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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153805521
Report Date: 04/07/2023
Date Signed: 04/07/2023 04:30:11 PM


Document Has Been Signed on 04/07/2023 04:30 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:MARIA'S CHILD CAREFACILITY NUMBER:
153805521
ADMINISTRATOR:LOPEZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 390-4053
CITY:ARVINSTATE: CAZIP CODE:
93203
CAPACITY:14CENSUS: 14DATE:
04/07/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Maria LopezTIME COMPLETED:
12:00 PM
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On 04/07/23 Licensing Program Analyst (LPA) Beneroso met with Licensee, Maria Lopez, who guided analyst on a tour of the facility for an Annual Inspection. This is a one story, 4-bedroom, 2-bathroom home with kitchen, dining area, living room, family room, laundry room and garage. Upon arrival, LPA observed 14 children in care and two adults providing care and supervision. Family members residing in the home include 4 adults (licensee, licensee's husband, two adult sons and 2 minors). Facility operation are Monday-Friday 5:00AM-5:00PM. Incidental Medical Services (IMS) policy was discussed.

Physical Plant: Main care is provided in the living room and family room. Children use the family room’s bathroom (daycare area). Off limit areas include all bedrooms, kitchen, bathroom #2 and laundry room. The backyard is partially divided (half is within limits and half off limits). All room have safety doorknob to make them inaccessible. The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (under kitchen sink with safety latch), medicines (kept in pantry and master bedroom) and hazardous items (sharp knives in upper kitchen cabinet unreachable to children in care) that can pose a danger to children. Safe and age appropriate toys, play equipment and materials were observed.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:
DATE: 04/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/07/2023
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: MARIA'S CHILD CARE
FACILITY NUMBER: 153805521
VISIT DATE: 04/07/2023
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The smoke detector and carbon monoxide detector, Fire Extinguisher (2A40BC) are in operable condition. Per Licensee, no one smokes in the home. Electrical outlets are inaccessible. LPA reminded licensee no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/ play equipment are allowed on the premises. There is a designated area for ill children as necessary in the living room. Per Licensee, there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (landline and cell). There is no pool/spa or body of water on the premises. Naps are provided in the main care area. LPA observed mats in the main care area.

Fire/disaster drill is maintained current. Last Fire/Disaster Drill was completed on 10/07/2023, Roster complete and maintained current.



Bathroom: LPA observed the bathroom to be clean and in good condition. Toilet and faucet are clean and operable. The bathroom does not have cabinets or storage areas.

Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. If food is brought from the children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. The home has a clean and fully stocked refrigerator/freezer. Per licensee, she is part of the food program. Meals provided are breakfast, lunch and snacks as needed
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:

DATE: 04/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2023
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: MARIA'S CHILD CARE
FACILITY NUMBER: 153805521
VISIT DATE: 04/07/2023
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Outdoor: The backyard is completely fenced (with block cement). There is an additional unit where licensee’s adult son lives. LPA inspected and was observed the backyard to be free of hazards, lose or sharp parts and tools. LPA observed appropriate and safe toys in the play area. Per licensee and LPA’s observations, there are no pools or bodies of water in the premises

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expires on 7/17/2023 Mandated Reporter expired on 04/05/2024. Licensee has the Mandated Reporter certificate current. LPA reminded licensee the mandated reporter training is to be renewed every two years at www.mandatedreporterca.com

Documents Provided and or Discussed: Fire Drill Log, Roster, Postings, Safe Sleep PIN 20-24-CCP and LIC 9227 (Individual Sleeping Plan). Licensee stated currently has no day care insurance.


Licensee Lopez 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 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.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:

DATE: 04/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2023
LIC809 (FAS) - (06/04)
Page: 5 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: MARIA'S CHILD CARE
FACILITY NUMBER: 153805521
VISIT DATE: 04/07/2023
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LPA discussed the safe sleep regulations with licensee Lopez 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.

Inspection was conducted in Spanish; LPA is certified as bilingual by the department.

No deficiencies have been cited at this time.

A notice of site visit was given to licensee and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Maria Lopez, along with her appeal rights and Notice of Site Visit.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:

DATE: 04/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2023
LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 04/07/2023 04:30 PM - It Cannot Be Edited

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: MARIA'S CHILD CARE
FACILITY NUMBER: 153805521

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(a)
Infant Safe Sleep
(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations the licensee did not comply with the section cited above. There was no crib present for infant to sleep in, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/07/2023
Plan of Correction
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Licensee obtained a Pack & Play during visit.
Type B
Section Cited
CCR
102425(j)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, interview and record review, the licensee did not comply with the section cited above. Licensee did not have an infant napping log, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/14/2023
Plan of Correction
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Licensee will submit proof of infant nap logs to LPA Beneroso via email or text message.
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: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:
DATE: 04/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/07/2023
LIC809 (FAS) - (06/04)
Page: 2 of 5