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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700226
Report Date: 04/14/2023
Date Signed: 04/14/2023 03:39:39 PM


Document Has Been Signed on 04/14/2023 03:39 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:SANDOVAL FAMILY CHILD CAREFACILITY NUMBER:
197700226
ADMINISTRATOR:SANDOVAL, MELISSAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 521-8868
CITY:PALMDALESTATE: CAZIP CODE:
93551
CAPACITY:14CENSUS: 8DATE:
04/14/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:5TIME COMPLETED:
04:00 PM
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On 04/14/2023 Licensing Program Analyst (LPA) Andrew Alemoh, met with licensee, Melissa Sandoval, and assistant #1 who guided analyst on a tour of the facility for the One Year Required inspection. This is a two story 3 bedroom, 2 bathroom home with kitchen, dining room , family room, and garage. Upon arrival LPA observed 8 children in care(2 infants) and 2 adults caring for them(licensee and licensee sister/assistant). Family members residing in the home include 1 adult (licensee, licensee's minor daughter). Facility hours of operation are Monday - Friday 6:30AM- 6 PM. Incidental Medical Services (IMS) policy was discussed. There is no pool on the premises.

Physical Plant: Main care is provided in the playroom and living room area. Naps are provided on cots/mats the living room area. The children use the bathroom located in the playroom. The off-limits areas are:(upstairs is barricaded by a baby gate) all bedrooms, second restroom and the kitchen(barricaded by a baby gate). Laundry room and garage are also off limits and are kept locked during business hours. The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds which are kept in the garage, medicines are kept in licensee's bedroom and hazardous items (sharp knives are kept in the kitchen in the cabinet with a safety latch. There is a fireplace in the playroom that is barricaded,

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew AlemohTELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:
DATE: 04/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2023
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: SANDOVAL FAMILY CHILD CARE
FACILITY NUMBER: 197700226
VISIT DATE: 04/14/2023
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Safe and age appropriate toys, play equipment and materials were observed. The smoke detector, carbon monoxide detector and Fire Extinguisher (2A10BC) are all in operable condition. Electrical outlets are inaccessible. No 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 living room. Per Licensee, no one smokes in the home, and there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (cell).

Fire/Disaster drills are maintained current. Last fire disaster drill was completed on 04/23. LPA advised licensee to conduct a fire/disaster drill every 6 months. Children's roster is maintained current.

Bathroom: (There is no shower/tub). Toilet and faucet are clean and operable. LPA observed the bathroom cabinet to have a safety latch. There are no prohibited items in the children's bathroom.

Kitchen:(Barricaded by a baby gate). Sharp utensils, open bottles or alcohol are inaccessible. The home has a clean and fully stocked refrigerator/freezer. All kitchen cabinets have safety latches. Cleaning supplies are in the garage which is locked during business hours. Breakfast, lunch, snacks. are provided. Licensee stated she currently does have a food program.

Outdoor: The front yard is off limits. The backyard is completely fenced in with a brick wall. There is a gate separating a dog run on the right side of the backyard. There are three dogs in the premises. Per licensee, dogs do not come in contact when children are present. In the dog run LPA observed the AC unit(barricaded by a fence) as well as the BBQ pit which is inaccessible to children. LPA observed age appropriate toys, well secured and safe for children. There is a gated and separate area where licensee keeps a barbecue pit inaccessible to children.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew AlemohTELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: SANDOVAL FAMILY CHILD CARE
FACILITY NUMBER: 197700226
VISIT DATE: 04/14/2023
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 Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expires 06/2023. Mandated Reporter has expired. LPA reminded licensee; mandated reporter/CPR training must be completed every 2 years.

Documents Provided and or Discussed: Fire Drill Log, Postings, Employee's and Children's records, Safe Sleep PIN 20-24-CCP and Individual Sleeping Plan (LIC9227). Licensee currently does not have child care insurance.

Licensee Melissa 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 Melissa and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPAs 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.

An exit interview was conducted, a copy of this report was reviewed and provided to licensee along with the appeal rights.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew AlemohTELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2023
LIC809 (FAS) - (06/04)
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