoke detectors upstairs. All devices were tested and are operable.
· The First Aid Kit: There were two (2) first aid kits. Both were inside the Garage (off limits). All the First Aid Kits were observed complete with supplies and a first aid manual.
· Transportation: The licensee will provide transportation for the children. The vehicle registration, and liability insurance were valid.
· Weapons or Firearms: Per Licensee, there are No Firearms currently in the home. LPA did not observe any firearms.
· Hot Water: Was tested at a safe temperature between 105-120 degrees.

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

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
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: BRAVO & HERNANDEZ FAMILY CHILD CARE
FACILITY NUMBER: 367700328
VISIT DATE: 03/02/2023
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Documentation:
ü CPR/First Aid: LPA observed licensee has current Pediatric CPR and First Aid Training with expiration date of 9/2023 (Hugo) and 4/2023 (Ana) Eight (8) hours of Preventive Health and Safety Training including one (1) hour Nutrition and Lead Poisoning Prevention Training completed on 9/08/2019 (Hugo) and 9/17/22 (Ana).
ü Mandated Reporter Training: Applicant completed the required training on 10/26/2021 (Hugo) and 8/5/22 (Ana).
ü Criminal Record: Per Guardian, all adults who live in this facility obtained a Criminal Record Clearance.
ü Facility fees: Per Licensing Information System (LIS), facility fees were current.
ü Emergency Disaster Plan: LIC 610 A was submitted and received by CCLD.
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 11/6/2023 (Hugo) and Spouse: CDL expires: 10/18/2024 (Ana).
ü Infant Sleeping Plan (LIC 9227) and Sleeping Log: LPA shared the Safe Sleeping Regulation with the licensee.
LPA advised licensee to post as required: Emergency Disaster Plan, Earthquake Preparedness, and Parent's Rights Roster.

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 always required for all children.
ü Capacity limits, parent/child roster maintenance, posting facility license, knowledge of Emergency Plan, and documenting Disaster Drills (Fire and Earthquake).
ü All food is properly labeled if brought from child’s home; and all food is checked periodically for expiration dates.
ü Applicant was advised how to access forms and Regulations for Family Child Care online at: www.ccld.ca.gov.
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: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
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: BRAVO & HERNANDEZ FAMILY CHILD CARE
FACILITY NUMBER: 367700328
VISIT DATE: 03/02/2023
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üA licensed child care provider, administrator, or employee of the licensed child day care 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 $100.00
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, Rubella, Mumps, 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: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
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: BRAVO & HERNANDEZ FAMILY CHILD CARE
FACILITY NUMBER: 367700328
VISIT DATE: 03/02/2023
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üType 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 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, exer-saucers, 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 AüThe On 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.

ü **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

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.

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

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
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: BRAVO & HERNANDEZ FAMILY CHILD CARE
FACILITY NUMBER: 367700328
VISIT DATE: 03/02/2023
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Applicant advised visit www.shotsforschool.org for Immunization information.dvocates information: www.childcareadvocatesprogram@cdss.ca.gov.

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: March 30, 2023.

· Provide proof of the Two AC Unit’s covered.


· Provide proof of gate across the kitchen to make it inaccessible to the children.
· Current postings for Parents Rights.
· Photo of isolation area.

**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 Visit were discussed and left with Ana Bravo and Hugo Hernandez, Applicant(s).

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

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
LIC809 (FAS) - (06/04)
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