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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011678
Report Date: 03/06/2020
Date Signed: 03/06/2020 10:51:51 AM

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:LIZARRAGA FAMILY CHILD CAREFACILITY NUMBER:
198011678
ADMINISTRATOR:LIZARRAGA, ESTELAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 352-9138
CITY:SUNLANDSTATE: CAZIP CODE:
91040
CAPACITY:14CENSUS: 2DATE:
03/06/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Estela LizarragaTIME COMPLETED:
11:00 AM
NARRATIVE
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Licensing Program Analyst (LPA) Nadia Flores conducted an annual inspection at the above facility. Upon arrival LPA was greeted by licensee, Estela Lizarraga. LPA observed 2 day care children. Per Licensing Information System (LIS) all adults residing in the home have obtained background clearances. Licensee stated that her older children will be moving back from college and stated she will have them fingerprinted. Per LIS, facility annual fees are current. The licensee is operating within proper capacity and ratios. LPA observed licensee to be present at the home and providing adequate care and supervision.

The home is a 3 bedroom, 1.5 bathrooms with a front and back yard and an attached garage. The full bathroom, the 3 bedroom, the garage and back yard are all off limits. The home is comfortable and well ventilated. LPA observed a working smoke detector and Carbon Monoxide, fully charged 2A10BC fire extinguisher and working telephone. There are several age appropriate toys and a first aid kit on the premises. Knives and medications are in accessible to children. Kitchen and bathroom areas were inspected for inaccessibility of toxins/cleaning compounds and other potentially dangerous objects/materials. All chemicals are in a lock and key cabinet. Electrical outlets around the home were properly covered. Children play in the front yard which is gated. There are no bodies of water on the premises. Per the licensee, there are no firearms on the premises. The licensee has current CPR and first aid that expires 7/2020

SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Nadia FloresTELEPHONE: (616) 568-8970
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 5
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: LIZARRAGA FAMILY CHILD CARE
FACILITY NUMBER: 198011678
VISIT DATE: 03/06/2020
NARRATIVE
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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 informed about the mandated reporter training that needs to be taken between January-March 2018 for free at the following website www.mandatedreporterca.com please make sure to print out your certificate and keep it for your records. This training must be renewed every 2 years. Licensee was not able to provide copy of a renewed Mandated Reported Certificate. Licensee stated that she needs to take it because it has not be renewed.

LPA observed a current child roster. Per the licensee, fire and disaster drills are conducted monthly. Last fire drill was conducted on 2/2020. Child files were found to be complete.

Licensee has all immunization on file and statement declining to take the flu shot.

All required documents were posted in visible view.

SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Nadia FloresTELEPHONE: (616) 568-8970
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2020
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: LIZARRAGA FAMILY CHILD CARE
FACILITY NUMBER: 198011678
VISIT DATE: 03/06/2020
NARRATIVE
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Capacity requirements, Roster requirements, Posting requirements, Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children’s files and provider’s files, and Safe Sleep Awareness. The role and responsibilities of being a mandated reporter were reviewed. Licensees reminded that supervision is always required to children in care. Licensees were made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. Licensees was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility’s phone number ; if the phone number is changed, licensing must be notified.

Regulation prohibits the smoking of tobacco in a private residence that is licensed as a family child care home and in those areas of the family day care home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category.

--Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.


--Licensee was informed of responsibility to report suspected Child Abuse, 1-800-827-8724
--Licensee was advised visit www.shotsforschool.org for Immunization information.
-- Our Quarterly updates come out every 3 months they are also now in Spanish please log in to the CCLD website or you can email our advocates to have the quarterly updates send directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Nadia FloresTELEPHONE: (616) 568-8970
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2020
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: LIZARRAGA FAMILY CHILD CARE
FACILITY NUMBER: 198011678
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/06/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/13/2020
Section Cited

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1596.8662(b)(1) Health and Safety Code. On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal
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mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement was not met as evidenced by, licensee did not provide certificate of completion.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Nadia FloresTELEPHONE: (616) 568-8970
LICENSING EVALUATOR SIGNATURE:
DATE: 03/06/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/06/2020
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: LIZARRAGA FAMILY CHILD CARE
FACILITY NUMBER: 198011678
VISIT DATE: 03/06/2020
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Licensee is aware of CCLD child care videos on Community Care Licensing website at: https://ccld.childcarevideos.org/

The on Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 AM - 5:00 PM.

A copy of Safe Sleep Proposed Regulations was provided to Licensee.

LPA provided consultation during inspection.

The facility was not in compliance per Title 22 regulations, a Type B deficiency will be cited today 3/6/2020. An exit Interview was conducted, a copy of this Report and a Notice of Site visit was provided and appeal rights were discussed.

SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Nadia FloresTELEPHONE: (616) 568-8970
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2020
LIC809 (FAS) - (06/04)
Page: 5 of 5