364841901-10-22-2021-12-CC-CHEH-C82VBM-20211022161746

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364841901
Report Date: 10/07/2021
Date Signed: 10/22/2021 04:18:21 PM

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:	ARCHILA FAMILY CHILD CARE		FACILITY NUMBER:	364841901
ADMINISTRATOR:	VILMA ARCHILA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 628-6705
CITY:	VICTORVILLE	STATE: CA	ZIP CODE:	92395
CAPACITY:	14	CENSUS: 5	DATE:	10/07/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:40 AM
MET WITH:	VILMA ARCHILA		TIME COMPLETED:	03:01 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	On 10/7/2021, Licensing Program Analystist (LPAs) Carol Heath and Babatunde Ibitoye conducted an unannounced Required 1 Year inspection at the above facility. Upon arrival, the LPA met with licensee’s husband Ariel Saavedra Pereira who guided the LPAs on a tour of the facility. Individuals that reside in the home include 3 adults (licensee, her husband and daughter) and minor children. Per LIS, facility annual fees are current. All adults living in the home have been background cleared. Per licensee, the hours of operation are Monday through Friday 6:00 a.m. to 6:00 p.m. The Home is set up as follows: This is a single story house with 5 bedrooms, 2 bathrooms, kitchen/dining room, family/daycare room, living room, and attached garage. Per Licensee the living room, and family room/kitchen, 1 bathroom are utilized for the family child care activity area. Per licensee off-limit areas of the home is the all bedrooms, master bathroom, laundry room, and garage. The home was inspected for safety, comfort, cleanliness, telephone service, central air and heat and ventilation. Main Area: Main care will be conducted in the living room. There is a security gate located prevents children from accessing Living room. Family room/ Daycare area: In the Family room which is the designated playroom, LPA observed age-appropriate toys and furniture for the children. A small table was observed with a total of eight chairs. Several plastic storage bins were observed in which games and toys are stored for the children. There are games and books on the premises of this facility. There are mats on the floor that have educational/learning activities on them. The mats were observed to be in good condition. The home has central heating and air conditioning. All windows have screens and are free of cracks, bugs, and debris. Hanging window blinds cords are inaccessible to children. Bedroom #1: For older children to do their ZOOM meeting and younger children for taking nap.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ARCHILA FAMILY CHILD CARE	FACILITY NUMBER: 364841901
	VISIT DATE: 10/07/2021

NARRATIVE

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Family Room: In the family room a fireplace was observed that was properly screened via mirror glass doors. However, the glass door needs a repair to make the fireplace is inaccessible to children. In the family room, there were additional toys observed to be in the room stored on cubbies.

Kitchen The kitchen was inspected to ensure hazardous and dangerous items were inaccessible to children (Safety latches). LPAs inspected the kitchen and observed that all lower cabinets and drawer have child proof latches that are in good condition.

Bathroom #1: Children utilize a bathroom that is in the hallway. Bathrooms were toured, and inspected sink/toilet are in operable condition. Toilet and faucets are clean, safe, and operable. All poison and medications are made inaccessible to children with child safety latches on the sink cabinet. There was one cabinet that was observed to have a child proof latch on it; hand soap was observed in the cabinet.

Backyard: The backyard was inspected; the backyard is dirt landscaping surrounded by vinyl fencing. Children have access to the backyard. LPA's observed, a plastic kid's slide, several fruit trees, a basketball hoop with other age appropriate toys. LPAs did not observe a swimming pool or bodies of water on the premises. LPAs also observed a big playhouse on the top the hill. According to Licensee’s husband, it is only for his own children. It is not for daycare child. Licensee will ensure that children are always supervised while outside in the backyard. There is no body of water on the premises.

The Licensee states the off-limit areas of the home are the bedrooms (2,3,4,5) and bathroom #2, the garage, and laundry room.

Ø Others:
AC/Heating Unit was observed. AC/Heating Unit is located on the right side of the home it accessible to children via barrels blocking access the unit.
Napping: Children will nap in the designated nap areas with adult supervision. Licensee stores napping equipment in the bedroom near the front door entrance. Per licensee children nap in the living room. There are 4 cots, 1 crib and 1 playpen. LPAs observed a 11 months old baby sleep inside the crib with blankets and hanging object above the crib. Inside the playpen, there are many toys, pillows and blanket. LPAs discussed Safe Baby Sleep with the Licensee’s daughter.
The First Aid kit is located in the Master Bedroom inaccessible to children. The First Aid Kit was observed complete with supplies and a first aid manual.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021

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: ARCHILA FAMILY CHILD CARE	FACILITY NUMBER: 364841901
	VISIT DATE: 10/07/2021

NARRATIVE

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ü Safe Sleep: LPA discussed the safe sleep regulations with licensee [or facility representative] 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 [facility representative] 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.

