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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197412416
Report Date: 02/13/2020
Date Signed: 02/13/2020 10:56:10 AM

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:LEDEZMA FAMILY CHILD CAREFACILITY NUMBER:
197412416
ADMINISTRATOR:LEDEZMA, MARTHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 893-8691
CITY:MISSION HILLSSTATE: CAZIP CODE:
91345
CAPACITY:14CENSUS: 3DATE:
02/13/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Licensee, Martha LedezmaTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Maddox conducted a Required 1 yr annual random inspection at the above facility. Upon arrival LPA was greeted by licensee, Martha Ledesma. LPA observed 3 pre-school age children present with licensee and her Assistant. Per Licensing Information System (LIS) all adults residing and working in the home have obtained background clearances. The facility annual fees were current per LIS. The licensee is operating within proper capacity and ratios.

The home is clean, orderly, comfortable and well ventilated. LPA observed a working smoke detector and Carbon Monoxide detector, 2 fully charged fire extinguishers and a working telephone.

There are several age appropriate toys and a first aid kit on the premises. The day care children use the family room/ day care room where there is a designated restroom for day care children only and a designated day care play, rest, and eating area. The rest of the home is off limits and gated off. The backyard is completely fenced in. There is a swing set in the back which was securely anchored to the ground and some bikes and scooters for children. The ground where children's swing set is, is padded. The licensee has no pets. There are no bodies of water on the premises and Per the licensee, there are no firearms on the premises. CPR and first aid are current (exp 10/2021).

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020
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: LEDEZMA FAMILY CHILD CARE
FACILITY NUMBER: 197412416
VISIT DATE: 02/13/2020
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LPA observed a current child roster. Licensee has the required documents posted in the FCCH; Facility License (LIC 203), Emergency Disaster Plan (LIC610A), Notification of Parents' Rights Poster (PUB 394).

The licensee and her assistants have completed their mandated reporter training which was taken 10-11-18 and 6-15-19 respectively. The licensee has her required immunization.



Please be mindful of the following safe sleep best practices:

• Always place infants on their backs for sleeping

• Use only a tight-fitting sheet on the crib or play yard mattress

• Do not hang any items from the crib or above the crib

• Keep all items, including blankets, out of the crib or play yard

• Pacifiers may be used as long as they do not have items attached to them

• Infants should not be swaddled or have any items covering them while sleeping

• The temperature of the room should be comfortable enough for an adult to wear a t-shirt and not be too hot or too cold

Note: the above guidelines are recommendations for best practices only, until regulations are approved and adopted.

An exit Interview was conducted, a copy of this Report, appeal rights, and a Notice of Site visit was provided to the licensee on this date.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020
LIC809 (FAS) - (06/04)
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