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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157700056
Report Date: 04/19/2022
Date Signed: 05/02/2022 02:30:11 PM


Document Has Been Signed on 05/02/2022 02:30 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:BOYD-VELASCO FAMILY CHILD CAREFACILITY NUMBER:
157700056
ADMINISTRATOR:BETSY/JESICA BOYD-VELASCOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
8055013044
CITY:TEHACHAPISTATE: CAZIP CODE:
93561
CAPACITY:14CENSUS: 0DATE:
04/19/2022
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:57 PM
MET WITH:Betsy Boyd, Licensee TIME COMPLETED:
04:20 PM
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 On 04/19/22 at 02:57 p..m. Licensing Program Analysts (LPA) Esequiel Rodriguez conducted an unannounced annual inspection at the Boyd-Velasco Family Child Care Facility to assess the Facility operation of their program and current physical plant status. Also, to evaluate the Facility's continuing ability to meet compliance with California Code of Regulations (CCR) Title 22, Health and Safety requirements, and other applicable State and Licensing Statutory requirements. LPA Rodriguez met with Betsy Boyd, Licensee and stated the reason for the inspection. The LPA provided a copy of the Entrance checklist form, LIC 126.

The Licensee. provided copy of the Child Care Center children rosters for each classroom (LIC 9040), Personnel Report (LIC 500). At 03:15 p.m. LPA Rodriguez along with the Licensee conducted a walk trough of the inside and outside of the facility along with the entire operation of the Facility.

The Facility license is posted on a prominent place of the facility. The home is licensed to provide day care services to 14 children. The Facility is clean, safe, sanitary and well maintain. All utilities are operational and in good order. There is plenty parking space. The first aid kit is present and complete and is inaccessible to children/infants. The fire extinguishers, smoke alarms and carbon monoxide monitors are in compliance and fully operational. The Facility conducts and records quarterly emergency disaster drills. The parent board was reviewed and has all the required forms and required items posted in an area accessible to parents. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are inaccessible to children. Furniture and equipment were inspected for age appropriate.

The LPA observed the Facility to be in good repair and defects free. Sign in/out rosters, telephone service, heating, lighting and ventilation were evaluated and no defects were noted. There are clean safe and sanitary individual space/cubbies with children's names. The Facility utilizes a designated isolated area to isolate ill.
SUPERVISOR'S NAME: Scott HerringTELEPHONE: (661) 202-3314
LICENSING EVALUATOR NAME: Esequiel RodriguezTELEPHONE: (661) 202-3321
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2022
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: BOYD-VELASCO FAMILY CHILD CARE
FACILITY NUMBER: 157700056
VISIT DATE: 04/19/2022
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The toys and material use for instructions meet regulatory requirements. The trash cans contain tight lids.
Staff to children ratio is in compliance.

The Facility care providers provide the children with healthy snacks. Purified water is available to all children. There is hot and cold running water in the kitchen and food preparation area. Cleaning supplies are out of reach of children.
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The inside classroom and play area is free of hazards. All items use for teaching and playing are age appropriate. Children and Staff records are complete. The facility roster was up to date and all staff have been fingerprinted and association to the designated license number. Licensee and assist are certified in Pediatric CPR/First Aid and current on their Mandated Reporting training.

Per licensee all children are accorded with their Personal Rights. These rights include, but are not limited to, the following:

(1) To be treated with dignity in his/her personal relationship with staff and other persons.
(2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.
(3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning.

The Facility does not provide Incidental Medical Services (IMS) The Licensee is well aware of the California Department of Social Services - Community Care Licensing Division(CDSS-CCLD) Web Site www.cdss.ca.gov and uses it often for consultation, and revision of current CCL issues/regulations updates. The Licensee is aware of the current immunization requirements that went in effect on 07/01/19 regarding varicella (chickenpox) vaccination now due at 15 months month instead 18 months.

The LPA provided follow up information and technical assistance such telling the facility representative where to locate Provider Information Notices (PINs) Mandated Reporter and other applicable training (Lead Poisoning) instructions in how to obtain Quarterly Child Care Updates,. Etc. Compliance and Regulatory Enforcement
SUPERVISOR'S NAME: Scott HerringTELEPHONE: (661) 202-3314
LICENSING EVALUATOR NAME: Esequiel RodriguezTELEPHONE: (661) 202-3321
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022
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: BOYD-VELASCO FAMILY CHILD CARE
FACILITY NUMBER: 157700056
VISIT DATE: 04/19/2022
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Overall, the Facility is in compliance per Title 22 regulations, no deficiencies cited during this inspection.

An exit Interview was conducted and a copy of this Report, Children's Record Review form, LIC 857, Review of Staff Records form, LIC 859, and Notice of Site Visit, LIC 9213 were provided to the Licensee.
SUPERVISOR'S NAME: Scott HerringTELEPHONE: (661) 202-3314
LICENSING EVALUATOR NAME: Esequiel RodriguezTELEPHONE: (661) 202-3321
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022
LIC809 (FAS) - (06/04)
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