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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153910076
Report Date: 10/02/2023
Date Signed: 10/03/2023 10:31:15 AM


Document Has Been Signed on 10/03/2023 10:31 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:GIL, CAROLINA FAMILY CHILD CAREFACILITY NUMBER:
153910076
ADMINISTRATOR:GIL, CAROLINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 699-9135
CITY:LAMONTSTATE: CAZIP CODE:
93241
CAPACITY:14CENSUS: DATE:
10/02/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:43 PM
MET WITH:Maria Elena AyalaTIME COMPLETED:
01:55 PM
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On 10/02/2023, Licensing Program Analyst (LPA) Beneroso conducted an unannounced Required 1-Year inspection at the Gil Family Child Care Home. Upon arrival, the LPA met with assistant, Maria Elena Ayala, who guided LPA on a tour of the facility. Licensee is currently out of the country for a few days Family members residing in the home include 3 adults (licensee and licensee’s mother and licensee’s brother) and 3 minor children. All adults living in the house have been background cleared. Per the Licensee, hours of operation are a day Monday through Saturday 5am to 5pm. Per assistant, no overnight care is provided at the moment. Upon arrival, there were not children present at the day care. Incidental Medical Services (IMS) were discussed.

Physical Plant:
This is a one-story, 3-bedrooms, 2-bathrooms home with a kitchen, living room, dining area, backyard, garage and laundry area. 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. There are no cords hanging from the windows. All electrical outlets are covered.

Main Care Area: Main care is provided in the in the living room and dining area. Children use the bathroom located on the hallway on the left-hand side. LPA observed age-appropriate toys and furniture for the children. There are age-appropriate games and books on the premises. Per assistant, there is a designated area for ill/sick children in the living area (day care area). Children nap in the living room area in mats that are properly stored.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:
DATE: 10/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/02/2023
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: GIL, CAROLINA FAMILY CHILD CARE
FACILITY NUMBER: 153910076
VISIT DATE: 10/02/2023
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Children's bathroom: Children use the bathroom located in the hallway on the left-hand side. The bathroom was clean, sanitized, and in good repair. The bathroom was toured and inspected sink and toilet which is in operable condition.

Kitchen/Dining Room: The kitchen has a physical barrier; two child safe gates are installed (mesh). Sharp items are kept in an upper cabinet. Cleaning compounds are stored in a lower cabinet, made inaccessible by two child safety gates (mesh). Per licensee, she does currently have a food program. Meals offered: Breakfast, Lunch, and PM Snack.

Backyard/Outdoor areas: The backyard is completely fenced (wooden fence). The backyard has play equipment that is safe and in well repair. The backyard was found to be clean, free of debris or harmful materials. The backyard is divided into two, one side for personal use and the other side is used for day care children. A wooden fence divides the two sides of the backyard. There is a storage shed that is located on the off-limits side of the property. Per licensee and LPA’s observations, there are no bodies of water in the premises. There are no pets in the home.

Off-limits: Off-limit areas include all the bedrooms of the home, bathroom #2, garage (detached) and partially the backyard. LPA observed all doors of off-limit bedrooms to have a safety doorknob.



Care and Supervision: Licensee is within the ratio for a small facility. The Licensee was reminded that supervision is always required for children in care.


Fire/Health/Safety: There is a cell phone kept charged and on the Licensee at all times.
Smoke Detectors and Carbon Monoxide were observed to be in operable conditions.
The First Aid kit was observed to be complete with supplies including thermometer, tweezers, scissors, gauze, bandages, cleansing pad/solution, and a first aid manual. LPA observed a required fire extinguisher (3A40BC) reading in Green and currently serviced. The facility currently does have childcare insurance.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2023
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: GIL, CAROLINA FAMILY CHILD CARE
FACILITY NUMBER: 153910076
VISIT DATE: 10/02/2023
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Medications/ Hazardous Materials: Medications are stored in the master bedroom (bathroom) made off-limits and secured with a safety doorknob and also in the kitchen, in an upper cabinet. Cleaning compounds were observed to be kept in a lower cabinet in the kitchen, made inaccessible by child safety gates (mesh). Per licensee, there are No Firearms at the facility.

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.

Records: Children’s records were observed to be complete and current.
Licensee’s CPR/First Aid is maintained current, it expires on 03/25. Mandated reporter is maintained current, it expires 02/27/2025. Per Licensee, fire and disaster drills are conducted every 6 months. Per LPA’s observations, the Facility License, Emergency Disaster plan, Earthquake Preparedness and Parents Rights Poster were posted.

Documents Provided and or Discussed: Safe Sleep PIN 20-24-CCP and LIC9227 (Individual Sleeping Plan).

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. Applicant was advised that all LIC forms can be found at: www.cdss.ca.gov/inforesources/forms-brochures/forms-alphabetic-list/i-l

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

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

DATE: 10/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: GIL, CAROLINA FAMILY CHILD CARE
FACILITY NUMBER: 153910076
VISIT DATE: 10/02/2023
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Assistant Ayala 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 Assistant and discussed the Child Care Licensing Safe Sleep webpage at 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 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 bilingual by the department.

No deficiencies have been cited at this time. A notice of site visit was provided 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 assistant Ayala, 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: 10/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4