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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419067
Report Date: 07/03/2019
Date Signed: 07/03/2019 04:07:59 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:ROSAZZA FAMILY CHILD CAREFACILITY NUMBER:
197419067
ADMINISTRATOR:ROSAZZA, LESLIE YFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 673-5454
CITY:SAUGUSSTATE: CAZIP CODE:
91350
CAPACITY:14CENSUS: 9DATE:
07/03/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Leslie RosazzaTIME COMPLETED:
02:20 PM
NARRATIVE
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On 7/3/2019 Licensing Program Analyst (LPA), Brianna Reynoso arrived at the above facility for the purpose of conducting a case management inspection. LPA met with Staff 2, who stated licensee, Leslie Rosazza had recently left to run an errand and would be returning shortly.

Upon entering the facility, LPA observed Staff 2 providing care for nine children. At 1:55 p.m., LPA informed Staff 2 that a single staff member could not provide care for more than eight children at one given time. Staff 2 then contacted the licensee and informed her of what LPA had stated.

At 2:10 p.m., LPA met with the licensee and reminded her of the regulations regarding the ratios and capacities for large Family Child Care Homes. Licensee stated her Adult 1 and Adult 2 were present in the home, and LPA explained to licensee that neither Adult 1 or Adult 2 were in the day care area providing care upon LPAs arrival.

The above facility was not in compliance per Title 22 regulations, and deficiencies were cited during today's inspection.

Upon receipt of the Type A Violation(s), licensee shall post the report for 30 days in addition to the Notice of Site Visit and provide copies of the licensing report to parents/guardians of children in care at the facility by the close of business the following day or the next day child returns to the facility. The same report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months and licensee will obtain a signed Acknowledgement of Licensing Reports (LIC9224) from parent/guardian and place it in each child's file.

An exit interview was conducted, a copy of this report, notice of site visit, and appeal rights were provided to licensee, Leslie Rosazza.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Brianna ReynosoTELEPHONE: (661) 568-8179
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019
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: ROSAZZA FAMILY CHILD CARE
FACILITY NUMBER: 197419067
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/03/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/05/2019
Section Cited
CCR
102416.5(e)
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102416.5 Staffing Ratio and Capacity (e) 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 evidenced by: Based on LPA
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Licensee stated she will no longer leave Staff 2 or any other employee alone with more than eight children at one given time. Licensee has also stated she will inform Adult 1 and Adult 2 if an when she must leave the home, they must assist Staff 2 with the children in care, in order to maintain proper ratios. Licensee will also provide LPA with a declaration
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observations. Upon arrival, Staff 2 informed LPA that the lciensee stepped outof teh home to run an errand. Upon entering the home, LPA observed nine children under the care of Staff 2. This poses an immediate risk to the health and safety of children in care.
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indicating her understanding of ratios and capacities that must be maintained when she is not present. This declaration is to be submitted via email, no later than the plan of correction due date.
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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: Brianna ReynosoTELEPHONE: (661) 568-8179
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019
LIC809 (FAS) - (06/04)
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