197407897-10-19-2023-12-CC-IORA-CWRR86-20231019124724

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197407897
Report Date: 10/19/2023
Date Signed: 10/19/2023 12:47:32 PM

Document Has Been Signed on 10/19/2023 12:47 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:	RIVERA FAMILY CHILD CARE		FACILITY NUMBER:	197407897
ADMINISTRATOR:	EDITH RIVERA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 287-1691
CITY:	NEWHALL	STATE: CA	ZIP CODE:	91321
CAPACITY:	14	CENSUS: 0	DATE:	10/19/2023
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:01 AM
MET WITH:	Edith Rivera		TIME COMPLETED:	01:05 PM

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On10/19/2023 LPA Isabel Ortega conducted an annual unannounced inspection LPA announced the purpose of the inspection and was granted entry by Licensee. A tour of the facility was completed. Upon arrival LPA did not observe any children in care. Licensee is a Small family child care home up to 8 children

This is a single story with three bedrooms, two restrooms, den, kitchen, livening room, back yard and an attached garage. Main care is provided in the den referred to as the childcare area and nap area is in room #2. Children use the restroom located in the middle of the hallway to the left of the entrance. The off-limit area include two bedrooms#1 and #3(master bedroom with restroom), and the attached.

According to Licensee provides breakfast, morning snack, lunch, and afternoon snack.

The operating child care hours are Monday through Friday from 7:00 a.m. to 7:00 p.m.

SUPERVISOR'S NAME: Lady King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2023

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: RIVERA FAMILY CHILD CARE	FACILITY NUMBER: 197407897
	VISIT DATE: 10/19/2023

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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. The knives are kept in the kitchen in a child lock drawer. All cleaning chemicals are stored underneath the sink and maintained locked with a child safety latch. Medication are inaccessible to children in care.

There are age appropriate toys and equipment on the premises. Per the licensee there are no weapons or firearms of any kind in the facility. The LPA did not observe any weapons.

The First Aid kit was observed and complete. The required fire extinguisher (2A10BC), smoke and carbon monoxide detectors (dual)are in operable condition (tested 10:50 a.m.). Fire and disaster drills are conducted every six months and logged last emergency drill was conducted on 04/27/2023. Licensee's Pediatric CPR and First Aid certificate expires on 3/30/2025.

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)

The licensee and Assistant provided proof of immunization against pertussis (TDAP), measles (MMR), and influenza.

SUPERVISOR'S NAME: Lady King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2023

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: RIVERA FAMILY CHILD CARE	FACILITY NUMBER: 197407897
	VISIT DATE: 10/19/2023

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The LPA observed a current child roster. Child files were found to be complete.
The outside backyard is off limits. The backyard is gated all around. The outdoor play area was inspected and was observed to be free of hazards, loose and sharp parts.

The following were discussed: No smoking, infant walkers, Johnny jumpers, exersaucers and any other item that falls into that category are permitted in the facility. The LPA also discussed earthquake safety and necessity of drills, required forms for children’s files, facility files and posting requirements and penalty.

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 analysis of any person who will be visiting regularly or for longer than #1 week.

The applicant was advised of the requirement to report Unusual Incidents. A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. The applicant was informed to utilize the Unusual Incident Report/Injury Report form LIC624B when submitting the report to the department.

SUPERVISOR'S NAME: Lady King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2023

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: RIVERA FAMILY CHILD CARE	FACILITY NUMBER: 197407897
	VISIT DATE: 10/19/2023

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Safe Sleep regulations were discussed with Licensee and referred to the CCL web site for additional information and PINS. According to license she does enroll infants under 2 year olds.

Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com.

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

SUPERVISOR'S NAME: Lady King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2023

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: RIVERA FAMILY CHILD CARE	FACILITY NUMBER: 197407897
	VISIT DATE: 10/19/2023

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Child Care Advocates:
To sign up for our Quarterly Updates please email the Child Care Advocates at
chilcareadvocatesprogram@dss.ca.gov & (916) 654-1541

The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot-line at 1-800-540-4000.

The facility was in compliance per Title 22 regulations, a no deficiencies will be cited today. An exit Interview was conducted, a copy of this Report and a Notice of Site visit was provided to the licensee. Appeal rights were provided and discussed with licensee

SUPERVISOR'S NAME: Lady King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2023

LIC809 (FAS) - (06/04)

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