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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197407198
Report Date: 10/20/2021
Date Signed: 10/22/2021 04:39:29 PM

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:BERNARDO FAMILY CHILD CAREFACILITY NUMBER:
197407198
ADMINISTRATOR:BERNARDO, ANITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 266-2674
CITY:PALMDALESTATE: CAZIP CODE:
93551
CAPACITY:14CENSUS: 4DATE:
10/20/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:07 PM
MET WITH:Anita BernardoTIME COMPLETED:
04:15 PM
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On 10/18/2021, Licensing Program Analysts (LPA) Carol Heath and conducted an unannounced Required 1 Year inspection at the above facility. Upon arrival, the LPA met with licensee Anita Bernardo who guided the LPA on a tour of the facility. Present are 5 children (2 infant, 3 preschool). Family members residing in the home include 3 adults (licensee, licensee spouse and daughter). Incidental Medical Services (IMS) policy was discussed. Per LIS, facility annual fees are current. All adults living in the home have been background cleared. Per licensee, the hours of operation are Monday through Friday 7:30 a.m. to 5:00 p.m.

The Home is set up as follows:
This is a two story home with 5 bedrooms, 3 bathrooms. This home has a kitchen, living room, family room, dining room, laundry room, and attached garage. The home was inspected for safety, comfort, cleanliness, telephone service, central air and heat and ventilation. Also for inaccessibility to poisons, detergents, cleaning compounds, medicines, and other hazardous items that can pose a danger to children. Per the licensee, there are no weapons or firearms on premises; LPA did not observe any firearms during this inspection. There is a bodies of waters (pool) observed on premises during the inspection.

Main Area: Main care is conducted in the living room, downstairs bedroom 1(classroom/playroom), downstairs bedroom 2 (napping/playroom) and back yard areas. Children use the bathroom (Bathroom #1) on the left at entrance. Off limit areas include the entire upstairs (Bedroom #2, #3, #4 and #5, bathroom #2 and #3), laundry and garage (key lock).
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2021
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: BERNARDO FAMILY CHILD CARE
FACILITY NUMBER: 197407198
VISIT DATE: 10/20/2021
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o Living Room: In the living room, LPA observed age-appropriate toys and furniture for the children There is a TV which plays educational videos for the children and an adult size couch. The home has central heating and air conditioning. All windows have screens and are free of cracks, bugs, and debris. Hanging window blinds cords are accessible to children. In the living room a fireplace was observed that was properly screened via mirror glass doors. The fireplace is inaccessible to children.

o Bedroom #1 and #2: In the room, there were additional toys observed to be in the room stored on cubbies. Several plastic storage bins were observed in which games and toys are stored for the children. There are games and books on the premises of this facility. There are mats on the floor that have educational/learning activities on them. The mats were observed to be in good condition.

o Kitchen The kitchen was inspected to ensure hazardous and dangerous items were inaccessible to children with magnet locks. LPA observed proper storage of all cleaning detergents, medications, and sharp pointed objects. Many of the cabinet were secured with safety latch. Sharps objects such as knives and scissors are inaccessible to children with safety latches. All lower cabinets and drawers in the kitchen were observed to have child proof latches that were in good condition. There is a pantry in the kitchen which food is stored. LPA observed a safety latch on the door.

o Bathroom #1: The bathroom located in the hallway in which the children utilized. Bathroom was toured, and inspected sink/toilet are in operable condition. Toilet and faucets are clean, safe, and operable. LPA observed that the bathroom was free, and clear of debris. The bathroom was in sanitary condition. Child proof latches were observed to be on the lower cabinet. No hazardous cleaning detergents or cleaning compounds were observed in the bathroom.

o Backyard: The backyard was inspected; The backyard is completely fenced. There is body of water on the premises. There are several items of toys available for the children that was observed in the backyard.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2021
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: BERNARDO FAMILY CHILD CARE
FACILITY NUMBER: 197407198
VISIT DATE: 10/20/2021
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The off-limit Areas: The Licensee states the off-limit areas include the (Bedroom #2, #3, #4, #5 bathroom #2 and #3), Bedroom #1 (key lock), laundry and garage (key lock). The garage was observed to be locked, it has a dead bolt lock. The garage is used for storage only, the garage is off limits to children.

Ø Other security gates were observed on the staircase and the formal family room. The security gates were in good condition prevent children from accessing the off limit areas.
Ø Kitchen The kitchen was inspected to ensure hazardous and dangerous items were inaccessible to children with magnet locks. LPA observed proper storage of all cleaning detergents, medications, and sharp pointed objects. Many of the cabinet were secured with safety latch. Sharps objects such as knives and scissors are inaccessible to children with safety latches. All lower cabinets and drawers in the kitchen were observed to have child proof latches that were in good condition. There is a pantry in the kitchen which food is stored. LPA observed a safety latch on the door.

