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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364843735
Report Date: 11/17/2022
Date Signed: 11/17/2022 01:10:09 PM


Document Has Been Signed on 11/17/2022 01:10 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:FIGUEROA DE GARCIA FAMILY CHILD CAREFACILITY NUMBER:
364843735
ADMINISTRATOR:IRMA FIGUEROA DE GARCIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 782-7959
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY:14CENSUS: 2DATE:
11/17/2022
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Irma Figueroa De Garcia, DirectorTIME COMPLETED:
01:30 PM
NARRATIVE
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On 11/17/2022, at 11:00 am., Licensing Program Analysts (LPA), Kuliema Calloway and Licensing Program Manager (LPM), Claretta Yates, arrived at the facility for the purpose of conducting a case management inspection. LPA/LPM met with Licensee, Irma Figueroa De Garcia to deliver an enhanced civil penalty of $2,000 based on licensed capacity (14). The enhanced civil penalty is being assessed today as a result of a lack of supervision violation previously cited on 10/13/2022 due to a child sustaining a dog bite by the licensee’s dog. The child sustained a serious injury to the chin that required stitches.

The acknowledgement of receipt of licensing reports (LIC 9224) shall be signed and kept in each of the children's records. The report shall be provided no later than the next business day or the next day the child is in care. Failure to meet the posting requirement shall result in an immediate $100.00 civil penalty.

LPA/LPM have provided the Licensee with a copy of the LIC.421D, Civil Penalty Assessment – Death / Serious Injury / Physical Abuse (Child Care) form and a copy of this report. Appeal rights were provided and discussed with the Licensee.

Exit interview conducted with Licensee Irma Figueroa De Garcia. A copy of this report, notice of the site visit, and LIC 9224 was provided to the licensee.

Notice of the Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema CallowayTELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:
DATE: 11/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/17/2022
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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Document Has Been Signed on 11/17/2022 01:10 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: FIGUEROA DE GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 364843735

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/17/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/18/2022
Section Cited

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(f) (1) For a violation that the department determines constitutes physical abuse or resulted in serious injury, as defined in Section 1597.58 (f) (1) to a child, the civil penalty shall be assessed as follows:This requrement was not met as eviidenced by: interviews, file reviews, and observation.
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 Licensse has three families with children's files missing the LIC 9224 formed signed which is 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: 11/17/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/17/2022
LIC809 (FAS) - (06/04)
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