364810833-10-3-2022-12-CC-KZIS-CJUUTB-20221003155141

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364810833
Report Date: 10/03/2022
Date Signed: 10/03/2022 03:52:00 PM

Document Has Been Signed on 10/03/2022 03:52 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:	FIERRO FAMILY CHILD CARE		FACILITY NUMBER:	364810833
ADMINISTRATOR:	FIERRO, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(909) 882-8162
CITY:	SAN BERNARDINO	STATE: CA	ZIP CODE:	92405
CAPACITY:	14	CENSUS: 3	DATE:	10/03/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:05 PM
MET WITH:	Licensee Maria Fierro		TIME COMPLETED:	04:05 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	Licensing Program Analyst (LPA) Zirbes met with Licensee, Maria Fierro who guided analyst on a tour of the facility for the One Year Required inspection. This is single story home with two bedrooms, one bathroom, living room, dining room, kitchen, detached garage, front and backyard. Per Licensee the living room, dining room, kitchen, and bathroom are utilized for child care activities. Per licensee, the off-limit areas of the home are all bedrooms and the detached garage. The off limits areas were inaccessible via doors equipped with key locks. Upon arrival, LPA observed three children in care (two, three, four). Currently living in the home is the Licensee and three adults. Per Licensee there is another adult who visits the home regularly. All adults are associated and have eligible clearances. Current days and hours of operation are 7 days a week, 5:00am - midnight. Physical Plant: The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds, medicines and hazardous items that can pose a danger to children. According to Licensee and LPAs observation, all cleaning products are stored the cabinet under the kitchen sink which is equipped with a key lock. Sharp knives were stored in a cabinet equipped with a key lock. Licensee and LPA discussed that the family child care license allows the Licensee to care for children until 12 years of age. Therefore the Licensee had to continually assess the environment to ensure items are inaccessible to children from 0-12. Household medications are stored in the locked closet in the hallway of the home. Per recorded documentation Fire/earthquake drills were last completed in September 2022. The fire extinguisher was serviced in May 2022. Safe and age appropriate toys, play equipment and materials were present. The smoke detector and carbon monoxide detector were operable. Per Licensee no one smokes in the home. Electrical outlets are inaccessible, no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/ play equipment were observed on the premises. The living room is the designated area for ill children in the child care. Report continued on page two

SUPERVISOR'S NAME: Lady King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal Zirbes	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2022

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: FIERRO FAMILY CHILD CARE	FACILITY NUMBER: 364810833
	VISIT DATE: 10/03/2022

NARRATIVE

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Report continued from page one

Per Licensee, there are zero firearms stored in the home. The home does not have a fireplace. The home has a wall heater in the bathroom that is covered and has been disconnected. The home has a window air conditioning unit.
Bathroom: Toilet, sink, faucet were clean and operable. The following were inaccessible: Sharp items, mouthwash, shampoo, razor, nail polish.
Outdoor: The outdoor area is divided into two fenced spaces. The area to the back of the property is utilized for outdoor play. Per Licensee the children are supervised as they walk between the home and the fenced play space. The outdoor space is enclosed with a fence. LPA observed dramatic play houses, basketball hoop, empty water table, and additional outdoor materials for the children. The Licensee has locked outdoor sheds which hold household materials. There were zero bodies of water at the time of this inspection.

Per Licensee, there is two dogs in the home, who are current on shots. Per Licensee the dogs do interact with the child care children.

CPR/First Aid expires 5.10.23 and mandated reporter training was current.

Review of records to be maintained: LPA reviewed with licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

LPA reviewed 11 child files, the Licensees file, two assistants file and one household members file. Based on LPAs record review the staff and child files were complete and included all required information to included the required 15 minutes checks and 9227.
Documents Provided and/or Discussed: Fire Drill Log, Roster, Postings, Safe Sleep.
The following were observed: Notification of Parents' Rights (PUB394), Roster (LIC9040), License, Emergency and Disaster Information (LIC610A).

The following was discussed with the licensee:

Licensee reminded that 100% supervision is required at all times to children in care. Licensee was made aware that it is he/her responsibility to know the regulations as well as anyone who assists in providing care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified. Report continued on page three

SUPERVISOR'S NAME: Lady King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal Zirbes	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: FIERRO FAMILY CHILD CARE	FACILITY NUMBER: 364810833
	VISIT DATE: 10/03/2022

NARRATIVE

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Report continued from page two

The regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare 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 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 and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/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 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 and Licensee discussed Unusual Incident Reports and the need to report within the required time frames.

Based on LPAs record review there were zero citations issued today.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Maria Fierro.

SUPERVISOR'S NAME: Lady King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal Zirbes	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2022

LIC809 (FAS) - (06/04)

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