<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197407897
Report Date: 10/19/2023
Date Signed: 10/19/2023 11:52:32 AM


Document Has Been Signed on 10/19/2023 11:52 AM - 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 CAREFACILITY NUMBER:
197407897
ADMINISTRATOR:EDITH RIVERAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 287-1691
CITY:NEWHALLSTATE: CAZIP CODE:
91321
CAPACITY:14CENSUS: 0DATE:
10/19/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Edith RiveraTIME COMPLETED:
10:00 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
On 10/13/2023 LPA Isabel Ortega conducted a Case Management inspection as Licensee is requesting to decrease capacity from 14 children to 8 children. 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 was initially licensed on 1/08/2001 as a Small Family Child Care Home. Family Child Care Home operates Monday through Friday varied 23 hours depending on family's need. The facility provides breakfast, morning snacks, lunch, and afternoon snack.

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 garage.

SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (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)
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
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
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 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. There are age-appropriate toys and equipment on the premises. LPA did not observe any bodies of water. Per the licensee there are no weapons or firearms of any kind in the facility, nor did the LPA observe any weapons during inspection. LPA observed folding mats for napping.

The backyard is utilized by the children for outside play and is fenced all around. The outdoor play area was inspected and play equipment was observed to be free of hazards, loose and sharp parts. LPA observed age-appropriate toys both inside and outside of the home.

The facility’s fire extinguisher (2A10BC) is reading in green and met the State Fire Marshal standards. Licensee tested the smoke and carbon monoxide detectors(dual) at 11:15 a.m., and LPA found them to be in operable condition. The facility annual fees are current. The parent board was reviewed and had all the required forms posted and accessible to parents.

Licensee was provided with a capacity and ratio handout pertaining to small Family Child Care Homes and the various age groups that can be under care at one given time.

SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (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)
Page: 2 of 3
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
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
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 has met Title 22 regulations; therefore, a Small Family Child Care Home License capacity of 8 children has been granted 10/19/2023.

An exit interview was conducted, and a copy of this report, appeal and notice of site visit was provided to Licensee on this day. All Licensing reports are recommended to be kept on file for a minimum of three years.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (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)
Page: 3 of 3