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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198010589
Report Date: 03/14/2024
Date Signed: 03/14/2024 02:53:59 PM


Document Has Been Signed on 03/14/2024 02:53 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 CAREFACILITY NUMBER:
198010589
ADMINISTRATOR:ANA FUENTES & SAUL HURTADOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 982-2173
CITY:SUN VALLEYSTATE: CAZIP CODE:
91352
CAPACITY:14CENSUS: 8DATE:
03/14/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Ana Fuentes and Saul HurtadoTIME COMPLETED:
03:15 PM
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On Thursday, March 14, 2024 Licensing Program Analyst (LPA) Evelyn Garcia conducted an unannounced required inspection and met with licensee Ana Maria and Saul Hurtado who guided LPA Garcia on a tour of the facility. During the visit, there were 8 children in care between the ages of 1-5 years old. Operating hours are from Monday–Friday 7:00am – 6:00pm. Family members residing in the home have been finger printed and cleared. This facility is a single - story home that consists of 4 bedrooms, 3 bathrooms, kitchen, living area, dining room, garage, and front and backyard fenced.

Areas off limits to children include- 1 bedroom located to the right of the home and bathroom in the main part of the home adjacent to bedroom off limits. Kitchen is off limits to children and there is a safety gate to make it inaccessible to children in care. However the children are escorted through the kitchen to access the bathroom. Areas off limits outdoor include the right side of the yard where it is gated off by a white wooden fence, a guest home that has 2 occupants which are finger printed and cleared. There are also 2 sheds in the backyard which are off limits one in the right and one on the left of the home. In the backyard there is a bedroom that is also off limits to the children which is locked with key and lock and inaccessible to the children. Areas on limits for the children include living room, back day care room, 1 bedroom used as a learning room that is locked when not in use and another bedroom that is used for infant napping and crib placement.

LPA Garcia inspected the facility for safety, comfort, cleanliness, ventilation and working phone (cell phone and landline). For ventilation, LPA Garcia observed central AC and the vents located on the ceiling and also observed air conditioner wall unit. LPA observed the furniture, children’s materials, to be in good condition and age appropriate. LPA did observe a fireplace, however it is barricaded by a bookshelf and made inaccessible to the children in care. LPA observed mats and cribs that are used for nap time and napping takes place in living room and infants sleep in a bedroom in crib.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Evelyn GarciaTELEPHONE: (661) 202-3785
LICENSING EVALUATOR SIGNATURE:
DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/14/2024
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: 03/14/2024
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LPA Garcia observed cleaning compounds items stored under the kitchen cabinet sink that is secured with a safety magnets and under the bathroom sink that is locked with safety latch. Knives are stored in a plastic container and placed on a high microwave in the kitchen. For water drinking, licensee stated they provide filtered water and use disposable cups. The licensee stated the facility provides breakfast, lunch and p.m. snacks and licensees currently do participate in a food program. Licensees stated they currently does not have any children with severe food allergies nor on medication.

LPA Garcia entered the bathroom located in the kitchen and observed the toilet, hand washing sink, hand soap and cleaning materials were observed to be inaccessible to children in care. LPA observed the restroom to be in good condition.

LPA Garcia asked the licensee if there were any pets, poisons, firearms, weapons, or bodies of water. The licensee stated there are no pets, no poisons and no bodies of water, no firearms, and no weapons. LPA did not observe pets, poisons, firearms, weapons, nor bodies of water. The licenses was informed that if any poisons (ex; Drano, rat poison or items that fall into that category), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately.



LPA Garcia observed the required 2A10BC fire extinguisher located in the kitchen and the valve on the green area indicating fully charged and serviced on 4/12/23. LPA observed carbon monoxide detector and smoke alarm located in the daycare room and dining room. LPA tested the carbon monoxide and smoke alarm. LPA Garcia heard the sounds and are operable. LPA observed the first aid complete with band aids, gauzes, adhesive bandages, and antiseptic wipes and located near the entrance of the daycare. For ill isolation, licensee stated another room in the daycare is used for ill isolation until parents pick up the child.

LPA Garcia inspected the play outdoor area which include backyard and front yard (right side) area that is utilized by children for safety, comfort, and cleanliness. LPA observed the backyard to be fenced and gates closed and with a locked with a pad lock. LPA observed the play equipment to be age appropriate and in a safe condition, free of sharp, no lose or pointed parts. The surface of the outdoor activity space (concrete, artificial turf) is maintained in a safe condition and is free of hazards and consists of concrete and artificial turf. For outdoor water drinking, licensees bring out water jugs and disposable cups and refill as needed.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Evelyn GarciaTELEPHONE: (661) 202-3785
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
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: 03/14/2024
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LPA Garcia observed licensee Pediatric First Aid/ CPR certification dated 1/21/24 and Health and Safety certification dated 2/9/19 and licensee has proof of immunization against Pertussis, TB, and Influenza, Tdap. Licensee has completed the Child Abuse Mandated Reporter (AB 1207) training dated 12/14/23. Licensee was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

LPA observed the following required postings: LIC 610A Emergency Disaster Plan, LIC 999 Facility sketch, Pub 394 Notification of Parents Rights, and child car seat law poster. LPA also, reviewed children roster, children files and staff files and were observed to be completed.

The following was also discussed with the licensee:



1. In the absence of the licensee a qualified adult must be present, supervising the children; a qualified adult is an individual who has a valid and current Pediatric first aid/ CPR-adult-child- infant certification (EMSA approved), a valid criminal record clearance associated to the facility license, immunization's (MMR, TDAP, TB and Influenza or Influenza declination), AB 1207 Child Abuse Mandated Reporter Certificate.

2. A current roster of children enrolled must be available and maintained for a period of 3 years, even after children are no longer attending the facility.

4. Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the license shall be terminated.

5. The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.

6. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.



7. Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing (refer to LIC 624B). Mandated reporter requirements were reviewed and explained.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Evelyn GarciaTELEPHONE: (661) 202-3785
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
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: 03/14/2024
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8. Fire and safety drills must be performed every six (6) months and documented for review by the Department.

9. Smoking is prohibited in the family childcare home.



10. Children and staff records must be maintained and updated as needed and be available for review by the Department.

11. Immunization Requirement: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The licensee and all adults working with children have proof of immunizations.

12. Inspection Authority: All adults living and working in the home shall be made of aware of the Department’s right to inspection the home, which includes, but is not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.



13. The facility license number must be on all advertisements, publications, or announcements with the intent to attract clients.

14. Isolation for Ill children: When a child is ill, he/she shall be separated from other children (reference 102417(e) Operation of a Family Child Care Home).

15. Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information.

13. Dog(s) and/or pets are recommended to be isolated from children in care.

14. No baby bouncers, no infant walkers, no Johnny jumpers, no saucer chairs, and any other item that falls into this category is not permitted in the facility.



To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Evelyn GarciaTELEPHONE: (661) 202-3785
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
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: 03/14/2024
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE Saul Hurtado, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Saul Hurtado.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Evelyn GarciaTELEPHONE: (661) 202-3785
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024
LIC809 (FAS) - (06/04)
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