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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700351
Report Date: 07/10/2023
Date Signed: 07/10/2023 02:13:14 PM

Document Has Been Signed on 07/10/2023 02:13 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:GALVEZ ALBIZURES FAMILY CHILD CAREFACILITY NUMBER:
367700351
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
07/10/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Applicant, Yuliana Galvez Albizures TIME COMPLETED:
02:30 PM
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On July 10, 2023, at 9:55 a.m Licensing Program Analyst (LPA) Kendal Zirbes, conducted a Pre-Licensing inspection with applicant Yuliana Galvez Albizures to ensure the facility meets basic licensing requirements set forth by Title 22, Health and Safety and statutory requirement. The applicant is requesting to open a Small family child care home (FCCH) with a capacity of eight children. Currently living in the home are two adults (Applicant and Adult 1) and two minor children (ages 6 and 8). LPA toured the home indoor and out to ensure it meets FCCH requirements. Applicant is requesting to provide care for children, birth through 12 years of age and is requesting the days and hours of operation will be Monday through Friday, 24 hours a day.
The home is described as follows:

This is a one story home with three bedrooms, two bathrooms, kitchen, living room, dining room, laundry room, daycare room, attached garage, and front and back yard. There were zero bodies of water on the premises at the time of this inspection. Off-limits areas: All bedrooms (1,2,3), bathroom 2, garage, laundry room, front yard. The off limit areas were inaccessible via door knobs equipped with key locks. On limits: daycare room, dining room, kitchen, living room, and backyard.

Indoor:

On limits: Playroom: LPA observed, cubbies for the children belongings near the front door, an alphabet rug, educational posters, books, puzzles, dramatic play kitchen area, dinosaur action figures, child size tables and chair.


Dining area: LPA observed a dining room table and six chairs. This area will be used for meal times and as a homework area for the school age children.
Kitchen: LPA observed refrigerator, stove, sink. The area was clean and sanitary. Sharp knives were stored in a container on a high inaccessible shelf. Zero chemicals were stored in the kitchen at the time of the inspection. Continued on page two
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 07/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/10/2023
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 5
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: GALVEZ ALBIZURES FAMILY CHILD CARE
FACILITY NUMBER: 367700351
VISIT DATE: 07/10/2023
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Report continued from page one
Living room: LPA observed a sofa, fireplace, play yard and a changing table. The fireplace was inaccessible via a glass screen.
Bathroom 1: LPA observed toilet, sink, and shower. Zero personal care items or chemicals were stored in the bathroom at the time of this inspection. The bathroom was clean and sanitary.
Backyard: The backyard is completely fenced. LPA observed a climbing structure placed on sand, three rose bushes, multiple cactuses, propane BBQ equipped with a cover, and a trampoline. LPA and Applicant discussed supervision and safety of the trampoline and the propane tank. LPA expressed the plants with sharp thorns need to be inaccessible to the children in care. Per Applicant a fence will be created to enclosed a smaller area of the backyard which will be utilized for child care activities.
Off-limit area
Bedroom 1: Occupied by minor children. The room is furnished with two twin beds and personal items. The room was inaccessible via the use of a door knob with a key lock.
Bedroom 2: Currently unoccupied. The room was furnished with a desk and personal items. The room was inaccessible via the use of a door knob with a key lock.
Bedroom 3: Currently occupied by Applicant and Adult 1. The room is furnished with a bed and personal items. The room was inaccessible via the use of a door knob with a key lock.
Garage: Used for the storage of cars and household items. The room was inaccessible via the use of a door knob with a key lock.

Napping equipment: LPA observed two cots and a play yard.
Electrical outlets: All outlets in the on limit areas were equipped with safety covers.
Weapons or Firearms: Per the applicant there is one firearm stored in the home. At the time of the inspection the fire arm was stored in accordance with the regulations.
Cleaning compounds: Observed in the laundry room. The door leading to the laundry room was equipped with a key lock. LPA advised the Applicant to ensure the key is stored in an area inaccessible to the child care children.

Report continued on page three
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2023
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: GALVEZ ALBIZURES FAMILY CHILD CARE
FACILITY NUMBER: 367700351
VISIT DATE: 07/10/2023
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Report continued from page two


Smoke detector and a carbon monoxide detector: Tested and operable.
Fire extinguisher (3A40BC). Located in the kitchen. The fire extinguisher was purchased January 2023. LPA and Applicant discussed the State Fire Marshall Standards during the inspection.
Pet: There is one dog on the property. Per Applicant the dog will interact with the child care children and is current on licensing and shots.
Household Medications: Stored in the off limits bedroom 3.
Knives/Sharp Items: Stored on a high inaccessible shelf in the kitchen.
Documentation:
Applicant has current CPR, First Aid Training with the expiration dates of 2/27/2025. Applicant completed the Prevented Health and Safety Training with the nutrition and lead components on 2/11/2023 and mandated reporter training on 3/15/23. Applicant and adult 1 have fingerprint clearance and required immunization's on file. Per Applicant transportation will not be provided. Meals and snacks will be provided by the Applicant.

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.


Report continued on page four
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2023
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: GALVEZ ALBIZURES FAMILY CHILD CARE
FACILITY NUMBER: 367700351
VISIT DATE: 07/10/2023
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Report continued from page three

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to 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.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage: atttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

LPA also informed applicant 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.

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.


LPA reviewed with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

As a result of this inspection, the following corrections are required prior to being issued a license:

1. Make the plants with thorns inaccessible to the children in care. Applicant has requested a week to make this correction.

An exit interview was conducted, and a copy of this report and appeal rights were discussed with the Applicant Yuliana Galvez Albizures.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2023
LIC809 (FAS) - (06/04)
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