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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417780
Report Date: 10/03/2019
Date Signed: 10/03/2019 05:23:42 PM

COMPREHENSIVE INSPECTION
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME:GARCIA FAMILY CHILD CAREFACILITY NUMBER:
197417780
ADMINISTRATOR:GARCIA, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 400-3310
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY:14CENSUS: 5DATE:
10/03/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:40 PM
MET WITH:Maria GarciaTIME COMPLETED:
05:30 PM
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Licensing Program Analyst (LPA) Lady King-Lewis conducted an Annual Random inspection at the above facility. Upon arrival LPA was greeted by licensee, father Francisco Castillo who stated the licensee left to pick up children. Licensee father called the licensee and allowed LPA to speak with the licensee via cell phone. Licensee informed LPA that she is picking up children and should be back in 30 minutes. Licensee arrived to facility at 3:20 PM with 5 additional children giving a total of 10 children in care no infants. A copy of Child Care Facility Roster was emailed to LPA. LPA observed all available children files and all files were incomplete however all files contained a signed copy of Notification of Parents Rights. Per Licensing Information System (LIS) all adults residing and working in the home have obtained background clearances. Per LIS, facility annual fees are current. The licensee is operating out of ratios due to not having an assistance.

The home is clean, orderly, comfortable and well ventilated. Licensee's poisons, detergent, cleaning compounds, medications and other items which could pose a danger to child are stored where they are inaccessible to children. LPA observed working smoke detector and Carbon Monoxide, fully charged 1A10BC fire extinguisher and working cell phone. There are several age appropriate toys and

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Lady KingTELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 197417780
VISIT DATE: 10/03/2019
NARRATIVE
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a first aid kit on the premises. The day care takes place in family room, hallway bathroom and rear yard. The backyard is completely fenced in. There are no bodies of water in the FCCH. Per the licensee, there are no firearms on the premises. The licensee took an online course for the CPR and first aid. .

The licensee has taken the mandated reporter training; completion date 09-03-19



The licensee has the required immunization, however licensee was not able to show to day assistance immunization. Licensee states everyone in the home helps with the children.

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

The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot-line at 1-800-540-4000. Also call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Lady KingTELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 197417780
VISIT DATE: 10/03/2019
NARRATIVE
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The licensee was informed that the presence of adults in the home without Criminal Record Clearance or Exemption will be cited and civil penalty assessed for $100 per day. The licensee may find additional information and forms on the DSS website at www.ccld.ca.gov including information on the Live Scan application (LIC 9163). Appointments can be made for Live Scan at 1-800-315-4507

Our Quarterly updates come out every 3 months they are also now in Spanish please log in to the CCLD website or you can email our advocates to have the quarterly updates send directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

Per the licensee, fire and disaster drills are conducted monthly; last drill documented and conducted on 08-08-19.

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 following was discussed with the licensee;


No smoking, No infant walkers, Johnny jumpers, exersaucers and any other item that falls into that category, earthquake safety and necessity of drills (every 6 months), required forms for children’s files, facility files, posting requirements, penalty, fingerprint clearance, and the transfer process and penalty. For additional information and forms visit our website at: www.ccld.ca.gov
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Lady KingTELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 197417780
VISIT DATE: 10/03/2019
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Licensee is aware of CCLD child care videos on Community Care Licensing website at: https://ccld.childcarevideos.org/

The following deficiencies cited in accordance to Title 22 of the California Code of Regulations and/or Health & Safety codes.

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

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Lady KingTELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 197417780
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/03/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/10/2019
Section Cited

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Operation of a Family Child Care Home: Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement was not met by evidence Licensee roster of children did not have all the children in care listed on the roster.
Type B
10/31/2019
Section Cited

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Staffing Ratio and Capacity: If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c). This requirement was not met as evidence per licensee she is in the process of looking for help, today was an emergency.
Type B
11/01/2019
Section Cited

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Personnel Requirements The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement was not met by evidence the licensee completed an online CPR training
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and licensee was not able to show LPA father in law training or immunization to care for the children.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Lady KingTELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:
DATE: 10/03/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/03/2019
LIC809 (FAS) - (06/04)
Page: 5 of 5