197418290-6-24-2022-30-CC-VWHY-CFQ8VM-20220624225123

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197418290
Report Date: 06/24/2022
Date Signed: 06/24/2022 10:51:31 PM

Document Has Been Signed on 06/24/2022 10:51 PM - 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	PALACIO FAMILY CHILD CARE		FACILITY NUMBER:	197418290
ADMINISTRATOR:	PALACIO DARLA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 696-9208
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90047
CAPACITY:	14	CENSUS: 8	DATE:	06/24/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Darla Palacio		TIME COMPLETED:	06:00 PM

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 June 24, 2022, Licensing Program Analyst (LPA), Veronica Wheatley conducted an unannounced Annual Required Inspection at 1:30pm. The licensee Darla Palacio was present with her own 4 minor children. LPA toured the home inside only and a census was taken of 6 day care children (one infant). Current facility sketch reviewed and confirmed that the living room and one bedroom are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible. There is no swimming pool or other bodies of water on the premises. Per licensee, there are no firearms or ammunition on the premises. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate ventilation for safety and comfort. The wall heater is not working. According the licensee, she uses space heaters. There are no stairs in the home. Safe toys and play equipment are observed. The home has working telephone (cellular phone). LPA discussed Safe Sleep Regulations with licensee. Cribs and play yards will be kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider will physically check on sleeping infants every fifteen minutes and document any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Veronica Wheatley	TELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2022

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: PALACIO FAMILY CHILD CARE	FACILITY NUMBER: 197418290
	VISIT DATE: 06/24/2022

NARRATIVE

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Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. Licensee states she transports children. LPA informed licensee that she must have written approval from the parents or authorized representative in order to transport children. Capacity as specified on the license is being maintained. The outdoor play area in the backyard is fenced however the yard is now off limits until it is safe. The licensee has 8 dogs (puppies) that she plans to sell or give away. The dogs will be kept inaccessible to the children in care.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporter Training was completed on June 2022. Licensee’s pediatric CPR/First Aid expires on May 2024. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA discussed with the licensee the Community Care Licensing website www.ccld.ca.gov. Licensee states she is receiving the Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

Exit interview. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

A copy of this report was provided to the licensee today.

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Veronica Wheatley	TELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2022

LIC809 (FAS) - (06/04)

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