198010589-4-25-2023-12-CC-AALH-CR8U83-20230425152051

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198010589
Report Date: 04/25/2023
Date Signed: 04/25/2023 03:21:25 PM

Document Has Been Signed on 04/25/2023 03:21 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:	FUENTES FAMILY CHILD CARE		FACILITY NUMBER:	198010589
ADMINISTRATOR:	ANA FUENTES & SAUL HURTADO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 982-2173
CITY:	SUN VALLEY	STATE: CA	ZIP CODE:	91352
CAPACITY:	14	CENSUS: 8	DATE:	04/25/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Licensee Ana Maria and Saul Hurtado		TIME COMPLETED:	03:40 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 04/25/2023 Licensing Program Analysts (LPA) Andrew Alemoh, met with licensee's, Saul Hurtado and Ana Maria Fuentaswho guided analyst on a tour of the facility for the One Year Required inspection. This is a one story 3 bedroom, 2 bathroom home with kitchen two playrooms, learning room, baby room and garage. Upon arrival LPA observed 8 children in care(2 infants) and 2 licensees caring for them. Family members residing in the home include 4 adults (licensee's,licensee sister licensee's father). Facility hours of operation are Monday - Friday 7AM- 5:30PM. Incidental Medical Services (IMS) policy was discussed. Physical Plant: Main care is provided in the playrooms. Playrooms are barricaded by a baby gate. Naps are provided on mats in playroom#1. There cubbies for children toys as well as children belongings in both playrooms. There is a learning room where children go to learn. When toddlers and or school age children are in the learning room (separately) there is always at least one staff member present and supervising. Per licensee the learning room is remained locked when not in use. The children use the bathroom located in the hallway. The off-limits areas are all three bedrooms, second restroom, kitchen, and guest house. Laundry room and garage are also off limits and are kept locked during business hours.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew Alemoh	TELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 04/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2023

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: FUENTES FAMILY CHILD CARE	FACILITY NUMBER: 198010589
	VISIT DATE: 04/25/2023

NARRATIVE

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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 children's cabinet high enough making it inaccessible to children, medicines are kept in staff bathroom, and licensee bedroom. and hazardous items (sharp knives are kept in the kitchen in a plastic box high enough that they are inaccessible to children.

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 04/2023. There is a fireplace in the playroom that is barricaded by a cabinet. Child roster was observed and maintain current.

Bathroom: No Shower/tub. All cabinets are locked. Toilet and faucet are clean and operable. Medications are also stored in the bathroom with a lock making it inaccessible to children. No prohibited items were observed in the children's bathroom.

Kitchen: Off-limits and barricaded by a baby gate. Sharp utensils, open bottles or alcohol are inaccessible. Sharp knives are stored in a plastic box high enough making it inaccessible to children. The home has a clean and fully stocked refrigerator/freezer. Cleaning supplies are underneath the kitchen sink with a safety latch. Breakfast, lunch, snacks and dinner are provided. Licensee stated he currently does have a food program.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew Alemoh	TELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 04/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2023

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: FUENTES FAMILY CHILD CARE	FACILITY NUMBER: 198010589
	VISIT DATE: 04/25/2023

NARRATIVE

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Documents Provided and or Discussed: Employee's and Children's records, Safe Sleep PIN 20-24-CCP and Individual Sleeping Plan (LIC9227). Licensee currently does have child care insurance.

Licensee Saul 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 Saul 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 Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew Alemoh	TELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 04/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2023

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: FUENTES FAMILY CHILD CARE	FACILITY NUMBER: 198010589
	VISIT DATE: 04/25/2023

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Outdoor: The front yard is on limits. The front yard is barricaded by an iron fence. LPA observed age appropriate toys and play equipment in the front yard. There is a washing sink with soap in the front yard for the children to wash their hands. The AC unit in the front yard is high enough making it inaccessible to children. The backyard is completely fenced in with a brick wall. LPA observed age appropriate toys, well secured and safe for children. AC units in the backyard are are high enough making it inaccessible to children. There is a large gate that is locked during business hours and makes access to the alley way inaccessible to children. The garden is off limits and barricaded by two fences with a locking system.

There is guest house in the backyard that is off-limits to daycare children. Family members are residing in the guest house are two. LPA checked guardian and observed the individuals to be fingerprint cleared. There is 3 storage areas. Storage #1 is locked and inaccessible to children by the guest house. Storage #2 is also locked and inaccessible to children by being barricaded by the garden fence. Storage #3 is locked and inaccessible to children by being in the off-limits garden area. Age appropriate toys and play equipment were observed in the backyard.

There are no bodies of water in the premises.

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expires 12/24. Mandated Reporter expires on 01/24. LPA reminded licensee; mandated reporter training must be completed every 2 years.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew Alemoh	TELEPHONE: 661-202-3365
LICENSING EVALUATOR SIGNATURE:	DATE: 04/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2023

LIC809 (FAS) - (06/04)

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