197404752-6-29-2023-12-CC-AVIA-CT9SLN-20230629135837

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197404752
Report Date: 06/29/2023
Date Signed: 06/29/2023 02:01:58 PM

Document Has Been Signed on 06/29/2023 02:01 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	SUAREZ FAMILY CHILD CARE		FACILITY NUMBER:	197404752
ADMINISTRATOR:	MARIA SUAREZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 686-1691
CITY:	MISSION HILLS	STATE: CA	ZIP CODE:	91345
CAPACITY:	14	CENSUS: 5	DATE:	06/29/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:20 PM
MET WITH:	Maria Suarez, Licensee		TIME COMPLETED:	02:35 PM

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On June 29, 2023, Licensing Program Analysts (LPAs) Annelise Villa and Evelyn Garcia met with licensee, Maria Suarez, who guided analyst on a tour of the facility for the One Year Required inspection. Upon arrival LPAs observed 2 infants and 3 preschool age children in care and the licensee caring for them. Licensee is the only adult 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 one story family home. The home consists of a kitchen, living room, dining room, 3 bedrooms, 2 bathrooms, laundry room, and front and back yards. The primary care for children is conducted in Bedroom #1. The home was inspected inside and out for safety, comfort, cleanliness, orderliness, telephone service (cell phone), 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 on mats or 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 (3A40BC) 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 use Bathroom #1 located in the front of bedroom #1. LPAs observed toilet and faucet are clean and operable. LPAs observed Licensee removing all shampoos and toiletries from bathroom #1. Water temperature is appropriate and toilet paper and paper towels are readily available.

Continued on LIC 809-C

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Annelise Villa	TELEPHONE: 661-202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023

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: SUAREZ FAMILY CHILD CARE	FACILITY NUMBER: 197404752
	VISIT DATE: 06/29/2023

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Kitchen: The kitchen is off limits to children in care. 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 she is a participant 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. LPAs observed age-appropriate toys, well secured and safe for children. LPAs 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 are no bodies of water in the premises.

Advisory/Other: First Aid kit was observed in the daycare area with supplies readily available. CPR/First Aid expired 4/2019. Licensee will enroll in a course as soon as possible and send proof of completion to LPA Villa no later than 8/1/2023. Licensee could not locate her Mandated Reporter Training Certificate. Licensee will take Mandated Reporter Training and send proof of completion to LPAs Villa no later than 6/30/2023. LPAs 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.

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.

Continued on LIC 809-C

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Annelise Villa	TELEPHONE: 661-202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023

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: SUAREZ FAMILY CHILD CARE	FACILITY NUMBER: 197404752
	VISIT DATE: 06/29/2023

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LPAs 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. LPAs 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 Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Annelise Villa	TELEPHONE: 661-202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/29/2023 02:01 PM - It Cannot Be Edited

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: SUAREZ FAMILY CHILD CARE	FACILITY NUMBER: 197404752
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/29/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102416(c)

Personnel Requirements

(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in1 out of 1 courses which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/01/2023
	Plan of Correction
1 2 3 4	Licensee will enroll in a CPR/First Aid course and send proof of completion to LPA Villa before August 1, 2023.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Annelise Villa	TELEPHONE: 661-202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023

LIC809 (FAS) - (06/04)

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