197419206-1-9-2024-12-CC-JDMO-CZC28U-20240109161055

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197419206
Report Date: 01/09/2024
Date Signed: 01/09/2024 04:11:12 PM

Document Has Been Signed on 01/09/2024 04:11 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	MUNOZ FAMILY CHILD CARE		FACILITY NUMBER:	197419206
ADMINISTRATOR:	MUNOZ, EDITH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 754-0107
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93535
CAPACITY:	14	CENSUS: 9	DATE:	01/09/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Edith Munoz		TIME COMPLETED:	04:10 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 01/09/2024, at 12:30 P.M., Licensing Program Analyst (LPA) Joselito L. Del Mundo conducted an unannounced Regulations (CCR) Title 22, Health, and Safety requirements. LPA Del Mundo met with Licensee, Edith Munoz and stated the reason for the inspection. The LPA provided copies of the LIC 126 Entrance Checklist Form, LIC 311D Forms/Records to Keep in the Family Child Care Home, and all records/forms that need to be maintain in the facility. Licensee guided the analyst on a tour of the day care areas. The day care takes place in the following area of the home: living room (main day care), family room, bedroom # 1, hallway bathroom, and backyard (outdoor play area). Licensee states the day care hours of operation is 4:30 A.M. to 12:00 A.M. midnight, seven days a week. Currently living in the home is the licensee, three adults (licensee’s spouse, licensee’s daughter, licensee’s sister), and minor child. Licensee is currently providing transportation to children in care. Licensee has a current driver’s license, vehicle registration, and car insurance. During this visit, LPA observed nine children present in the facility and two assistants providing care and supervision. Physical Plant: The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds, medicines and hazardous items that can pose a danger to children. The smoke detector and carbon monoxide detector are in operable conditions (checked at 3:19 P.M.). The facility has a fully charge fire extinguisher with a 3-A:40-B:C classification (reading in green, checked at 2:30 P.M.) and the last service date was on 04/19/2023. Licensee stated that she owns no firearms, and no one smoke in the facility. LPA observed all cleaning products and detergents are stored in the upper cabinet above the cubbies in the family room where they are locked and inaccessible to children. Knives and other sharp items are stored in the upper cabinets of the kitchen (off limits). Per licensee, household medications are stored in the licensee’s room where children do not have any access. Licensee also told LPA that she will be providing medications to children in care if needed. Licensee was advised to send Incidental Medical Services (IMS) Plan if she will be providing IMS

SUPERVISOR'S NAME: Lady King	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundo	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2024

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: MUNOZ FAMILY CHILD CARE	FACILITY NUMBER: 197419206
	VISIT DATE: 01/09/2024

NARRATIVE

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later. Licensee stated that she is a member of a food program and is providing meals and snacks to children.
The facility is a one-story house. There is a fireplace in the facility and is covered with a metal fence. Cubbies for storing toys also blocks the fireplace. The home has central heating and air conditioning units.

Based on records review, licensee conducted the fire/earthquake drills on December 4, 2023, at 8:32 A.M. and 8:49 A.M., and is conducted once a month.

LPA observed safe and age-appropriate toys, books, dolls, manipulative toys, blocks, puzzles, paper, colors, play equipment, cubbies, and other learning materials. Licensee provides two cribs and twelve sleeping cots for children to use.

Licensee has first aid kit box stored on top of the refrigerator in the kitchen. LPA observed electrical outlets are child proof.

Licensee is advised that baby bouncers, saucer chairs, or any recalled and or banned toys or sleep/ play equipment are prohibited on the premises. Licensee is advised to check for fixture, furniture and equipment that have been banned or recalled by the United States Consumer Product Safety Commission.

Bathroom: Toilet, sink and faucet were clean and operable. During the inspection, LPA observed a step stool and a diaper changing table mounted on the wall inside the bathroom. LPA did not observed razors and/or sharp objects, shampoos, mouthwash, medications, perfumes, air freshener, nail polish and nail remover that will pose a health and safety risk to children in care.

Currently, the licensee has 12 children enrolled in the facility. Licensee stated that when a child shows signs of illness, he/she is separated from other children in bedroom #1 of the facility.

Outdoor: The facility has no body of water on the premises. The outdoor play area has a covered porch and age-appropriate toys and play equipment. LPA observed toy house with slides, wooden tables and benches, wooden kitchen sink toy, and other age- appropriate toys. Per licensee, she supervised children while

SUPERVISOR'S NAME: Lady King	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundo	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2024

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: MUNOZ FAMILY CHILD CARE	FACILITY NUMBER: 197419206
	VISIT DATE: 01/09/2024

NARRATIVE

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playing outside.

At the time of inspection, Licensee is aware of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing on the day of the incident and/or 24 hours of incident by telephone, fax and/or in writing to the Department. Licensee is familiar with the Unusual Incident Report form, LIC624B. The report on unusual incident/injuries can also be mailed to unusualIncidentreport@dss.ca.gov

Review of records to be maintained: LPA reviewed with licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. LPA reviewed five children’s files, licensee, and assistants’ files. Based on records review, children’s files are complete; licensee and assistants have current mandated reporter trainings completed on 07/28/2023, 07/29/2023, 07/05/2023 and 09/09/2022; CPR/First Aid trainings were completed on 06/10/2023, 03/11/2023, and 05/06/2022. Licensee and assistants have proof of immunization against measles, pertussis, and influenza. Licensee and assistants have TB skin test on file.

Licensee and other adults working and living at the facility have received criminal record clearance.

The following was discussed with the licensee:

The licensee was reminded that 100% supervision is always required for children in care. Licensee was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care. Licensing must always have the facility’s phone number; if the phone number is changed, licensing must be notified.

The regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare home and in those areas of the family day care home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exersaucers, and any other items that fall into that category.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

SUPERVISOR'S NAME: Lady King	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundo	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2024

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: MUNOZ FAMILY CHILD CARE	FACILITY NUMBER: 197419206
	VISIT DATE: 01/09/2024

NARRATIVE

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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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

Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates on courses and updates/changes to the regulations. Our Quarterly updates come out every 3 months and are also in Spanish. Please log in to the CCLD website, or you can email our advocates to have the quarterly updates sent directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 AM - 5:00 PM.

The facility is in compliance per Title 22 regulations. During today's inspection, LPA Del Mundo did not observed deficiencies that may hinder the health and safety of the children in care. No deficiencies were cited during this inspection. An exit Interview and discussion of observations were conducted with the licensee.

Notice of Site Visit: A Notice of Site Visit (LIC 9213 was given and must remain posted for 30 days.
Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
A copy of this Report was reviewed, and Appeal Rights were also provided to Licensee, Edith Munoz.

SUPERVISOR'S NAME: Lady King	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundo	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2024

LIC809 (FAS) - (06/04)

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