197700256-7-19-2019-12-CC-BREO-BE8PZQ-20190719114556

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700256
Report Date: 07/19/2019
Date Signed: 07/19/2019 11:46:03 AM

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:	RYERSON FAMILY CHILD CARE		FACILITY NUMBER:	197700256
ADMINISTRATOR:	RYERSON, TERI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 291-2330
CITY:	PALMDALE	STATE: CA	ZIP CODE:	93552
CAPACITY:	14	CENSUS: 1	DATE:	07/19/2019
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Teri Ryerson		TIME COMPLETED:	12:00 PM

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On 7/19/2019 at 9:10 a.m., Licensing Program Analyst (LPA) Brianna Reynoso arrived at the above facility to conduct an announced prelicensing inspection. LPA was greeted by applicant, Teri Ryerson, who guided LPA on a tour of the facility.

Also present during today's inspection was applicant's assistant and Child 1. Applicant was reminded all children of her own, or children living in the home that are under 10 years of age will count towards her ratio during hours of operation.

The applicant will operate Monday through Friday, 8:00 a.m. to 3:00 p.m. The applicant will provide snack and lunch, and is planning on enrolling in a food program. Applicant stated she will not be transporting any children in care. There is a pet cat which applicant has stated will be kept separate from the children in care.

This is a two story family home which consists of five bedrooms, three bathrooms, a kitchen, living room, family room, laundry room, and attached garage. The living room, kitchen area, and the downstairs bedroom will be the primary locations in which care is provided. Children will use the bathroom located across the laundry room. The backyard will be used for outside play. The off-limit areas include the entire upstairs portion of the home, four of the five bedrooms, two of the three bathrooms, laundry room, and attached garage. The stairs have been made inaccessible to children in care as the applicant has placed a baby gate at the bottom of the staircase.

The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation. The home has age appropriate toys, play equipment and materials. Medications are stored upstairs, and sharp knives are stored in a locked kitchen cabinet underneath the sink. Applicant has a First Aid Kit in the home, which is stored in the kitchen. Cleaning solutions are stored under the locked kitchen sink cabinet. LPA observed a fireplace in the family room which was properly gated and screened.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Brianna Reynoso	TELEPHONE: (661) 568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019

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: RYERSON FAMILY CHILD CARE	FACILITY NUMBER: 197700256
	VISIT DATE: 07/19/2019

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The backyard will be used for outside play. LPA found the backyard to be free of hazards, loose, or sharp objects. Applicant stated she plans on installing outdoor activity centers for the children in care, and was reminded she must inform LPA once the activity centers have been installed. LPA observed no bodies of water during today's inspection, and the yard had a shaded rest area for the children in care.

LPA observed a fire extinguisher (2A10BC) that met the state fire marshal standards. LPA was shown a receipt as proof of purchase for the fire extinguisher, which indicated it was purchased on 7/17/2019. Applicant tested the smoke detector and carbon monoxide detector at 9:58 a.m., and they were found to be in operable condition. Home has central air conditioning and heating. Per the applicant, there are no weapons or firearms in the home, nor did LPA observe any weapons or firearms during the inspection.

The applicant's and her assistant's Pediatric CPR/First Aid expire on 11/27/2020, and the Mandated Reporter training was completed on 9/14/2018. Preventative Health and Safety class that includes one hour of child nutrition was completed on 10/5/2018. A fire clearance for a capacity of 14 was granted on 7/3/2019. The applicant and her assistant had the required immunizations against pertussis (Tdap), measles (MMR), and tuberculosis (TB). The required documents were posted on the parent board located to the left of the facility entrance.

The following was discussed with applicant:
Mandatory licensing forms for the children’s files, facility forms/records, and information to be posted in the family child care home; Requirements to conduct fire and disaster drills once every six months and record it; Role and responsibilities of being a mandated reporter were reviewed; Applicant was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care; Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified; Regulation prohibits the smoking of any kind in the family child care home.

The applicant was informed that all adults living in or having access to the home, or employees are required to have fingerprint clearances with Department of Justice, FBI and Child Abuse Central Index prior to having contact or working 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 applicant was advised to utilize the Request for Live Scan Service form LIC9163 to have adults fingerprinted and associated to the home.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Brianna Reynoso	TELEPHONE: (661) 568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019

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: RYERSON FAMILY CHILD CARE	FACILITY NUMBER: 197700256
	VISIT DATE: 07/19/2019

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The applicant was advised of the requirement 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 applicant was informed to utilize the Unusual Incident Report/Injury Report form LIC624B when submitting the report to the department.

The applicant was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days whenever a licensing inspection is conducted. If a Type A deficiency is cited, a copy of the licensing report must also be posted for 30 days. The same report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months and licensee must obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian and place it in each child's file. Copies of the reports must be provided to each parent when a Type A violation is cited along with Acknowledgment of Receipt of Licensing Reports (LIC 9224). If these requirements are not met civil penalties per violation will be assessed.

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.

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

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Brianna Reynoso	TELEPHONE: (661) 568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019

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: RYERSON FAMILY CHILD CARE	FACILITY NUMBER: 197700256
	VISIT DATE: 07/19/2019

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The applicant was advised it is her responsibility to visit the department's website to access licensing forms, Quarterly Updates and Provider Information Notices (PINs): www.ccld.ca.gov

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

The following was provided to the applicant: All licensing forms required in children's files; All licensing forms required in the facility; All licensing forms to be posted in the home; Fire and Disaster Drill log; California Car Seat Flyer; Safe Sleep Flyer; Parent Notification Requirements; and the new 2019 Safe Sleep in Child Care brochure; and additional resources for the applicant and her Family Child Care Home.

The facility was in compliance per Title 22 regulations, and based on today's inspection is ready for licensure.

An exit interview was conducted, and a copy of this report was provided to applicant, Teri Ryerson.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Brianna Reynoso	TELEPHONE: (661) 568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019

LIC809 (FAS) - (06/04)

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