197411579-7-11-2022-12-CC-JTAO-CG5PSZ-20220708113509

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197411579
Report Date: 07/08/2022
Date Signed: 07/11/2022 10:16:23 AM

Document Has Been Signed on 07/11/2022 10:16 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:	VELEZ FAMILY CHILD CARE		FACILITY NUMBER:	197411579
ADMINISTRATOR:	VELEZ, BEATRIZ ELENA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(747) 500-9103
CITY:	SAN FERNANDO	STATE: CA	ZIP CODE:	91340
CAPACITY:	14	CENSUS: 9	DATE:	07/08/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Beatriz Velez		TIME COMPLETED:	11:50 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 07/08/22 Licensing Program Analysts(LPAs) Justeene Tamayo and Barbara Beneroso met with Licensee, Beatriz Velez, who guided analyst on a tour of the facility for the One Year Required inspection. This is a one story, 3 bedroom, 2 bathroom home with kitchen/dining, family room, living room, laundry room and garage. There is no pool/spa or body of water on the premises. Upon arrival LPA observed 3 infants, and 6 preschool age children in care, along with three assistants and the licensee. Family members residing in the home include 2 adults (licensee and licensee's husband) and no children. Facility operation are Monday-Friday 6AM-6 PM. Incidental Medical Services (IMS) policy was discussed. Physical Plant: Main care is provided in the backroom. LPAs observed the visual permit from the city posted on the board in the main care area. Children use bathroom one on the right in the main care area. Children have access to the backroom,and there is also a nursery room in the backroom. LPAs observed a spacious play pen in the living room. Per licensee, infants are only allowed to have access to the play pen for crawling and play time. The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (in laundry closet above the washer and dryer), medicines (upper kitchen cabinet) and hazardous items (sharp knives in upper kitchen cabinet above the stove) that can pose a danger to children. LPAs did not observe a fireplace in the home. Safe and age appropriate toys, play equipment and materials were observed. The smoke detector and carbon monoxide detector, Fire Extinguisher (3A40BC) 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 living room. Per Licensee there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (landline and cell).

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Justeene Tamayo	TELEPHONE: 661-202-3796
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022

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: VELEZ FAMILY CHILD CARE	FACILITY NUMBER: 197411579
	VISIT DATE: 07/08/2022

NARRATIVE

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Fire/Disaster Drill is current and up to date. Last Fire/Earthquake Drill was conducted on 03/14/2022. Roster complete and maintained current.

Bathroom: Shower/tub are free of hazards (child care bathroom). LPAs observed a diaper changing station in the child care bathroom. Cabinets in the bathroom have a child lock. LPAs did not observe any hazardous items in the children's bathroom. Toilet and faucet are clean and operable.

Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. If food is brought from the children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. The home has a clean and fully stocked refrigerator/freezer. Cleaning supplies are in laundry room (off limits area). Lunch, snacks and dinner are provided. Per licensee she currently has a food program. Naps are provided in the back room (main care area). Cots are used for sleeping equipment. LPAs also observed cribs following Title 22 regulations for the infants in the nursery room.

Outdoor: The backyard is safe for children. LPAs observed the garage attached to a red back fence with a self latch that is closed at all times. The backyard is completely barricaded (with block cement and fence). LPAs observed the front gate to be self latched as well. There is no body of water. LPAs observed age appropriate toys. Per licensee, there is one dog behind the red fence in the off limit areas.

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expire 01/15/2024. Mandated Reporter expires 02/26/2024. Staff files and children's files were reviewed. There are no window cords accessible to children.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Justeene Tamayo	TELEPHONE: 661-202-3796
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022

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: VELEZ FAMILY CHILD CARE	FACILITY NUMBER: 197411579
	VISIT DATE: 07/08/2022

NARRATIVE

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Documents Provided and or Discussed: Safe Sleep PIN 20-24-CCP and Forms to Keep in Your Home LIC311D. Licensee stated currently has child care insurance.

Licensee Velez 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.

LPAs discussed the safe sleep regulations with licensee Velez 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. 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.

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

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

Exit interview conducted and report was reviewed with the licensee Beatriz Velez along with her appeal rights.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Justeene Tamayo	TELEPHONE: 661-202-3796
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022

LIC809 (FAS) - (06/04)

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