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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198010589
Report Date: 04/09/2025
Date Signed: 04/09/2025 02:01:37 PM

Document Has Been Signed on 04/09/2025 02:01 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:FUENTES FAMILY CHILD CAREFACILITY NUMBER:
198010589
ADMINISTRATOR/
DIRECTOR:		ANA FUENTES & SAUL HURTADOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 982-2173
CITY:SUN VALLEYSTATE: CAZIP CODE:
91352
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
04/09/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:36 PM
MET WITH:Ana Fuentes and Saul Hurtado, Licensee'sTIME VISIT/
INSPECTION COMPLETED:
02:20 PM
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On 04/09/2025, Licensing Program Analysts (LPA) Justeene Tamayo, met with licensee's, Saul Hurtado and Ana Maria Fuentas who 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 7 preschool age children in care(1 infant), and 6 preschool age children, along with the 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 near front entrance. 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 bedroom #3, second bathroom, kitchen, and guest house. Laundry room and garage are also off limits and are kept locked during business hours.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Justeene Tamayo
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/09/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: FUENTES FAMILY CHILD CARE
FACILITY NUMBER: 198010589
VISIT DATE: 04/09/2025
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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 under the kitchen sink with a safety latch, medicines are kept in children's bathroom(key locked), 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 03/24/2025. 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: Kitchen is 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 are provided. Licensee stated he currently does have a food program.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Justeene Tamayo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2025
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: FUENTES FAMILY CHILD CARE
FACILITY NUMBER: 198010589
VISIT DATE: 04/09/2025
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Outdoor: The front yard is accessible to day care children. 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 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 adults. 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 01/21/2026 for both licensee's. Mandated Reporter expires on 08/15/2026 for both licensee's. LPA reminded licensee; mandated reporter training must be completed every 2 years.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Justeene Tamayo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2025
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: FUENTES FAMILY CHILD CARE
FACILITY NUMBER: 198010589
VISIT DATE: 04/09/2025
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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's were 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's, 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.

No deficiencies have been cited at this time.

An exit interview was conducted, a copy of this report was reviewed and provided to licensee's along with the appeal rights and Notice of Site Visit.

NAME OF LICENSING PROGRAM MANAGER: Mariela Ramon
NAME OF LICENSING PROGRAM ANALYST: Justeene Tamayo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2025
LIC809 (FAS) - (06/04)
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