197700328-9-6-2019-12-CC-VHUT-BFRQ8N-20190906115700

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700328
Report Date: 09/06/2019
Date Signed: 09/06/2019 11:57:25 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:	GONZALEZ FAMILY CHILD CARE		FACILITY NUMBER:	197700328
ADMINISTRATOR:	GONZALEZ, PRISCILLA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 317-9720
CITY:	PALMDALE	STATE: CA	ZIP CODE:	93551
CAPACITY:	14	CENSUS: 0	DATE:	09/06/2019
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:34 AM
MET WITH:	Priscilla Gonzalez		TIME COMPLETED:	09:35 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 Analysts (LPAs) Hunt and Montoya met with applicant Priscilla Gonzalez and conducted a tour of the facility for the purpose of a Pre-licensing inspection. This is a two story home with 4 bedrooms, 3 bathrooms with kitchen, living room, dining room, family room, laundry room and attached garage. The home was inspected as follows: Living room, family room, kitchen, dining room, laundry room, all bedrooms and bathrooms in the home; along with the backyard area and the attached garage. The home is set up as follows: This is a two-story home with 4 bedrooms, 3 bathrooms. This home has a kitchen, dining room, family room, living room, laundry room and the garage. The home was inspected for safety, comfort, cleanliness, telephone service, central air and heat and ventilation. Also, for inaccessibility to poisons, detergents, cleaning compounds, medicines, and other hazardous items that can pose a danger to children. Per applicant, there are no weapons or firearms on premises; LPAs did not observe any firearms during this inspection. This facility does have a pool on premises. Main care is provided in the family room which will be the designated as the play room. Children will have access to the kitchen/ dining room areas.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Victoria Hunt	TELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2019

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: GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 197700328
	VISIT DATE: 09/06/2019

NARRATIVE

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Room #1 LPAs observed age appropriate furniture in the room, there was a small table observed with six chairs. Napping equipment (cots), was observed in the room in good and sanitary condition. Dress up clothes were observed for dramatic play. A security gate was observed that separates the play room from the kitchen and living rooms. Another security gate was observed on the staircase that leads to the upstairs bedrooms. The security gate is in good condition.

Room # 2, downstairs, in this room LPAs observed napping equipment in which the children will utilized. There was (2) play yard cribs that are in good condition and sanitary. LPA advised applicant of new proposed sleeping regulations for infant children.

Room #3 ( Living Room ), in the living room LPAs observed a fireplace that was barricaded by glass mirror doors and a couch.

Children will utilized the bathroom located near the laundry room. The bathroom was inspected there is an operational sink and toilet. Cabinets were inspected and are free and clear of debris. The sink underneath the cabinet were empty. Applicant will supply towels in the cabinet drawers. There is a closet next to the bathroom used for storage only it was observed to have a child proof knob on the door.

The kitchen was inspected for proper storage of of all cleaning detergents, medications, sharp and pointed objects. LPAs observed detergent and cleaning products are stored in upper cabinet that is inaccessible to children. Applicant will store knives and sharp objects in the upper cabinet. There is a door in the kitchen that leads to the play room the door was observed to have a child proof knob on the door.
All electrical outlets were covered in the home. There is a first aid kit on premises. LPA observed that applicant has a fire extinguisher 2A10BC which meets fire marshal standards. Smoke detector was tested and is in operational condition. Applicant has at least one working carbon monoxide detector located . Applicant's Pediatric CPR & First Aid is valid until: 5/2021 as indicated on the certificate. LPA observed that applicant has been immunized against measles and pertussis and influenza.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Victoria Hunt	TELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2019

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: GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 197700328
	VISIT DATE: 09/06/2019

NARRATIVE

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There is a laundry room that was observed to have a child proof knob on the door. The garage can be access through the laundry room. The garage will remain off limits to children and is for storage only. Areas off limits include: All bedrooms upstairs , the garage, and storage sheds on the backyard.