ü Notice of Site Visit: A notice of site visit was given and must remain posted for 30 days.

ü 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.

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

n 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

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

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

ü LPA provided consultation during the inspection.

Deficiencies cited: (See LIC 809D). The following Type B deficiencies are being cited in accordance with Title 22 of the California Code of Regulations and/or Health & Safety codes.

Exit interview conducted and report was reviewed with the licensee Vilma Archila.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021

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: ARCHILA FAMILY CHILD CARE	FACILITY NUMBER: 364841901
	VISIT DATE: 10/07/2021

NARRATIVE

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Fire extinguisher (2A10BC): LPA observed there is a required fire extinguisher (3A40BC) few years back and located in the kitchen inaccessible to children.
Smoke Detectors and Carbon Monoxide: The smoke detectors and carbon monoxide devices tested operable.
Electrical outlets: All unused electrical outlets are plugged in and made inaccessible to children.
Bodies of water: There are no bodies of water in the home.
Medications and cleaning solutions are stored in locked cabinets in the off-limits area (Master Bedroom).
Weapons or Firearms: Per licensee, there are no weapons or firearms. LPA did not observe any weapons or firearms.
Transportation: The licensee will transport daycare children.
Incidental Medical Services (IMS): 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 will not be providing medication to children.

Ø Documentation:

· CPR/First Aid: LPA observed licensee has current Pediatric CPR and First Aid Training with expiration date (04/2023) 1 hour of nutrition training, (8) hours of Preventive Health and Safety Training.
· Immunization: The licensee has the required immunization. The licensee provided a written statement declining the influenza vaccination.
· Mandated Reporter Training: The licensee has completed the online mandated reporter training at www.mandatedreporterca.com, and need to renew by 09/29/2020
· Transportation: The licensee does provide transportation for children. The licensee has a valid California driver's license with an expiration date of 02/23/2019. Licensee has valid vehicle insurance with the expiration date of 05/19/2024 and 7/24/2023 and 3/5/2023 (Ester Delgado) and vehicle registration dated 05/18/20.
· Child files: LPA observed 6 children files contained all required licensing documents.
· Staff File: Her 17 years old daughter is her assistant
· Fire Drill and Disaster Drill: Per the licensee, fire and disaster drills are conducted every 6 months; the last drill was documented and conducted on 09/03/2021 .

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021

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: ARCHILA FAMILY CHILD CARE	FACILITY NUMBER: 364841901
	VISIT DATE: 10/07/2021

NARRATIVE

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· Facility Roster: LPA observed Child Care Facility Roster. Per Licensing Information System, facility annual fees were current.
· Licensee has posted as required the Facility License, Emergency Disaster plan, and Parents Rights Poster. The facility roster is not current. there are no current facility earthquake/fire drills documents observed during the time of this inspection.

The following information was discussed with the licensee:

ü Mandatory Forms for the children’s files and provider’s files.
ü Requirements for fire drills, earthquake drills, and documentation for both.
ü The role and responsibilities of being a mandated reporter were discussed.
ü The licensee is reminded that 100% supervision is required for children at all
times.

ü 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. The licensee was reminded that supervision is always required for children in care.

ü Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. Licensee 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.

ü Licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B

ü The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot-line at 1-800-540-4000. Also call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).

ü Criminal Record Statement: Licensee [or facility representative] 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.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021

LIC809 (FAS) - (06/04)

Page: 6 of 14

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: ARCHILA FAMILY CHILD CARE	FACILITY NUMBER: 364841901
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/07/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(g)

Infant Safe Sleep

An infant’s head shall not be covered while sleeping. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation,interview,record review, the licensee did not comply with the section cited above. LPAs observed the babe was sleeping inside the crib with blanket on her. The licensee also used the blanket as crib sheet which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/07/2021
	Plan of Correction
1 2 3 4	The licensee removed the blanket and hanging object. She also put the new crib sheet on the crib.

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day 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 mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record review, the licensee did not comply with the section cited above. LPAs observed licensee and her husband both Mandated reporter trainings were expired which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/11/2021
	Plan of Correction
1 2 3 4	The licensee will email the LPA her Mandated reporter training certification by 10/11/2021.

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 Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol Heath	TELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021

LIC809 (FAS) - (06/04)

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