197401259-7-12-2019-12-CC-JNEL-BDZNVY-20190712104843

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197401259
Report Date: 07/12/2019
Date Signed: 07/12/2019 10:48:52 AM

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:	LOPEZ FAMILY DAY CARE		FACILITY NUMBER:	197401259
ADMINISTRATOR:	LOPEZ, AIDA D.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 947-6637
CITY:	PALMDALE	STATE: CA	ZIP CODE:	93550
CAPACITY:	12	CENSUS: 6	DATE:	07/12/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Aida Lopez		TIME COMPLETED:	11:05 AM

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	Licensing Program Analyst (LPA) Neal met with licensee, Aida Lopez for the purpose of a random inspection of the family child care home. This is a single story 3 bedroom, 1 bathroom home with kitchen, formal dining, living room, enclosed patio (rear of home) and garage. There is no pool, spa or other bodies of water on the premises. Family members residing in the home include 3 adults (licensee, spouse, daughter) and no children. Main care is provided in the living room, bedroom #1 (open space adjacent to the living room) and the enclosed patio area. Children use the bathroom located in the hallway. Child lock observed on cabinet under sink. Wall heaters in the living room and the hallway are fenced for inaccessibility. Children have access to the backyard. Off limit areas include the home's other 2 bedrooms (high safety latch) and the garage. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds, medicines, and hazardous items that can pose a danger to children. Cleaning compounds are stored under the kitchen sink, safety latch observed. Medications are in child locked upper kitchen cabinet in a container. Sharp knives are in high cabinet above the stove. Facility roster was observed complete and maintained current. Fire/earthquake drills are also current. A sample of children's files were reviewed. Children play in the backyard. There is an open area for active play. There are no swings or slides. There are 3 locked sheds. The covered area on the left is currently off limits and boarded for inaccessibility to children. Licensee has two cats.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2019

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: LOPEZ FAMILY DAY CARE	FACILITY NUMBER: 197401259
	VISIT DATE: 07/12/2019

NARRATIVE

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Per licensee, there are no weapons or firearms of any kind in the facility at this time. The LPA did not observe any weapons. LPA observed age appropriate toys and napping equipment on the premises. Cots are provided for napping. The required fire extinguisher (2A10BC) and carbon monoxide/smoke detector are in operable condition. No fireplace. Home has AC and heat. Licensee, licensee's spouse and licensee's assistant (Live Scan cleared) all have current CPR/First Aid (expires 5/13/2021). The First Aid kit was observed. Licensee has required documents posted. Mandated Reporter training was completed 3/21/2019. Licensee was reminded that Mandated Reporter training for child care must be completed by licensee and any adults assisting at the child care at the website, www.mandatedreporterca.com every 2 years.
The following was discussed with the licensee:
Mandatory Forms for the children’s files and provider’s files, requirements for fire drills, earthquake drills and documentation for both. Role and responsibilities of being a mandated reporter were reviewed. Licensee reminded that 100% supervision is required at all times to children in care. The licensee was advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov. Licensee was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care. The licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified. Regulation prohibits the smoking of tobacco in a private residence that is licensed as a family child care home and in those areas of the family child care home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category.

Requirements for fingerprint clearances and associations were discussed with the licensee. Licensee can be cited a civil penalty of $100 per day, up to $500.00 for the 1^st offense and up to $3000.00 for the 2^nd offense within a 12 month period, PER PERSON.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2019

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: LOPEZ FAMILY DAY CARE	FACILITY NUMBER: 197401259
	VISIT DATE: 07/12/2019

NARRATIVE

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Licensee reminded to review quarterly updates and the regulations on the department website. Handout for Safe Sleep concepts was given to licensee and discussed.

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 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

Licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B. The "Notification of Parent's Rights" poster must be posted in an area of the home accessible to parents. The information regarding new legislation with regards to exemptions and Parent’s Rights was also discussed.

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. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent when a serious deficiency, Type A, is cited (LIC9224).

No deficiencies were cited during this inspection.

An exit interview was conducted and a copy of this report was provided to the licensee on this date.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2019

LIC809 (FAS) - (06/04)

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