<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153908738
Report Date: 06/09/2023
Date Signed: 06/13/2023 10:43:44 AM


Document Has Been Signed on 06/13/2023 10:43 AM - 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:MORENO, YOLANDA FAMILY CHILD CAREFACILITY NUMBER:
153908738
ADMINISTRATOR:MORENO, YOLANDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 854-8029
CITY:ARVINSTATE: CAZIP CODE:
93203
CAPACITY:14CENSUS: 8DATE:
06/09/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Yolanda MorenoTIME COMPLETED:
12:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 06/09/2023, Licensing Program Analyst (LPA) Beneroso conducted an unannounced Required 1-Year inspection at the Moreno Family Child Care Home. Upon arrival, the LPA met with the Licensee, Yolanda Moreno, who guided the LPA on a tour of the facility. Family members residing in the home include 3 adults (licensee, licensee’s spouse) and one adult son. All adults living in the house have been background cleared. Per the Licensee, the hours of operation are Monday through Friday, 5:00AM to 6:00 PM. Per licensee, no overnight care is provided. Upon arrival, LPA observed 8 children in care and two adults providing care and supervision. Licensee is within the ratio for a large facility. Incidental Medical Services (IMS) were discussed.

Physical Plant:
This is a two-story, 4-bedroom, 2-bathroom home with a kitchen, living room, dining area, day care room and backyard. There is no garage. The home was inspected for safety, comfort, cleanliness, telephone service, central air, and heat and ventilation. The house has central heating and air conditioning. All windows are free of cracks, bugs, and debris. All electrical outlets are covered.
Stairs: Stairs to second floor of the facility is properly barricaded. The stairs are barricaded by a child safety gate.
.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:
DATE: 06/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/09/2023
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 6


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: MORENO, YOLANDA FAMILY CHILD CARE
FACILITY NUMBER: 153908738
VISIT DATE: 06/09/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Main Care Area: Main care is provided in the converted garage. Children use the bathroom located on the hallway to the right of the main entrance. Children have access to the kitchen, living room and backyard. LPA observed age-appropriate toys and furniture for the children. There are age-appropriate games and books on the premises of this facility. Per licensee, there is a designated area for ill/sick children in the living room.

Children's bathroom: Children use the bathroom located on the hallway to the right of the main entrance The bathroom was clean, sanitized, and in good repair. The bathroom was toured and inspected sink and toilet which is in operable condition. Toilet and faucets are clean, safe, and operable.


Kitchen/Dining Room: The kitchen cabinets all have safety latches. Sharp knives are inaccessible and kept on an upper kitchen cabinet. Per licensee, she currently has a food program and serves Breakfast, Lunch, a snack and Dinner.

Backyard/Outdoor areas: The backyard is completely fenced (with cement block). LPA 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. There is a storage shed that remains locked and inaccessible to children.

Off-limits: Off-limit areas include the second floor and all the bedrooms and second bathroom made inaccessible by a safety gate, The laundry room is located in the second floor.



Others:
Per licensee and LPA’s observations, there are no bodies of water. Electrical outlets are covered and made inaccessible to children. There are no pets in the facility.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: MORENO, YOLANDA FAMILY CHILD CARE
FACILITY NUMBER: 153908738
VISIT DATE: 06/09/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Fire/Health/Safety: There is a cell phone kept charged and on the Licensee at all times.
Smoke Detectors was observed to be in operable conditions. Carbon Monoxide detector was observed not to have batteries. A type B citation was issued for this violation.
The First Aid kit is located in the pantry made inaccessible by safety doorknob. The first aid kit was observed complete with supplies including thermometer, tweezers, scissors, gauze, bandages, cleansing pad/solution, and a first aid manual. Transportation is currently offered. LPA observed licensee’s insurance policy.
LPA observed a required fire extinguisher (2A10BC) reading in Green and currently serviced.
Fireplace: The fireplace was observed in the living room and is properly screened. Per LPA’s observations, there were no hanging window blind cords. There are no pets in the home.
Medications/ Hazardous Materials: Medications are kept in the kitchen in an upper cabinet inaccessible to children. Cleaning compounds were observed to be located in a lower kitchen cabinet made inaccessible by a safety latch. Per licensee, there are No Firearms at the facility at this time. The facility currently does not have childcare insurance.

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 Licensee will not be providing IMS to the children at this time.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: MORENO, YOLANDA FAMILY CHILD CARE
FACILITY NUMBER: 153908738
VISIT DATE: 06/09/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Records: Children’s and infant’s records were observed to be complete and current.
Licensee’s CPR/First Aid is maintained current, it expires on 02/2025. Mandated reporter is also maintained current, it expires on 02/27/2025
Per Licensing Information System, facility annual fees are up to date. Licensee was reminded that fire and disaster drills are to be conducted every 6 months. Fire drill log was not current. Licensee conducted fire drill during inspection. A technical Violation was issued for this deficiency. Per LPA’s observations, the Facility License, Emergency Disaster plan, Earthquake Preparedness and Parents Rights Poster were posted.

Documents Provided and or Discussed: Fire Drill Log, Roster, Postings, Safe Sleep PIN 20-24-CCP and LIC 9227 (Individual Sleeping Plan). The Licensee was reminded that supervision is always required for children in care.

Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care.

Licensee Moreno 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.

LPA discussed the safe sleep regulations with licensee Moreno 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.

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

DATE: 06/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: MORENO, YOLANDA FAMILY CHILD CARE
FACILITY NUMBER: 153908738
VISIT DATE: 06/09/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Inspection was conducted in Spanish, LPA is certified as bilingual by the department.

One Type B deficiency and a Technical Violation were issued during visit.

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 Moreno, 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: 06/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023
LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 06/13/2023 10:43 AM - 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: MORENO, YOLANDA FAMILY CHILD CARE
FACILITY NUMBER: 153908738

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/09/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.543
Licensure Requirements
Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observations, the licensee did not comply with the section cited above. LPA obseved non operational Carbon Monoxide Detector which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/09/2023
Plan of Correction
1
2
3
4
Licensee obtained a Carbon Monoxide Detector during inspection.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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: 06/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/09/2023
LIC809 (FAS) - (06/04)
Page: 6 of 6