197419514-5-10-2023-12-CC-APIN-CREUMU-20230501154256

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197419514
Report Date: 05/01/2023
Date Signed: 05/10/2023 12:44:26 PM

Document Has Been Signed on 05/10/2023 12:44 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:	MARROQUIN FAMILY CHILD CARE		FACILITY NUMBER:	197419514
ADMINISTRATOR:	MARROQUIN, VILMA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 942-0904
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93534
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 2	DATE:	05/01/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:41 PM
MET WITH:	Licensee Vilma Marroquin		TIME COMPLETED:	04:15 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 5/10/2023 at 12:20pm, Licensing Program Analyst (LPA) Andrea Pittman met with Licensee Vilma Marroquin to amend the Facility Evaluation Report on 5/1/2023 to reflect the dismissal of the Type B Violation. On 5/1/2023 at 12:33pm, Licensing Program Analyst (LPA) Andrea Pittman conducted an unannounced annual random inspection. The LPA disclosed the purpose of the inspection and was granted entry by the Licensee’s Daughter Vilma Marroquin and was soon met by the Licensee Vilma Marroquin. The Licensee guided the LPA on a tour of the home. Upon entry to the facility, the LPA observe 2 children in care and two staff providing care and supervision (fingerprint cleared and associated to the center.) The operational childcare hours are Monday through Saturday varied up to 23 hours depending on family's need. This is a one-story family home. There is a living room, kitchen, four bedrooms, two bathrooms, laundry area, and detached garage but not accessible from inside the home. Licensee does provide napping and has 10 mats with three cribs. The off-limits areas are the three bedrooms and garage. Licensee provides breakfast, lunch, dinner, and snacks. 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. Hanging window blind cords: The cords are inaccessible to children. Pets: there are no pets on premises. Phone service: There is a working landline and cell phone, charged and kept on staff at all times. Transportation: The Licensee does provide transportation for children, the Licensee’s driver’s license expires: 1/31/2025, the Farmers Insurance expiration is 11/18/2023, and the vehicle registration expires: 7/16/2023. Knives are kept in the kitchen in a locked cabinet, inaccessible to children in care. Medication is kept in a locked cabinet in the laundry area, inaccessible to children in care. Cleaning supplies and chemicals are kept in a locked cabinet in the laundry area and in a locked cabinet under the kitchen sink and in a locked mirror cabinet in the second bathroom away from children in care.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023

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: MARROQUIN FAMILY CHILD CARE	FACILITY NUMBER: 197419514
	VISIT DATE: 05/01/2023

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There are age-appropriate toys and equipment on the premises. The outdoor area is free from sharp objects, broken toys/furniture & equipment, and other debris. Per the Licensee, there are no weapons, firearms, and ammunition in the facility. The LPA did not observe any weapons. Per the Licensee, there is no smoking on the premises.

The First Aid kit included a temperature thermometer, tweezer, scissors, gauzes, and cleansing pads/solution was observed to be complete and inaccessible to children kept in the off-limit cabinet in the master bedroom. The required fire extinguisher (2A10BC) is reading in the green. Smoke and carbon monoxide detectors were found to be in operating condition, tested at 2:48 p.m. Fire and Disaster drills are conducted at least every six-month, last drills were recorded on 1/20/2023.

Licensee had all the required posted documents: Facility License (LIC 203,) Notice of Parent's Rights Poster (PUB 394), Emergency Disaster Plan (LIC 610A), and Earthquake Preparedness Checklist (LIC 9148).

Licensee states that she has insurance coverage for the facility from Farmers Insurance but there is also the LIC 282 signed by each parent in the children's files, as well.

The Licensee provided proof of immunization against pertussis (TDAP), measles (MMR), TB, and Flu shot for self. Licensee was able to provide a valid CPR/First Aid training valid until 3/10/2025. Child Care Provider Mandated Reporter Training Certificate has been completed the Licensee and Staff on 3/8/2023. Staff Personnel files were complete with the: LIC 9052-Notice of Employee Rights, LIC 9108-Statement Acknowledging Requirement to Report Child Abuse, Mandated Reporter Training, Immunizations: MMR, Tdap, TB, & Flu shots/statements declining the Flu shot, background clearances, and Pediatric First Aid & CPR.

Children’s records: files were found to include the following required documents: LIC 700-Identification and Emergency Consent, LIC 627-Consent for Medical Treatment, LIC 995A-Notification of Parent’s Rights, LIC 995E-Caregiver Background Check Process, and LIC 9150- Parent Notification of Additional Children in Care, LIC 9212-Family Child Care Consumer Awareness Information, and PM 286-California School Immunization Record.

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SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023

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: MARROQUIN FAMILY CHILD CARE	FACILITY NUMBER: 197419514
	VISIT DATE: 05/01/2023

NARRATIVE

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Licensee's facility child roster is current and maintained up to date.

The following were discussed: No smoking, infant walkers, Johnny jumpers, exersaucers and any other item that falls into that category which are not permitted in the facility. The LPA also discussed earthquake safety and necessity of drills, required forms for children’s files, facility files, posting requirements, and penalty.

The Licensee was informed that all adults living in or having access to the home are required to have fingerprint clearances with Department of Justice, FBI, and Child Abuse Index prior to having contact with children. If the aforementioned is not adhered to, a Civil Penalty of up to $500, per non-cleared adult will be assessed immediately. Please, advise your Analyst of any person who will be visiting regularly or for longer than one week.

The Licensee was reminded to report Unusual Incidents. A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. The Licensee was informed to utilize the Unusual Incident Report/Injury Report form LIC624B when submitting the report to the department.

Safe Sleep regulations (under 24 months) were discussed with Licensee and referred to the CCL web site for additional information and PINS. Provided Licensee with an Infant Sleep Plan form LIC 9227 and the sleep log.

Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com.

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SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023

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: MARROQUIN FAMILY CHILD CARE	FACILITY NUMBER: 197419514
	VISIT DATE: 05/01/2023

NARRATIVE

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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

Child Care Advocates:

To sign up for our Quarterly Updates please email the Child Care Advocates at
chilcareadvocatesprogram@dss.ca.gov & (916) 654-1541.

The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot-line at 1-800-540-4000.

The facility was found to be in compliance per Title 22 regulations, no citations will be cited today.

An exit interview was conducted, a copy of this Report, a Notice of Site visit, and Appeal rights were provided and discussed with Licensee.

All licensing reports are recommended to keep for 3 years and the Notice of Site visit is to be posted and visible to parents for 30 days.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrea Pittman
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/10/2023 12:37 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 05/08/2023 04:12 PM

Created By: Andrea Pittman On 05/01/2023 at 03:06 PM

Link to Parent Document Below:

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: MARROQUIN FAMILY CHILD CARE	FACILITY NUMBER: 197419514
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/01/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Deficiency Dismissed

Section Cited

Administration of Child Day Care Licensing


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Ramon

LICENSING EVALUATOR NAME:

Andrea Pittman

LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023

LIC809 (FAS) - (06/04)

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