Ø Others:
§ AC/Heating Unit was observed. AC/Heating Unit is inaccessible to the unit with gate.
§ Napping: LPA observed 6 mats and 1 playpen equipment. Children will nap in the designated nap areas with adult supervision.
§ The First Aid kit is located in the landury room inaccessible to children on top of the cabinet. The First Aid Kit was observed complete with supplies and a first aid manual.
§ Fire extinguisher (2A10BC): LPA observed there is a required fire extinguisher (2A10BC) fully charged Date: 9/2016 and located in the kitchen and Classroom 1 inaccessible to children.
§ Smoke Detectors and Carbon Monoxide: The smoke detectors and carbon monoxide devices tested operable.
§ Electrical outlets: All unused electrical outlets are plugged in and made inaccessible to children.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2021
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: BERNARDO FAMILY CHILD CARE
FACILITY NUMBER: 197407198
VISIT DATE: 10/20/2021
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§ Bodies of water: During this inspection, there was a pool observed in the backyard area. LPA inspected fencing around the pool. The pool fencing was at least 5 feet high and made of wrought iron. The fence was constructed so that it does not obscure the pool from view. The wrought iron gate swings away from the pool. The pool has a self-closing latch located no more than four inches from the top of the gate. The gate was able to close by itself with no assistance. Pool can be observed through the sliding glass door in the kitchen and a window located in the family room. The window located in the family room has secured locks in place. LPA observed, a stick located at the bottom of the window and a latch that locks the window. The window also has an alarm which was observed to be in operation during this visit. The Licensee comlplying with previous ( declaration) for pool.
§ Medications and cleaning solutions: The detergents/cleaning compounds in located at laundry room with without a safety latch. All medicines (upstairs off-limits bedroom)
§ Weapons or Firearms: Per Licensee, there are no weapons or firearms on the premise.
§ Transportation: The licensee will transport daycare children.
§ Incidental Medical Services (IMS): 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. The Licensee will not provide medication to children in the future.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2021
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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: BERNARDO FAMILY CHILD CARE
FACILITY NUMBER: 197407198
VISIT DATE: 10/20/2021
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Ø Documentation:

· Child files: LPA observed 10 children files contained all required licensing documents.
· Staff File: Staff files were reviewed.
· CPR/First Aid: LPA observed licensee and her assistant registered the CPR and First Aid Training on 10/26/2021.The Pediatric CPR and First Aid Training was expirated date (07/2021) 1 hour of nutrition training, (8) hours of Preventive Health and Safety Training.
· Immunization: The licensee has the required immunizations. The licensee provided a written statement declining the influenza vaccination.
· Mandated Reporter Training: The licensee has completed the online mandated reporter training at www.mandatedreporterca.com, and will renew 11/1/2021
· Transportation: The licensee does not provide transportation for children.
· Fire Drill and Disaster Drill: Per the licensee, fire and disaster drills are conducted every 6 months; the last drill was documented and conducted on 10/05/2021.

· Facility Roster: LPA observed Child Care Facility Roster. Per Licensing Information System, facility annual fees were current.


· All required licensing document were posted and observed. Licensee has posted as required the Facility License, Emergency Disaster plan, and Parents Rights Poster.
LPA observed the facility roster is current. There is current facility earthquake/fire drills documents observed during the time of this inspection.
Ø The following information was discussed with the licensee:
ü Mandatory Forms for the children’s files and provider’s files.
ü Requirements for fire drills, earthquake drills, and documentation for both.
ü The role and responsibilities of being a mandated reporter were discussed.
ü The licensee is reminded that 100% supervision is required for children at all
times.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2021
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: BERNARDO FAMILY CHILD CARE
FACILITY NUMBER: 197407198
VISIT DATE: 10/20/2021
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ü Capacity requirements, Roster requirements, Posting requirements, Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children’s files and provider’s files, and Safe Sleep Awareness. The role and responsibilities of being a mandated reporter were reviewed. The licensee was reminded that supervision is always required for children in care.

ü Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility’s phone number; if the phone number is changed, licensing must be notified.

ü 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

ü The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).

ü Criminal Record Statement: Licensee [or facility representative] 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.

ü Safe Sleep: LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] 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.

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2021
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: BERNARDO FAMILY CHILD CARE
FACILITY NUMBER: 197407198
VISIT DATE: 10/20/2021
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ü Notice of Site Visit: A notice of site visit was given and must remain posted for 30 days.

ü The regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare home and in those areas of the family day 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.

ü --Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.


n Our Quarterly updates come out every 3 months they are also now in Spanish please log in to the CCLD website or you can email our advocates to have the quarterly updates send directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

ü The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 AM - 5:00 PM.

ü A copy of the Safe Sleep Proposed Regulations was provided to Licensee.

ü LPA provided consultation during the inspection.

No deficiencies are being cited at this time, the facility complies with Title 22


Exit interview conducted and report was reviewed with the licensee Anita Bernardo

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2021
LIC809 (FAS) - (06/04)
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