197700363-3-3-2021-12-CC-IORA-BYS3Q9-20210303172645

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700363
Report Date: 03/01/2021
Date Signed: 03/03/2021 05:31:24 PM

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:	VILCAPOMA FAMILY CHILD CARE		FACILITY NUMBER:	197700363
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 5	DATE:	03/01/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	12:08 PM
MET WITH:	Charity Vilcapoma		TIME COMPLETED:	01:16 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	On 3/01/2021 at 12:00 p.m., Licensing Program Analyst (LPA) Isabel Ortega was greeted virtually by above licensee, to conduct a licensee initiated case management inspection for the purpose to increase the Family Child Care Home's(FCCH) capacity to a large FCCH. LPA disclosed the purpose of the inspection and was virtually guided on a tour of the Family Child Care Home. Upon entry LPA observed 5 children in care. Licensee is requesting an increase of capacity from a small FCCH to a large FCCH with a maximum capacity of 14 children in care. The operational hours are Monday through Friday from 6:30 AM to 6:30PM. Licensee is currently participating in a Food Nutrition Program. Licensee provides breakfast, morning snack, lunch, afternoon snack and dinner as needed. This is a two story family home, the home consist of a living room, dinning room, kitchen, three bedrooms and three bathrooms. Primary care for children will continue to be conducted in the living room. Children utilize the bathroom located to the right of the hallway. The back yard is utilized for outside play(shaded area observed). The off limits areas are the entire second upstairs floor(a child safety gate was observed at the bottom of the staircase) and the attached garage(maintained locked).

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2021

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: VILCAPOMA FAMILY CHILD CARE	FACILITY NUMBER: 197700363
	VISIT DATE: 03/01/2021

NARRATIVE

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The inside and outside of the home were inspected. LPA observed the home to be kept clean and orderly, with heating and ventilation for safety and comfort. LPA observed safe age appropriate toys and play equipment. Cleaning solutions, medications and knives are stored in the kitchen top cabinet and in a locked closet inaccessible to children. LPA observed all kitchen drawer to be child proof safe with a magnetic lock. Per the licensee there are no weapons or firearms of any kind in the facility at this time. The LPA did not observe any weapons.

The smoke and carbon monoxide detectors are in operable condition. The licensee was reminded that fire and disaster drills are to be conducted at least once every six months and logged. The home had a fire extinguisher that meets State Fire Marshal standards(in green).

The facility annual fees are current. The licensee had all the required licensing documents posted in the living room visible for parents. The LPA observed a current child roster and a first aid kit.

The out door back yard is used by the children for outside play. The back yard is gated all around. The outdoor play area was inspected and was observed to be free of hazards, loose and sharp parts. There are no bodies of water at the family day care home.
The following were discussed: Smoking is not permitted in the licensed facility. Baby walkers, baby jumpers, baby exersaucers, baby bouncers/rockers and any other items that fall into that category are not permitted in the facility. Licensee is aware of Earthquake safety and necessity of drills, required forms for children’s files, facility files and posting requirements.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2021

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: VILCAPOMA FAMILY CHILD CARE	FACILITY NUMBER: 197700363
	VISIT DATE: 03/01/2021

NARRATIVE

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The licensee was informed that all adults living in or having access to the home are required to have fingerprint clearances with Department of Justice, FBI and Child Abuse Index prior to having contact 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 #1 week.
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
The licensee was reminded it is her responsibility to visit the department's website to obtain licensing forms, Quarterly Updates, and Provider PINs.
Fire clearance was granted on 2/23/2021. An increase of capacity for a large FCCH has been approved max 14 children in care effective today 3/01/2021. Licensee is aware a qualified, cleared Assistant is required when 8 or more children are present. Copy of this report, appeal rights and notice of Site visit will be via mailed to licensee.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2021

LIC809 (FAS) - (06/04)

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