364843612-6-15-2023-12-CC-KCAY-CSTQNG-20230615121907

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364843612
Report Date: 06/15/2023
Date Signed: 06/15/2023 12:19:15 PM

Document Has Been Signed on 06/15/2023 12:19 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:	TERRAZAS FAMILY CHILD CARE		FACILITY NUMBER:	364843612
ADMINISTRATOR:	DELIA TERRAZAS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 977-0095
CITY:	HESPERIA	STATE: CA	ZIP CODE:	92344
CAPACITY:	14	CENSUS: 8	DATE:	06/15/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:59 AM
MET WITH:	Delia Terrazas, Licensee		TIME COMPLETED:	12:30 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 June 15, 2023, Licensing Program Analyst (LPA) Calloway met with Licensee, who granted access and guided analyst on a tour of the facility for an Annual Random inspection. Family members residing in the home include 3 adults (licensee, spouse, adult son). Upon arrival LPA observed eight day care children two infants, five preschoolers, and one school aged child in care. Licensee and licensee’s son were interacting with the children. Day care is 23 hours for a capacity of 14 children and Monday-Sunday hours. Transportation is provided. Physical Plant: This is a two-story house with 6 bedrooms, 3 bathrooms, kitchen/dining room, family room, living room, and attached garage. Main care is provided in the living room (upon entry). Children use the bathroom to the right of the kitchen. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (upstairs), medicine (locked, file cabinet- family room) and hazardous items. There is no landline phone only cell phone. Fireplace (family room) has glass/screen. Stairs have a gate. Napping (cots, playpen) equipment. Home has central AC and heat. Fire/earthquake drills complete and maintained current. Roster complete and maintained current. Per Licensee, there are no weapons or firearms on the premises. LPA did not observe any in the home. There are age-appropriate toys, and furniture in the day care area. Kitchen: Refrigerator/freezer is in operable condition. Off limits (sharp knives in upper cabinet above the microwave) that can pose a danger to children. Eating for ten counted.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema Calloway	TELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023

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: TERRAZAS FAMILY CHILD CARE	FACILITY NUMBER: 364843612
	VISIT DATE: 06/15/2023

NARRATIVE

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Others: Fire extinguisher (2A10BC) is full/green (pantry). Smoke detectors and carbon monoxide detectors are in operable condition. Mandated Reporter training is not current for all residing in the home. CPR/First Aid is current. Licensee has a First Aid kit on the premises (locked file cabinet). Required postings are on the parent board. Child and staff files were reviewed.Off limits: include the entire upstairs: (Bedrooms 1,2,3, 4,5, and 6 Bathrooms #2 and #3, laundry) and garage (key lock).
Outside: Bricks/Dirt (Declaration provided) Off limits. The backyard is completely fenced. There are Little Tikes slides and age-appropriate bikes/scooters for play. There is concrete/grass area for play. There is one pet (dog) vaccinated and per Licensee, interacts with the day care children. There is no pool/spa or body of water on the premises.
The following was discussed with the Licensee: Capacity requirements, Notification of Parent's Rights, Roster requirements (keep updated names), Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children’s files and provider’s files, updated Safe Sleep regulations were discussed. The role and responsibilities of being a mandated reporter were reviewed. Everyone working in the home must renew mandated reporter training every two (2) years. www.mandatedreporterca.com Licensee reminded that 100% supervision is always required to children in care. If food is brought in, it is properly labeled. Check food expiration dates periodically. Licensee was advised on how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov. Licensee was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care. Licensee advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Report Unusual Incidents to Licensing (LIC 624B) within 24 hours of incident occurring.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema Calloway	TELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023

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: TERRAZAS FAMILY CHILD CARE	FACILITY NUMBER: 364843612
	VISIT DATE: 06/15/2023

NARRATIVE

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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 childcare home and in those areas of the family day care home where children are present (24/7 ban).
Type A citation: Type A citation(s) shall be posted for 30 consecutive days along with the Notice of Site Visit Letter (printed out after every visit) and posted during hours of operation, as there is/are immediate risk(s) to the health, safety, or personal rights of children in care. Licensee shall provide a copy any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Failure to do so will result in a Civil Penalty being assessed. State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category.

The On Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm. LPA provided consultation (Safe Sleep) during the inspection.

There were deficiencies cited during this inspection, Per Title 22 Regulations, See 809 D pages.

Exit interview was conducted and a copy of this report was read and provided to Delia Terrazas, Licensee at the facility.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema Calloway	TELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/15/2023 12:19 PM - It Cannot Be Edited

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: TERRAZAS FAMILY CHILD CARE	FACILITY NUMBER: 364843612
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/15/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

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 in two out of two staff members S2 and S3 did not have the required training in their staff files which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/26/2023
	Plan of Correction
1 2 3 4	Licensee will provide proof of mandated reporter training to Licensing by POC date of 6/26/23.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Kuliema Calloway	TELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023

LIC809 (FAS) - (06/04)

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