157700012-3-5-2020-12-CC-EROZ-BMELQX-20200305075814

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 157700012
Report Date: 03/03/2020
Date Signed: 03/05/2020 07:58:24 AM

COMPREHENSIVE INSPECTION

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	GARCIA FAMILY CHILD CARE		FACILITY NUMBER:	157700012
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	03/03/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:07 AM
MET WITH:	Rita Garcia		TIME COMPLETED:	12:38 PM

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On 03/03/20, at 10:07 AM Licensing Program Analyst (LPA) Esequiel Rodriguez made an unannounced inspection at the Garcia Family Child Care home facility. The purpose for the inspection is to inspect the facility to ensure the facility meets licensing requirements set forth by Title 22, and Health and Safety Code, and statutory requirements regarding care and supervision; facility administration; personal rights of the children; physical plant issues; records upkeep; staffing ratios and capacity requirements.

The LPA met with Licensee, Rita Garcia stated the purpose for the inspection. The facility is licensed to provide care up to eight children. Currently there are no children present. The licensee indicated she ensures the facility does not go over the capacity specified on the license.

The Licensee is well aware that when there are children in the home the facility maintains a current copy of children in care. Nonetheless, licensee provided a list of the children previously in care. Home roster. Posted on a prominent place of the facility is the Parent's Board. It contains the following posted items: Emergency/Disaster Preparedness, Emergency Disaster Plan (610A); Earthquake Preparedness Checklist (LIC9148); Department's Complaint hotline; Notification of Parent's Rights, (Pub 394); and other safety information such Safe Sleep program, lead poisoning information, car seat law and never shake a baby information.

Per Licensee, fire and disaster drills are conducted every three months or sooner and maintain a log indicating when the emergency/type of drills are conducted. The facility is currently working on a more comprehensive plan for Earthquakes, Fire emergency, and floods

Posted on a prominent place is the License.

Per licensee, she is the primary caregiver and is present in the home more than 80% of the operating hours. The facility operating hours are Monday thru Saturday 05:00 AM to 05:00 PM and when children are

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Esequiel Rodriguez	TELEPHONE: (323) 981-3315
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2020

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: GARCIA FAMILY CHILD CARE	FACILITY NUMBER: 157700012
	VISIT DATE: 03/03/2020

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The off-limits areas are the rooms, storage areas, entire second floor, and the garage area. The stairway is properly gated at the bottom. LPA advise Licensee that Community Care Licensing (CCL) must be contacted prior to changing off-limits rooms/areas in the house. Storage areas used for poisons, detergents, cleaning compounds, medications and other items which could pose a danger to children are stored are inaccessible to children.

Overall, the facility is clean, orderly, safe and sanitary, in good repair and with appropriate heating and ventilation.

Per Licensee, when a child has a contagious or symptoms of contagious disease, the child is not accepted for care. However, if the symptoms are noted after the child parents leave the facility, the child is immediately separated from others, and the parents or legal guardian are immediately notified. The home has an isolation area for sick children. There is an area of the home where children who are not feeling well are placed while they wait for their parents to pick them up.

The day care home provides lunch, snack throughout the day, and dinner as needed. The food is also inspected, in an ongoing basis, by the United States Department of Agriculture (USDA).

Licensee documents immunizations and maintains, and updates records for children in care.

The Licensee and assistant have a current Pediatric CPR/First Aid, and has attended the required Mandated Reporter training.. The facility annual fees are current.

Licensees provided proof of immunization against pertussis (TDAP), measles (MMR), and Influenza. All adults living in the home have current (TB) Tuberculosis clearance/assessment. Proof of Preventive Health Practices, including 1 hour on Childhood Nutrition was provided. Ms. The Licensee as well as her assistance have a current Mandated Reported Certificate and have completed training on preventive health practices including Pediatric First Aid and CPR. Licensee is aware about the requirements to report unusual incidents/injury to the Department in accordance with Title 22 reporting requirements. stated she provides thechildren’s parents or representatives with a copy of the Family Child Care Home Notification of Parent’s Rights.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Esequiel Rodriguez	TELEPHONE: (323) 981-3315
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2020

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: GARCIA FAMILY CHILD CARE	FACILITY NUMBER: 157700012
	VISIT DATE: 03/03/2020

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Smoking in the facility premises is prohibited, infant walkers, Johnny jumpers, exersaucers and any other item that falls into that category are not permitted in the facility. The LPA also LPAs reminded Licensee that the required mandated reported training and shall be renew every two years. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com.

Incidental Medical Services (IMS) policy was also discussed. Currently, Licensee does not provide IMS. LPA Rodriguez informed licensee that when any IMS is provided, a Plan for Providing IMS must be submitted to the Department for approval.

The following information regarding American with Disabilities Act (ADA) was provided: US Department of Justice (USDOJ) toll-free ADA Information Line is (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA is available at http://www.ada.gov/childqanda.htm. LPAs remind Licensee that she shall continue to familiarize with the guidelines established by the American Academy of Pediatrics to help reduce the risk of Sudden Infant Death Syndrome (SIDS) when caring for infants. Also, explained that Unusual Incident Reporting Requirements such the Licensee is required to file an Unusual Incident Report when any of the following situations occur:

An injury to a child in care, requiring professional medical attention. A missing child. Death of a child. Explosions, fires or other physical damage to the home. It must also subsequently be reported to the local fire authority within 24 hours. Medical Epidemics. Poisonings. Also advise Licensee to sign up for CCL Quarterly Updates by emailing the Child Care Advocates at childcareadvocatesprogram@dss.ca.gov or by calling (916) 654-1541 Licensee was informed the Palmdale Regional Office can be contacted for information at (661) 202-3318 Monday through Friday from 8:00 AM - 5:00 PM.

