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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364843612
Report Date: 02/02/2023
Date Signed: 02/02/2023 01:37:27 PM


Document Has Been Signed on 02/02/2023 01:37 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 CAREFACILITY NUMBER:
364843612
ADMINISTRATOR:DELIA TERRAZASFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 977-0095
CITY:HESPERIASTATE: CAZIP CODE:
92344
CAPACITY:14CENSUS: 3DATE:
02/02/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Delia Terrazas, LicenseeTIME COMPLETED:
01:30 PM
NARRATIVE
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On February 2, 2023, at 11:30 a.m., Licensing Program Analyst (LPA), Kuliema Calloway made an unannounced case management inspection visit to Terrazas Family Child Care. LPA met with Licensee's spouse who granted access. The purpose of the visit was to interview the Licensee, Delia Terrazas regarding allegations that were cross reported to Palmdale CCLD regarding Foster Child 1.

LPA observed one infant in care as a foster care child and two (2) two year old's as day care children sleeping on cots. There were three adults inside the home. Licensee's spouse (Adult 1), Licensee's son (Adult 2), and Licensee's sister-in-law, (Adult 3).

It was revealed during the visit that (Adult 3) was fingerprinted however, the results are pending and (Adult 3) was inside the home during day care hours and children were present in care. Therefore, Adult 3 is not Criminally Cleared or associated with the Family Child Care.

LPA conducted an interview with Licensee regarding foster child. The two children in care are too young to interview.


One Type A citation was issued, Per Title 22 Regulations, All adults providing care or inside the home while children are present, must be Criminally Cleared. This poses an immediate Health and Safety risk to the children in care.

Exit interview was conducted. A copy of this report, 809 D, Notice of Site Visit, and Appeal Rights were left at the facility with the Licensee.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema CallowayTELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:
DATE: 02/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/02/2023
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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Document Has Been Signed on 02/02/2023 01:37 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: 02/02/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/02/2023
Section Cited

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102370(d)(1) Obtain a California clearance or a criminal record exemption as required by the Department. This requirement is not met by evidenced by:
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Licensee shall provide proof of Criminal Background and Fingerprint Clearance for Adult 3 to CCLD no later than 2/3/2023.
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Based on observtion, & interview it was discovered Adult 3 is not Criminally Background/ Fingerprint Cleared. LPA observed Adult 3 inside the home & there were children in care. This poses an Immediate Health & Safety risk to the 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: Kuliema CallowayTELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:
DATE: 02/02/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/02/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2