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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191231320
Report Date: 07/10/2023
Date Signed: 07/10/2023 11:06:34 AM


Document Has Been Signed on 07/10/2023 11:06 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:ARECHIGA FAMILY DAY CAREFACILITY NUMBER:
191231320
ADMINISTRATOR:ARECHIGA, JEANNIE & JOSEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 353-8783
CITY:SHADOW HILLSSTATE: CAZIP CODE:
91040
CAPACITY:14CENSUS: 0DATE:
07/10/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Jeannie and Jose ArechigaTIME COMPLETED:
12:15 PM
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On July 10, 2023, Licensing Program Analysts (LPA) Annelise Villa met with licensees Jeannie and Jose Arechiga, who guided analyst on a tour of the facility for the One Year Required inspection. Upon arrival LPA no children in care. Licensees are the only adults living in the home. Facility hours of operation are 7:00 am to 7:00 pm. Incidental Medical Services (IMS) policy was discussed.

Physical Plant: This is a three-story family home. The home consists of a kitchen, living room, dining room, 4 bedrooms, 4 bathrooms, laundry room, and front and back yards. The primary care for children is conducted in family room. The home was inspected inside and out for safety, comfort, cleanliness, orderliness, telephone service (land line), heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds which are stored in the laundry room, knives are kept in the kitchen and are inaccessible to children. Children nap in cribs in the daycare area.

Safe and age-appropriate toys, play equipment and materials were observed. The smoke detector, carbon monoxide detector and Fire Extinguisher (2A10BC) are all in operable condition. Electrical outlets are inaccessible. No recalled and or prohibited toys or sleep/ play equipment were observed on the premises. There is a designated area for ill children as necessary. Per Licensee, there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (cell phone).

Bathroom: Children are free to use any restroom in the home. All restrooms were observed to have a toilet and a faucet that are clean and operable. The restrooms were observed to have all shampoos and soaps properly stored. Water temperature is appropriate and toilet paper and paper towels are readily available.

Continued on LIC 809-C

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Annelise VillaTELEPHONE: 661-202-3786
LICENSING EVALUATOR SIGNATURE:
DATE: 07/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/10/2023
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: ARECHIGA FAMILY DAY CARE
FACILITY NUMBER: 191231320
VISIT DATE: 07/10/2023
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Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. The home has a clean and fully stocked refrigerator/freezer. Breakfast, lunch, dinner, and snacks are provided. Licensee stated they are participants in a food program.

Outdoor: The front yard is off limits. The front yard is made inaccessible by a door with a lock. The back yard is completely fenced in. LPA observed age-appropriate toys, well secured and safe for children. LPA toured the back yard and observed it to be free of garden tools, poisonous plants, thorn trees, cactus, or lawn mower inaccessible to children. Per licensee, there are no pets on the premises.

Pools/Spas/Bodies of Water: There is a swimming pool and a spa in the backyard. The bodies of water are completely enclosed by a 5 ft metal fence. The fence runs all the way down to the concrete on which it sits, leaving approximately two inches between the bottom of the fence and the concrete. The pool gate was tested and observed to be self-closing and self-latching. The gate has an installed mechanism containing a key to lock the gate and it is located within 6 inches from the top of the gate. The lever to open the gate is located at the top of the gate. The pool gate opens away from the body of water. All items rendering the fence climbable are moved away from the fence. The metal fencing is sturdy and capable of withstanding the impact of children's toys including bicycles. There are no other bodies of water on the premises.

Advisory/Other: First Aid kit was observed in the daycare area with supplies readily available. CPR/First Aid expires 3/2025. Licensee could not locate her Mandated Reporter Training Certificate. Licensee will take Mandated Reporter Training and send proof of completion to LPA Villa no later than 7/13/2023. LPA reminded licensee mandated reporter training and CPR must be completed every 2 years.

The facility annual fees are current. Licensee had all the required posted documents: Facility License (LIC 203), Notice of Parent's Rights Poster (PUB 394), Emergency Disaster Plan (LIC 610A), and Earthquake Preparedness Checklist (LIC 9148). Children files were found to be complete. Last fire/disaster drill log is maintained current and last drill was completed on 6/29/2023.

Continued on LIC 809-C

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Annelise VillaTELEPHONE: 661-202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2023
LIC809 (FAS) - (06/04)
Page: 3 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: ARECHIGA FAMILY DAY CARE
FACILITY NUMBER: 191231320
VISIT DATE: 07/10/2023
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Documents Provided and or Discussed: Fire Drill Log, Postings, Employee's and Children's records, Safe Sleep PIN 20-24-CCP and Individual Sleeping Plan (LIC9227). Licensee currently does not have child care insurance.

Licensee 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 and discussed the Child Care Licensing Safe Sleep web page 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.

An exit interview was conducted, a copy of this report was reviewed and provided to licensee along with the appeal rights.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Annelise VillaTELEPHONE: 661-202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2023
LIC809 (FAS) - (06/04)
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