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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417863
Report Date: 10/11/2019
Date Signed: 10/11/2019 04:14:44 PM

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:ROSALES FAMILY CHILD CARE HOMEFACILITY NUMBER:
197417863
ADMINISTRATOR:CLAUDIA ROSALESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 480-7421
CITY:PALMDALESTATE: CAZIP CODE:
93551
CAPACITY:14CENSUS: 4DATE:
10/11/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:52 PM
MET WITH:Claudia Rosales, Licensee TIME COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Victoria Hunt met with Claudia Rosales licensee, who guided analyst on a tour of the facility for an annual random inspection. During the time of this inspection licensee was observed to have four children in care, (between the ages of 18 months to 5 years of age). Children were observed actively playing in the living room/playroom area. Residing in the home includes: adult (licensee), her spouse, and minor children. Per LIS, facility annual fees are current. All adults have been background cleared. Licensee was operating facility within ratio during the time of inspection. Licensee was observed providing adequate supervision during the inspection. This facility operates from less than 23 1/2 hours Monday- Sunday.

This family child care facility is a two story home 4 bedrooms, 3 bathrooms with kitchen, living room/play room, enclosed patio, and attached garage. The attached garage was observed to be locked. The garage is used for storage only, the garage is off limits to children.



Main care is conducted in the enclosed patio, living room, dining areas, and back yard.
LPA observed in the living which is designed as a playroom, a fireplace is properly screened and blocked by a cupboard in which displays children's arts projects and has educational material that is posted on cupboard and walls. This facility has cubbies in which children can store their belonging each cubby was personalized with a child's name. LPA observed age appropriate toys and furniture on the premises. In the living room, several small games, toys and a educational learning material was observed. There is a TV that is used to provide educational videos to the children for learning. There is a reading area that is designated for the children in which they can read. A changing table was observed in the living room. The changing table was observed to be in good condition at the time of the inspection.


SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Victoria HuntTELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2019
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: ROSALES FAMILY CHILD CARE HOME
FACILITY NUMBER: 197417863
VISIT DATE: 10/11/2019
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There is a security gate that separates the living room from the kitchen area and was observed to be in place during the inspection. Another security gate was observed to be in place, on the staircase, preventing children from accessing the upstairs bedrooms.

In the enclosed playroom, LPA observed additional toys in which children can play with. The toys were in good and condition. Age appropriate napping equipment was observed to be on the premises. The napping equipment was in good and sanitary condition.

Children utilize a bathroom that located in the hallway by the stairs. The bathroom was observed to be free and clear of hazardous items. The bathroom was observed to have working toilet, sink, and an ample supply of towels and soap accessible for the children to use. Lower cabinets were observed to be free and clear of hazardous items. The bathroom was clean, sanitized and in good repair.

Child have access to the backyard area. The backyard is completely surrounded by wood fencing that was in good condition during this inspection. There are three large sheds on the backyard that were observed to be locked via a pad lock. Two large dogs were observed to be on premises in the backyard, that were observed in the dog run. The dog run was locked and the dogs are inaccessible to children.

There is a jungle gym with swing and slide that was anchored to the ground. There is a sandbox with cover lock On the backyard a wooden playing apparatus climbing/swing/slide structure was observed. The play apparatus inspected and was securely anchored to the ground. There were no loose items observed on the play apparatus and during the time of this inspection the play structure was in good condition. Underneath the play structure LPA observed to be sand cushion that was free and debris. There was ample supply of sand underneath the play structure; enough cushion to aid a child if he/she were to fall.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Victoria HuntTELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2019
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: ROSALES FAMILY CHILD CARE HOME
FACILITY NUMBER: 197417863
VISIT DATE: 10/11/2019
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LPA reviewed children records, records were complete. Licensee did have the required immunization's for pertussis, measles, and influenza were observed.

All required licensing document were posted. All electrical outlets were properly covered. The home is clean, orderly, comfortable and well ventilated. LPA observed a working smoke detector and carbon monoxide that was in operational condition. The fire extinguisher 2A10BC meets fire marshal standards and was operational during visit. The home has a working telephone service available. Per licensee, disaster/fire drills are conducted every six months. LPA observed disaster/fire drill log as current.



This home was clean, orderly and comfortable for children in care. This facility has a first aid kit on premises. LPA observed that licensee and her assistant were observed to have a valid Pediatric CPR and First Aid card that expires on 1/2021 . Copy obtained for file. This facility has a current roster.

Per licensee there are no weapons or firearms on the premise. There were no bodies of water observed on premises.

There are a security gate that separates the off limit areas. Areas off limit include: all bedrooms and bathrooms upstairs and the garage.

Licensee is not providing any medical services to 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
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Victoria HuntTELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: ROSALES FAMILY CHILD CARE HOME
FACILITY NUMBER: 197417863
VISIT DATE: 10/11/2019
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The following was discussed: Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being in the home. Individuals within one month of their 18th birthday must be fingerprinted immediately or at least within 30 days or less of turning 18.

There shall be no smoking, no infant walkers, johnny jumpers, exersaucers and any other item that falls into that category. Also discussed were earthquake, fire & disaster drills shall be documented at least once every six months. Posting requirements were discussed such as the posting of the Parent’s Rights poster in a visible location for the children’s authorized representatives. Children records requirements, mandated child abuse and injury/ death reporting, background check clearance transfer requirements, SIDS, Infants Safe Sleep on Back, and Never Shake A Baby were all discussed. Licensee agrees children shall be positioned for sleep on their back.

**Licensee informed to review updates/regulations for 2016/2017/2018/2019 on the department website: www.ccld.ca.gov ; AB 1207 - all child care employees must complete mandated reporter training beginning January 1, 2018; AB 1387 - and AB 2236 process to request a formal review of deficiency and establishes an appeal process for civil penalties; SB 792 - requires all staff and volunteers to show proof of immunization against influenza, pertussis and measles, and TB clearance, beginning September 1, 2016; AB 2231 Effective July 1, 2017 - Civil Penalty Amount changes. AB1207 Mandated Reporter Training,

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Victoria HuntTELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2019
LIC809 (FAS) - (06/04)
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