364830987-4-10-2023-12-CC-KDIZ-CQRPGH-20230410111821

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364830987
Report Date: 04/05/2023
Date Signed: 04/10/2023 11:19:15 AM

Document Has Been Signed on 04/10/2023 11:19 AM - 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:	ROMERO FAMILY CHILD CARE		FACILITY NUMBER:	364830987
ADMINISTRATOR:	ROMERO, SOPHIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 843-0445
CITY:	VICTORVILLE	STATE: CA	ZIP CODE:	92392
CAPACITY:	14	CENSUS: 6	DATE:	04/05/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Sophia Romero		TIME COMPLETED:	01:15 PM

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On 4.5.23, Licensing Program Analyst (LPA) Kris Diaz, conducted an unannounced annual inspection. LPA spoke to licensee, Sophia Romero, who guided LPA on a tour of the home. People who reside in the home are the licensee and her spouse who is live scanned and has TB skin test on file. There were 6 childcare children present during the inspection and 1 assistant (licensee's adult daughter). Days and hours of operation are 24 hours. Licensee was advised that a staff member must always be awake while children are in care. Incidental Medical Services (IMS) were discussed.

This is a single-story family home 3-bedroom, 2 bath home with kitchen, dining area, living room, and family room. There is a pool on the premises. Main care is provided in the living room, family room and 1 bedroom down the hall to the right. Children use the bathroom located across from the childcare bedroom. There is a changing table in the family room. Children have access to the backyard. Off limit areas include the other 2 bedrooms, 1 bathroom and the gated backyard area where garage and vehicles are located. The garage is used for storage only and no childcare activities are conducted there. The home was inspected inside for comfort, cleanliness, telephone service, heating, and ventilation. The kitchen knives are stored in a drawer that has a safety latch to make inaccessible to children. Cleaning compounds are stored away under the kitchen sink making them inaccessible to children.

Facility roster is complete and maintained current. Fire/earthquake drills are also current. A sample of children's records were reviewed as well as staff records. Mandated Reporter certificates have been observed completed for Licensee and assistant.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kristina Diaz	TELEPHONE: (661) 202-3372
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023

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: ROMERO FAMILY CHILD CARE	FACILITY NUMBER: 364830987
	VISIT DATE: 04/05/2023

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Children play in the backyard. There is a large play structure with 2 swings and a slide with grass underneath. There is also a concrete area for active play. LPA observed play equipment and other age-appropriate toys both inside and outside of the home. There are no pets at the facility. There is a pool on the premises gated as specified by regulations. LPA observed key lock on gate and self-closing mechanism that is operable.

Per licensee, there are no weapons or firearms of any kind in the facility currently. The LPA did not observe any weapons. Several mats are provided for napping equipment. The required fire extinguisher (2A10BC), smoke detector and carbon monoxide detector are in operable condition. Home has AC and heat. Licensee and her assistant's CPR/First Aid expire 8.8.2023. Licensee has a First Aid Kit. LPA observed the parent board and required documents are posted. The First Aid kit is in a linen closet in the hallway inaccessible to children. The licensee and assistant had the required immunization against pertussis (TDAP) and measles (MMR). The completed the required Mandated Reporter training on 11/4/2021. Lead Training was not required. LPA discussed the requirement to complete if licensee relocates.

The required posted documents were posted and located in the living room: Notification of Parent's Rights Poster (PUB394), Emergency Disaster Plan (LIC610A), and Earthquake Preparedness Checklist (LIC9148).

The following was discussed with the licensee:

Mandatory licensing forms for the children’s files, facility forms/records, and information to be posted in the family child care home; Requirements to conduct fire and disaster drills once every six months and record it; Role and responsibilities of being a mandated reporter were reviewed; The licensee was reminded that 100% supervision is required at all times to children in care; Licensee was made aware that it is 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; Regulation prohibits the smoking of any kind during the operation of the day care.

The licensee was informed that all adults living in or having access to the home, or are employees are required to have fingerprint clearances with Department of Justice, FBI, and Child Abuse Central Index prior to having contact or working with children. If this is not adhered to, a Civil Penalty of up to $500, per non-cleared adult will be assessed immediately. Please advise your analyst of any person who will be visiting regularly or for longer than one week.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kristina Diaz	TELEPHONE: (661) 202-3372
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023

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: ROMERO FAMILY CHILD CARE	FACILITY NUMBER: 364830987
	VISIT DATE: 04/05/2023

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The licensee was advised to utilize the Request for Live scan Service LIC9163 to have adults fingerprinted and associated to the home.

The licensee was advised of the requirement to report Unusual Incidents. A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. The licensee was informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department.

The licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days whenever a licensing inspection is conducted. If a Type A deficiency is cited, a copy of the licensing report must also be posted for 30 days. The same report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months & licensee must obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file. Copies of the reports must be provided to each parent when a Type A violation is cited along with Acknowledgment of Receipt of Licensing Reports LIC 9224. If these requirements are not met civil penalties per violation will be assessed.

Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com.

Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: Conversion of a garage (either attached or detached) into a "child care" room; Room additions to the family child care home. Any change from an area of the family childcare home previously identified as "off limits" to an area where care and supervision will be provided to children in care. The licensee shall provide the Department with a copy of an inspection report when an inspection is required by the local building inspector as a result of the alteration, addition or construction.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kristina Diaz	TELEPHONE: (661) 202-3372
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023

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: ROMERO FAMILY CHILD CARE	FACILITY NUMBER: 364830987
	VISIT DATE: 04/05/2023

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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

Lead Flyer Requirement Health and Safety Code 1596.7996 mandated that effective January 1, 2019, CCC's and FCCH's are required to provide parents and guardians of children enrolling or reenrolling in care with written information on the risks and effects of lead exposure, blood lead testing requirements and recommendations, and options for locations of affordable blood lead tests as specified. A Lead Poisoning Facts Flyer was created, in partnership with the California Department of Public Health (CDPH), to satisfy this requirement.

The licensee was advised it is her responsibility to visit the department's website to access licensing forms, Quarterly Updates and Provider Information Notices (PINs): www.ccld.ca.gov

No deficiencies were cited during this inspection.

Exit interview was conducted and a copy of report was read and provided to Licensee on this date.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kristina Diaz	TELEPHONE: (661) 202-3372
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023

LIC809 (FAS) - (06/04)

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