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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153805521
Report Date: 05/22/2019
Date Signed: 05/22/2019 01:55:22 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME:MARIA'S CHILD CAREFACILITY NUMBER:
153805521
ADMINISTRATOR:LOPEZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 390-4053
CITY:ARVINSTATE: CAZIP CODE:
93203
CAPACITY:14CENSUS: 0DATE:
05/22/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Maria LopezTIME COMPLETED:
02:10 PM
NARRATIVE
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An unannounced annual inspection was conducted by Licensing Program Analysts (LPAs) Angelica Ramirez and Suzanne Smith at 12:40 PM on 5/22/19. During the inspection, LPA met with licensee Maria Lopez. This inspection is due to quarterly inspections required and therefore it is being recorded under a case management other report. There are currently 12 children enrolled in the family child care. Present during this inspection is the licensee, licensee's spouse and licensee's adult son. No day care children are present today due to rain. Per licensee residing in the home on 1/24/19 is the licensee, spouse, licensee's adult son, and licensee's three minor children (ages 11, 13, 16).

Per licensee, the living room, child care play room (located in back of house), one bathroom (located in child care play room), dining room, backyard (during summer) and front yard are utilized for the family child care. Per licensee off-limit areas of the home are the kitchen, three bedrooms, small house in back of house where licensee's adult son resides (criminally cleared), one bathroom (off hallway), and storage shed in backyard. All off limits bedrooms and one bathroom are made inaccessible with plastic doorknobs. The kitchen is made inaccessible with a security gate. Detergents and medications are kept in the off limits kitchen.

Operating hours are Monday through Saturday 5:00 AM to 5:00 PM. Licensee provides snacks and meals. The facility has a written emergency disaster plan and LPA observed a current roster. The home has a swamp cooler and a small electric fireplace.

The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, poisons, detergents/cleaning compounds, medication and hazardous items that can pose a danger to children. LPA observed age appropriate safe toys and napping equipment on the premises. Per licensee children nap in the living room.

SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (661) 369-2168
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: MARIA'S CHILD CARE
FACILITY NUMBER: 153805521
VISIT DATE: 05/22/2019
NARRATIVE
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The facility annual fees are current. Licensee had all the required posted documents: Facility License (LIC 203), Notice of Parent's Rights Poster (PUB 394), Emergency Disaster Plan (LIC 610A), and Earthquake Preparedness Checklist (LIC 9148). Children files were found to be complete. Licensee provided proof of fire drills, earthquake drills log, most recent drill conducted on 1/23/19.

Per licensee, there are no weapons or firearms on the premises. The backyard is used for outside play only during the summer. The backyard is gated all around. The outdoor play area was inspected and was observed to be free of hazards, loose and sharp parts. LPA observed backyard appropriate safe toys. Licensee has a dog that is kept on the side of the home, he is not part of the day care.

LPA observed the required fire extinguisher (2A10BC) fully charged. Smoke detectors and carbon monoxide devices tested operable. The First Aid Kit was observed complete with supplies and first aid manual. LPAs observed licensee and assistant have expired Pediatric CPR and First Aid Training dated 3/26/19. This will result in a Type B citation as no children are present today.

The following were discussed: There is an effective 24/7 ban on smoking tobacco in a home that is licensed as a family day care home, and in those areas of the family day care home where children are present.

Baby walkers, baby jumpers, baby exersaucers, baby bouncers/rockers and any other item that falls into that category are not permitted in the facility. The LPA also discussed earthquake safety and necessity of drills, required forms for children’s files, facility files and posting requirements.



Incidental Medical Services (IMS) were discussed. Per licensee, the facility is not currently providing IMS. LPA informed licensee to refer to IMS information in the 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.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (661) 369-2168
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: MARIA'S CHILD CARE
FACILITY NUMBER: 153805521
VISIT DATE: 05/22/2019
NARRATIVE
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The licensee was informed that all adults living in or having access to the home are required to have fingerprint clearances with Department of Justice, FBI and Child Abuse Index prior to having contact with children. If the aforementioned is not adhered to, a Civil Penalty of up to $500, per non-cleared adult will be assessed immediately. Please advise your analyst of any person who will be visiting regularly or for longer than one week.

The licensee was informed of the role and responsibilities of being a mandated reporter, renewal required every 2 years for a licensed child care provider, administrator, or employee ( www.mandatedreporterca.com ) It was completed in 2/1/18.

Child Care Advocates: To sign up for our Quarterly Updates please email the Child Care Advocates at


childcareadvocatesprogram@dss.ca.gov & (916) 654-1541.

The licensee was reminded it is his/her responsibility to visit the departments website to obtain licensing forms, Quarterly Updates, and Provider Information Notices (PINs): www.ccld.ca.gov

A Type B deficiency was cited during today's inspection (see LIC 809D).

The Licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days.

Exit interview conducted with Licensee. A copy of this report, notice of site inspection, Appeal Rights (LIC 9058) were given and explained during this inspection.

SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (661) 369-2168
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: MARIA'S CHILD CARE
FACILITY NUMBER: 153805521
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/22/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/14/2019
Section Cited
CCR
102416(c)
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(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement
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Licensee agrees to renew her pediatric first aid and cpr and provide proof of the certificate to the department via email or fax by 6/14/19. Licensee must also provide a copy of the certificate for her assistant (individual A).
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was not met as evidenced by: based on observations licensee failed to provide a current Pediatric first aid and CPR. This poses a potential health and safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (661) 369-2168
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4