197700305-8-29-2019-12-CC-JNEL-BFHNFT-20190829102604

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700305
Report Date: 08/29/2019
Date Signed: 08/29/2019 10:26:26 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:	GARCIA FAMILY CHILD CARE		FACILITY NUMBER:	197700305
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	08/29/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:25 AM
MET WITH:	Maria Garcia		TIME COMPLETED:	10:45 AM

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) Neal met with Applicant, Maria Garcia today for the purpose of conducting a pre-licensing inspection for a small family child care home. Home is 2 stories and consists of 3 bedrooms, 2.5 bathrooms, kitchen, formal dining area, living room, family room, garage and backyard. Parents will enter child care room through the front door. There is a pool on the premises. Family members residing in the home include 2 adults (Applicant and daughter) and 1 child. Incidental Medical Services (IMS) policy was discussed. Home was inspected inside and outside for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that are inaccessible to children. Fireplace is screened. Child care activities are to be conducted in the living room/dining room. Children will use the bathroom to the left of the family room. Off limits laundry room can be accessed through a door beside the downstairs bathroom and is made inaccessible by a child safety knob. Garage is accessed through the laundry room. It is used for storage only and no child are activities will be conducted there. Other off-limits areas include the homes entire upstairs floor and the kitchen, which has gates for both sides. Cleaning compounds/detergents are kept in child locked kitchen cabinet and bathroom cabinet. Licensee has a first aid kit. Medications are stored in high kitchen cabinet.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2019

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: GARCIA FAMILY CHILD CARE	FACILITY NUMBER: 197700305
	VISIT DATE: 08/29/2019

NARRATIVE

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Applicant shall conduct fire/earthquake drills every 6 months and document (form provided). A Child Roster form was provided and explained in detail. Children will play outside in the backyard. At present, the gate to the pool is 3 ft., 11 inches high with bars 4 inches apart. There is another portion of the gate that is of the same height, however is a standard chain link fence, also with access to the pool area. Pool gates currently do not meet regulations. There are 2 entrance gates that swing outward and self close. LPA discussed with applicant that entrances to the pool must swing outward and self-latch/self close per regulations.
Per Applicant, there are no weapons or firearms of any kind in the facility. The facility has central AC and heat. Applicant has current Pediatric CPR/First Aid certification, set to expire 4/14/2021. Preventative Health and Safety with child nutrition training was completed. Mandated Reporter training was completed 4/14/2019. Applicant was reminded mandated reporter training for child care must be completed every 2 years for licensee's and anyone assisting in child care.
The following was discussed with the Applicant:
Mandatory Forms for the children’s files and provider’s files, requirements for fire drills, earthquake drills and documentation for both. Roles and responsibilities of being a mandated reporter were reviewed. Applicant reminded that 100% supervision is required at all times to children in care. Applicant was advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov. Applicant was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care. Applicant was advised that inaccessibility of hazards must be constantly reassessed depending on the children in 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 tobacco in a private residence that is licensed as a family child care home and in those areas of the family child 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.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2019

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: GARCIA FAMILY CHILD CARE	FACILITY NUMBER: 197700305
	VISIT DATE: 08/29/2019

NARRATIVE

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To receive the quarterly updates on Community Care Licensing by email, please send your request to: Childcareadvocatesprogram@dss.ca.gov.

Applicant was advised to regularly review Quarterly Updates which includes information on: AB 1387 - process to request a formal review of deficiency and establishes an appeal process for civil penalties; SB 277 - requires all children attending day care or school based programs to be immunized and will eliminate personal/religious belief exemptions; SB 792 - requires all staff and volunteers to show proof of immunization against influenza, pertussis and measles and TB clearance.

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

Requirements for fingerprint clearances and associations were discussed with the licensee. Licensee can be cited a civil penalty of $100 per day, up to $500.00 for the 1^st offense and up to $3000.00 for the 2^nd offense within a 12 month period, PER PERSON.

Applicant was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B. The "Notification of Parent's Rights" poster must be posted in an area of the home accessible to parents. Handouts for Seat Belt Safety, SIDS, Shaken Baby Syndrome were discussed.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2019

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: GARCIA FAMILY CHILD CARE	FACILITY NUMBER: 197700305
	VISIT DATE: 08/29/2019

NARRATIVE

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Applicant was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent and a copy of the Acknowledgment of receipt of licensing report (LIC9224) must be kept in each child's file. In addition, any child enrolled within the following 12 months must also receive a copy of the Type A Citation.

A second pre-licensing corrections inspection will be conducted to ensure the following corrections have been completed before licensure:
1) Resident (Applicant's daughter) will obtain TB clearance.
2) Applicant will submit proof of measles immunization.
3) Applicant will obtain an operable carbon monoxide detector.
4) Applicant will ensure pool gates meet regulations for inaccessibility.
5) Stairs must have secure gate.
6) Knives will be made inaccessible.

Once corrections have been verified, the application for a small Family Child Care Home will be submitted for approval with a maximum capacity of 6 or 8 with parent notification. Applicant is advised that all corrections are due within 30 days or the application may be withdrawn.

Exit interview was conducted a copy of this report was printed and given to applicant.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2019

LIC809 (FAS) - (06/04)

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