197493184-1-11-2023-12-CC-JDOY-CMYV6R-20230111150958

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197493184
Report Date: 01/11/2023
Date Signed: 01/11/2023 03:10:36 PM

Document Has Been Signed on 01/11/2023 03:10 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	ANDRADE TRUJILLO FAMILY CHILD CARE		FACILITY NUMBER:	197493184
ADMINISTRATOR:	ANDRADE TRUJILLO, BEATRIZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 998-9650
CITY:	PALMDALE	STATE: CA	ZIP CODE:	93552
CAPACITY:	14	CENSUS: 4	DATE:	01/11/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:38 PM
MET WITH:	Beatriz Andrade		TIME COMPLETED:	04:01 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	Licensing Program Analyst (LPA) Justin Dorsey met with Licensee, Beatriz Andrade, who guided analyst on a tour of the facility for the One Year Required Inspection. This is a one story home with 4 bedrooms, 2 bathrooms, kitchen, dining room area, living room/converted indoor patio, and garage. There is no pool on the premises. Upon arrival LPA observed 4 children with the licensee. Physical Plant: Main care is provided in the living room/converted indoor patio. Children use the bathroom in hallway near the homes bedrooms. Children have access to the main care area, children's bathroom and backyard. Off limit area all of the homes bedrooms, kitchen, dining area and garage. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (stored in garage), medicines (locked in top kitchen cabinet) and hazardous items (sharp knives locked in top kitchen cabinet) that can pose a danger to children. There is no fireplace in the home. The home has safe and age appropriate toys, play equipment and materials. The smoke detector and carbon monoxide detector, and Fire Extinguisher (2A10BC) are in operable condition. Per Licensee no one smokes in the home. Electrical outlets are inaccessible, no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/ play equipment were observed on the premises. There is a designated area for ill children as necessary in the main care area. Per Licensee there are no weapon/firearms in the home. The last fire/earthquake drill was completed 09/04/22. LPA reminded licensee when disaster drills are conducted together to document both drills. Roster complete and maintained current. Bathroom: Shower/tub are free of hazards (child care bathroom). Toilet and faucet is clean and operable.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ANDRADE TRUJILLO FAMILY CHILD CARE	FACILITY NUMBER: 197493184
	VISIT DATE: 01/11/2023

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Kitchen: Sharp utensils are inaccessible. Per licensee breakfast, AM snack, lunch, PM snack dinner and snack (if necessary) are provided. LPA reminded licensee If food is brought from the children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. Cleaning supplies are stored in the garage. No chemicals in the kitchen were observed to be accessible.

Outdoor: The backyard is safe for children and completely fenced. The backyard has grass, and concrete areas for children to play. LPA observed the toys in the backyard to be in safe condition. LPA Dorsey observed there is a gated off-limits area on the right side of the backyard where 2 dogs (German Shepard and Mini Doberman) are kept.

Advisory/Other: First Aid kit was readily available. CPR/First Aid expire 10/09/24. Mandated Reporter was completed 04/12/22. Children nap on mats and cribs in the main care area.

Documents discussed: Title 22 102416.1 Personnel Records, Safe Sleep PIN 20-24-CCP, LIC 9227 and Infant Sleep Log.

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.

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.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Beatriz Andrade.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2023

LIC809 (FAS) - (06/04)

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