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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364810655
Report Date: 02/14/2020
Date Signed: 02/14/2020 11:20:50 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:DE HARO FAMILY CHILD CAREFACILITY NUMBER:
364810655
ADMINISTRATOR:DE HARO, FLAVIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 886-0254
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY:14CENSUS: 6DATE:
02/14/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:11 AM
MET WITH:TIME COMPLETED:
11:35 AM
NARRATIVE
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On 02/14/2020 at 8.11 AM Licensing Program Analyst (LPA) Aaron Mabika arrived at the facility and met Licensee, Flavia De Haro who was walking 6 children to school next block and upon coming back Licensee had questions about the rationale for the inspection but got that clarified, apologized to LPA and granted access to LPA. The purpose of the inspection is to conduct an Annual/Random Inspection. Licensee is licensed to provide care and supervision for a Large Family Child Care for the capacity of 14 children. There are currently 17 children enrolled in the family child care. Present during the time of this inspection is licensee, 2 children under care. Per licensee residing in the home on the above is licensee and spouse. Per licensee, all adults residing in the home have a Criminal Record Clearance. Licensee and LPA toured the areas of the home utilized for the Family Child Care to ensure the home is in compliance with Community Care Licensing Title 22 Regulations. The days and hours of operation are Monday through Friday 6:00 AM to 6:00 PM.
The home is set-up as follows:
This is a single story house with 3 bedrooms, 1 bathroom, kitchen/dining room, living room, and a detached garage. Per Licensee, the living room, one bathroom and backyard is utilized for the family child care activity area. Per licensee off-limit areas of the home is the all the bedrooms, (observed to be locked) and garage.
The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, poisons, detergents/cleaning compounds, medicines and hazardous items that can pose a danger to children. LPA observed all items detergents and cleaning products were in a locked cabinet and are made inaccessible to children during the time of this inspection. LPA observed age appropriate safe toys. Licensee did not have the official napping equipment as she claimed she did not have any full time children. By the time LPA left, Licensee was observed shopping online for the napping cots as per discussion.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020
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: DE HARO FAMILY CHILD CARE
FACILITY NUMBER: 364810655
VISIT DATE: 02/14/2020
NARRATIVE
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 LPA observed all electrical outlets made inaccessible to children with safety covers. LPA observed barricades on the 2 wall heaters in the hallway. There are 2 children present during today’s inspection. LPA tested hot water at a safe temperature between 105-120 degrees. Per licensee, there are no weapons or firearms on the premises. LPA did not observe a swimming pool or bodies of water on the premises.
LPA observed in the backyard a swing set, climbing/slide set (anchored in the ground), 2 play houses and a number of toys. LPA observed shade provided by a tarp and tree. The detached garage outside was certified locked. The play center was cushioned by rubber chips.
Incidental Medical Services (IMS) were discussed. Per licensee, the facility is not currently providing IMS. LPA informed licensee to refer to IMS information in the 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.
LPA observed the required fire extinguisher (2A10BC) with a service tag dated 15 February 2012, (Licensee states she has not used it so she thought it should be good still) smoke detectors and carbon monoxide devices tested operable. The First Aid Kit was observed complete with supplies and first aid manual.
LPA observed licensee has current Pediatric CPR and First Aid Training with expiration date 5/12/2020, 1 hour of nutrition training, 7 hours of Preventive Health and Safety Training. Licensee/Staff has proof of being immunized against influenza, pertussis and measles. Licensee provided a written statement declining the influenza vaccination. Licensee states she is not providing transportation. Per licensee 3 meals and 1 snack are being provided to children.
LPA reviewed 3 children’s records. LPA reviewed the child care facility roster and the fire drills, earthquake drills log (dome monthly) and documentation for both.
The following information was discussed with the licensee:
· Mandatory Forms for the children’s files and provider’s files.
· Requirements for fire drills, earthquake drills and documentation for both.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020
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: DE HARO FAMILY CHILD CARE
FACILITY NUMBER: 364810655
VISIT DATE: 02/14/2020
NARRATIVE
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· Role and responsibilities of being a mandated reporter was discussed.
· Licensee was made aware that it is their responsibility to know and review updates/regulations and forms online at www.ccld.ca.gov as well as anyone who assists in providing care.
· The licensing department must have the facility’s phone number. If the phone number is changed, the licensing department must be notified.
· Licensee is aware that all adults 18 years and older living in the home or visiting for extended periods of time should have criminal background clearances. Failure to comply will result in Civil Penalty assessments.
· On January 1, 2018 or before March 30, 2018, a person who, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the on-line mandated reporter training and shall complete renewal mandated reporter training every two years. @www.mandatedreporterca.com Licensee states she has not taken the training and was going to do so.
· AB 290 - for each new license issued, at least one director or teacher at a child care center or family child care home shall have at least one hour of childhood nutrition training;
· Senate Bill AB 2231 Civil Penalty Amount Changes. Changes Effective 7/1/2017.
· Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). **In addition; A copy of this report must be provided to the authorized representatives of all currently enrolled children and any newly enrolled child for the following 12 months.
· The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC9224) shall be signed and kept in each of the children’s records. The report shall be provided no later than the next business day or the next day the child is in care.
· Failure to meet the posting requirements shall result in an immediate $100.00 civil penalty · Licensee is made aware that Title 22 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).
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020
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: DE HARO FAMILY CHILD CARE
FACILITY NUMBER: 364810655
VISIT DATE: 02/14/2020
NARRATIVE
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*§1597.622 Employees or volunteers at family day care home; immunization requirements; records; exemptions (a) (1) 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. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
· **Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements
· Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed child care facility are aware of situations that present the greatest danger to children.
· State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category.
· Licensee advised visit www.shotsforschool.org for Immunization information.
· Child Care Advocates: You can now sign up for Quarterly Updates and PINs for one or more programs through our DSS website at www.ccld.ca.gov. Click on “Receive Important Updates” located in the right middle part of the page, immediately above the Quick links. Put your email address and choose which program(s) you would like to subscribe to and click “subscribe”.
· The following deficiencies are being cited in accordance to Title 22 of the California Code of Regulations and/or Health & Safety codes. Please refer to LIC809D for documentation of deficiencies cited :Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). **In addition; A copy of this report must be provided to the authorized representatives of all currently enrolled children and any newly enrolled child for the following 12 months.
Exit interview conducted with Licensee, Flavia De Haro. A copy of this report, notice of site inspection, Appeal Rights (LIC 9058), Confidential Names List (LIC 811) were given and explained during this inspection. Licensee’s signature on this form acknowledges receipt of these rights. Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty. Copies of this report must be posted for 30 days in visible location the authorized representatives of children.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2020
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: DE HARO FAMILY CHILD CARE
FACILITY NUMBER: 364810655
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/14/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/14/2020
Section Cited

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102417 Operation of a Family Child Care Home
The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshal
This requirement was not met as evidenced by;
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Based on observation LPA observed the servece tag of the available Fire extinguisher was 15 February, 2012.
This causes an immediate danger to children in care.
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Type B
02/14/2020
Section Cited

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1596.8662(a)(3) Article 02. Administration of Child Day Care Licensing
On and after January 1, 2018, a person who becomes an administrator or employee of a licensed child day care facility shall complete the mandated reporter training... every two years...
This requirement was not met as evidenced;
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Based on staff records review, LPA discovered Licensee failed to complete her training and admitted to it.
This causes a potential danger to children in care
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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: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:
DATE: 02/14/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/14/2020
LIC809 (FAS) - (06/04)
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