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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197409349
Report Date: 11/10/2022
Date Signed: 11/10/2022 11:31:57 AM


Document Has Been Signed on 11/10/2022 11:31 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:CALVILLO FAMILY CHILD CAREFACILITY NUMBER:
197409349
ADMINISTRATOR:VERONICA CALVILLOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 364-9489
CITY:SYLMARSTATE: CAZIP CODE:
91342
CAPACITY:14CENSUS: 4DATE:
11/10/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:32 AM
MET WITH:Veronica CalvilloTIME COMPLETED:
11:45 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 Analysts (LPA's) Justin Dorsey and Joselito Del Mundo met with Licensee, Veronica Calvillo, who guided analyst on a tour of the facility for the One Year Required Inspection. This is a two story 4 bedroom, 2.5 bathroom home with kitchen, dining room, living room, family room, laundry room and garage. There is no pool on the premises. Upon arrival LPA's observed 4 children with the licensee and Assistant #1.

Physical Plant: Main care is provided in the family room. Children use the bathroom in hallway in between the family room and living room. Children have access to the family room, children's downstairs bathroom and backyard. Off limit areas include the entire upstairs of the home, living room, kitchen, dining room, laundry room and garage. The home was inspected inside and out for safety, comfort, cleanliness, telephone service (cell and land line), heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (stored in upper kitchen cabinet) medicines (in off limits bedroom) and hazardous items (sharp knives locked in kitchen drawer) that can pose a danger to children. Fireplace is screened. The home has safe and age appropriate toys, play equipment and materials. The smoke detector and carbon monoxide detector, and Fire Extinguisher (2A10BC) are in operable condition. Per Licensee no one smokes in the home. Electrical outlets are inaccessible, no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/ play equipment were observed on the premises. There is a designated area for ill children as necessary in the dining room. Per Licensee there are no weapon/firearms in the home.

The last fire/earthquake drill was completed 11/02/22. Roster complete and maintained current.

Bathroom: Children's bathroom is free of hazards. Toilet and faucet is clean and operable.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:
DATE: 11/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/10/2022
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CALVILLO FAMILY CHILD CARE
FACILITY NUMBER: 197409349
VISIT DATE: 11/10/2022
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
Kitchen: Sharp utensils are inaccessible. Per licensee breakfast, AM snack, lunch, and PM snack are provided. LPA reminded licensee If food is brought from the children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. Cleaning supplies are stored in a top kitchen cabinet out of reach of children. No chemicals in the kitchen were observed to be accessible.

Outdoor: The backyard is safe for children and completely fenced. The backyard has grass, dirt and concrete areas for children to play. LPA's observed the toys and swing set/slide in the backyard to be in safe condition.

Advisory/Other: First Aid kit was readily available. CPR/First Aid expired 02/2022, LPA's advised licensee that the training must be completed every two years. Mandated Reporter expired 03/2020, LPA's advised licensee that the training must be completed every two years. Children nap on mats in the family room.

Documents discussed: Title 22 Personnel Records 102416.1, Safe Sleep PIN 20-24-CCP, LIC 9227 (emailed), LIC 508 (emailed) and Infant Sleep Log.

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.

LPA discussed the safe sleep regulations with licensee 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 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.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2022
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: CALVILLO FAMILY CHILD CARE
FACILITY NUMBER: 197409349
VISIT DATE: 11/10/2022
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
Exit interview conducted and report was reviewed with the licensee Veronica Calvillo. During the visit LPA Dorsey was having printer issues, LPA Dorsey emailed licensee Calvillo a copy of the Notice of Site Visit, Appeal Rights and LIC 809.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3