The backyard was inspected, the backyard is grass landscaping surrounded by brick. LPAs observed 1 storage shed on the left side of the home that was enclosed by a chain linked gate. The shed was unlocked and was empty. Licensee advised that shed will need to be locked when storing lawn equipment or tools. The AC/Heating Unit was enclosed in the chain linked gate. The AC/Heating unit is inaccessible to children.

During this inspection, there was a pool observed in the backyard area. LPAs inspected fencing around the pool. The wrought iron fencing is at least five feet high. The fence is constructed so that it does not obscure the pool from view. The wrought iron gate swings away from the pool. The pool has a self-closing latch located no more than four inches from the top of the gate. The gate was able to close by itself with no assistance. Pool can be observed through the glass window in the kitchen and a window located in the family room play room area. There are wooden panels in front of the windows that make access to the pool inaccessible. Applicant is being advise to secure windows that have direct access to the pool with an alarm that will chime once the door is open. Photos were taken of the pool and wooden panels covering the outside windows.

Applicant will not be providing medication to children. 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: Victoria Hunt	TELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2019

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: GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 197700328
	VISIT DATE: 09/06/2019

NARRATIVE

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LPAs discussed licensing capacity requirements. Applicant understands the ratio and capacity requirements of a large license. Applicant understands that any cleared adult left alone caring for children must have a background clearance check and current Pediatric 1st Aid and CPR certificates. Applicant advised that children residing in the home under the age of 10 count towards capacity/ratio. If applicant is operating a large family child day care and no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home. Therefore, the large family child care reverts to small capacity requirements of (8) children.

The following was discussed: Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being in the home. Individuals within one month of their 18^th birthday must be fingerprinted immediately or at least within 30 days or less of turning 18.

There shall be no smoking, no infant walkers, johnny jumpers, exersaucers and any other item that falls into that category. Also discussed were earthquake, fire & disaster drills shall be documented at least once every six months. Posting requirements were discussed such as the posting of the Parent’s Rights poster in a visible location for the children’s authorized representatives. Children records requirements, mandated child abuse and injury/ death reporting, background check clearance transfer requirements, SIDS, Infants Safe Sleep on Back, and Never Shake A Baby were all discussed. Licensee agrees children shall be positioned for sleep on their back.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Victoria Hunt	TELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2019

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: GONZALEZ FAMILY CHILD CARE	FACILITY NUMBER: 197700328
	VISIT DATE: 09/06/2019

NARRATIVE

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**Applicant informed to review updates/regulations for 2016/2017/2018 on the department website: www.ccld.ca.gov ; AB 1207 - all child care employees must complete mandated reporter training beginning January 1, 2018; AB 1387 - and AB 2236 process to request a formal review of deficiency and establishes an appeal process for civil penalties; SB 792 - requires all staff and volunteers to show proof of immunization against influenza, pertussis and measles, and TB clearance, beginning September 1, 2016; AB 2231 Effective July 1, 2017 - Civil Penalty Amount changes. LPA reviewed with applicant safe sleep regulations and applicant was referred to link of proposed safe sleep regulations requirement for homes applicant was also referred to https://www.nichq.org/resource

LPA informed applicant that children enrolled to her family day care must have received immunization's required by California Law. Licensee shall have the parents submit a copy of the immunization record for child's file on a blue card PM286B. LPA informed licensee she may visit www.ShotsForSchools.Org for details on California immunization laws. Other reference materials.

Fire Clearance was granted by fire inspector for a Large Family Child Care Home on 08/29/19.

A copy of this report was discussed and read to applicant. The following items will need to be completed before licensure is granted. Once items have been completed applicant is to contact LPA so that an inspection can be completed to approve corrections.

1. Applicant must post licensing documents on the parent board

2. Licensee will obtain alarms for the windows that have direct access to the pool.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Victoria Hunt	TELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2019

LIC809 (FAS) - (06/04)

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