192008262-5-17-2019-12-CC-ARAZ-BC9R7W-20190517124701

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 192008262
Report Date: 05/17/2019
Date Signed: 05/17/2019 12:47:10 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME:	CARDENAS FAMILY CHILD CARE		FACILITY NUMBER:	192008262
ADMINISTRATOR:	CARDENAS, OLGA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 768-2719
CITY:	SUN VALLEY	STATE: CA	ZIP CODE:	91352
CAPACITY:	14	CENSUS: 10	DATE:	05/17/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Olga Cardenas		TIME COMPLETED:	01:00 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

An unannounced annual inspection was conducted by Licensing Program Analyst (LPA) Angelica Ramirez at 11:35 A.M. on 5/17/19. During the inspection, LPA met with licensee Olga Cardenas. There are currently 10 children enrolled in the family child care. Present during this inspection is licensee, assistant and 10 child care children. Per licensee residing in the home on 5/17/19 is licensee, spouse, licensee's adult son and adult sister.

Per licensee, the living room, dining room, kitchen, day care room, one powder room (day care bathroom) located off the kitchen and backyard are utilized for the family child care. Per licensee off-limit areas of the home are the three bedrooms, one bathroom located in laundry room, laundry room, one bathroom located off hallway and detached garage.

Operating hours are Monday through Friday 6:00 AM to 6:00 PM. Licensee provides meals and snacks. The facility has a written emergency disaster plan and LPA observed a current roster.

The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, poisons, detergents/cleaning compounds, medication and hazardous items that can pose a danger to children. LPA observed age appropriate safe toys and napping equipment on the premises. Per licensee children nap in the day care room located in the back of the home.

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. LPA observed the fire and earthquake drill log with most recent drill conducted on 5/10/19.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Angelica Ramirez	TELEPHONE: (661) 369-2168
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2019

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 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: CARDENAS FAMILY CHILD CARE	FACILITY NUMBER: 192008262
	VISIT DATE: 05/17/2019

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

Per licensee, there are no weapons or firearms on the premises. The backyard is used for outside play. The backyard is gated all around. The outdoor play area was inspected and was observed to be free of hazards, loose and sharp parts. LPA observed backyard appropriate safe toys.

LPA observed the required fire extinguisher (2A10BC) fully charged and meets fire marshal standards. Smoke detectors and carbon monoxide devices tested operable. The First Aid Kit was observed complete with supplies and first aid manual. LPA observed licensee has current Pediatric CPR and First Aid Training with expiration dated 1/2021.

The following were discussed: There is an effective 24/7 ban on smoking tobacco in a home that is licensed as a family day care home, and in those areas of the family day care home where children are present. Baby walkers, baby jumpers, baby exersaucers, baby bouncers/rockers and any other item that falls into that category are not permitted in the facility.

AAP: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx

NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative

Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials

Incidental Medical Services (IMS) were discussed. Per licensee, the facility is not currently providing IMS. LPA informed licensee to refer to IMS information in the 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 following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www/ada.gov/childqanda.htm.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Angelica Ramirez	TELEPHONE: (661) 369-2168
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2019

LIC809 (FAS) - (06/04)

Page: 3 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: CARDENAS FAMILY CHILD CARE	FACILITY NUMBER: 192008262
	VISIT DATE: 05/17/2019

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

The licensee was informed that all adults living in or having access to the home are required to have fingerprint clearances with Department of Justice, FBI and Child Abuse Index prior to having contact with children. If the aforementioned is not adhered to, a Civil Penalty of up to $500, per non-cleared adult will be assessed immediately. Please advise your analyst of any person who will be visiting regularly or for longer than one week.

The licensee was informed of the role and responsibilities of being a mandated reporter, renewal required every 2 years for a licensed child care provider, administrator, or employee ( www.mandatereporterca.com ) Licensee completed on 11/18/18.

Child Care Advocates: To sign up for our Quarterly Updates please email the Child Care Advocates at

childcareadvocatesprogram@dss.ca.gov & (916) 654-1541.

The licensee was reminded it is his/her responsibility to visit the departments website to obtain licensing forms, Quarterly Updates, and Provider Information Notices (PINs): www.ccld.ca.gov

The Licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days.

Exit interview conducted with Licensee. A copy of this report, notice of site inspection, Confidential Names List (LIC 811) were given and explained during this inspection.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Angelica Ramirez	TELEPHONE: (661) 369-2168
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2019

LIC809 (FAS) - (06/04)

Page: 2 of 3