At the time of this inspection, the facility was in compliance per Title 22 regulations, and no deficiencies cited. LPA Rodriguez provided additional consultation regarding Title 22 requirements.

Exit interview conducted and a copy of this Report, LIC 811 as well as the Notice of Site visit (LIC 9213) was provided to Ms. Garcia

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Esequiel Rodriguez	TELEPHONE: (323) 981-3315
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2020

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: GARCIA FAMILY CHILD CARE	FACILITY NUMBER: 157700012
	VISIT DATE: 03/03/2020

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present, they are always directly supervised. Licensee indicated that when she is temporary absent from the home she arranges for a substitute responsible adult to care for, and supervise the children in her absence.

At 10:20 AM the LPAs along with Licensee conducted an inspection tour of the inside and out of the facility's physical plant. Per Licensee, there has been no physical plant changes since the last inspection conducted on 10/04/18. Adults living in the home are the Licensee and Ref-1. See LIC 811, Confidential Name form dated 03/03/20. Ms. Garcia stated that she provides a clean and safe environment to children in care. Licensee said they care for the children and monitor their food intake or special diets, assistance in diapering, toileting, dressing, grooming, provides personal hygiene needs, and other basic needs. Licensee stated she ensures that children in care are supervised at all times.

This home is a two story family home. There is a living/family room, dining room, kitchen, five bedrooms, two full bathrooms. The main day care area is in the family room and the a room located on the first floor. Each child has safe, healthful, and comfortable accommodations, furnishing, napping pads, and equipment. Electrical sockets/outlets and other items that may create a hazard in the home are properly covered or child proofed. The Licensee has a small dog. The dog has all required vaccinations.

Per Licensee, there are no firearms or anything that can be considered as weapon in the facility Physical plant. The carbon monoxide, fire extinguisher and smoke detectors are present, are fully operational, and meet State Fire Marshall standards. The fire extinguisher is a 2A10BC and is accessible in case of emergencies. Electrical outlets are properly covered. The home has a working telephone. The First Aid Kit is available and complete, but inaccessible to children. There is no fireplace available in the home. All off limit areas are secure with approved child safety protective devices.

The outdoor play area of the day care includes the back yard area, and is properly fenced. The area is free of defects or dangerous conditions and is clean and safe. Also, the toys use by the children are safe, clean and appropriate. There were no baby walkers, bouncers, jumpers and/or similar items present. Napping equipment (mats) on the premises met regulatory requirements. Per licensee children nap in the designated room/Living room. Outdoor play area is fenced. The front yard is properly maintained.

The kitchen area is properly secure and inaccessible to children, including cabinet drawers.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Esequiel Rodriguez	TELEPHONE: (323) 981-3315
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2020

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: GARCIA FAMILY CHILD CARE	FACILITY NUMBER: 157700012
	VISIT DATE: 03/03/2020

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The Licensee as well as her assistance have a current Mandated Reported Certificate and have completed training on preventive health practices including Pediatric First Aid and CPR. Licensee is aware about the requirements to report unusual incidents/injury to the Department in accordance with Title 22 reporting requirements.

The children files were inspected for the following: Emergency Information Card for each child; Parent Additional Children in Care (LIC 9150); Affidavit Regarding Liability Insurance (LIC 282) This facility has liability insurance; Consent for Medical Treatment (LIC 627); Consent/Verification for Nebulizer Care (LIC 9166) - if applicable; Identification and Emergency Information (LIC 700); Notification of Parents' Rights (LIC 995A) - This form must be given to each parent at the time a child is accepted for care, along with the LIC 995E - Bottom portion keep on file; Caregiver Background Check Process (LIC 995E); Family Child Care Consumer Awareness Information (LIC 9212); California School Immunization Record. Licensee has a blue form on file. However, is not the PM 286. Current form can be downloaded from the following website:http://www.dhs.ca.gov/publications/forms/immunization.htm but must be printed on blue paper only; and Incident reports LIC 624B.

Personnel Records were reviewed for the following: Unusual Incident/Injury Report (LIC 624B)
licensing office when reporting any incidents or injuries occurring during day care hours.
Child Care Facility Roster (LIC 9040); Notice of Employee Rights (LIC 9052); Statement Acknowledging Requirement to Report Suspected Child Abuse (LIC 9108); Property Owner/Landlord Consent Form (LIC 9149), Property Owner/Landlord Notification Form (LIC 9151), and deed or lease/rental agreement are not applicable. Licensee owns the home and has mortgage proof documentation on file. The Licensee has proof of completion of 16 hours of Preventive Health and Safety Training before a license can be issued. The training include Pediatric Cardiopulmonary Resuscitation (CPR), Pediatric First Aid, Preventive Health Practices, and one hour of Pediatric Nutrition.
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A review of the facility associations against Facility Report Summary (LIS 536) dated 03/03/2020 indicates that the licensee, and other individuals subject to a criminal record review have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed home/facility.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Esequiel Rodriguez	TELEPHONE: (323) 981-3315
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2020

LIC809 (FAS) - (06/04)

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