367700003-8-9-2022-12-CC-SMOA-CH5UF6-20220809153215

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 367700003
Report Date: 08/09/2022
Date Signed: 08/09/2022 03:32:19 PM

Document Has Been Signed on 08/09/2022 03:32 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	CERON FAMILY CHILD CARE		FACILITY NUMBER:	367700003
ADMINISTRATOR:	CERON,JULIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 339-5858
CITY:	VICTORVILLE	STATE: CA	ZIP CODE:	92392
CAPACITY:	14	CENSUS: 0	DATE:	08/09/2022
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	02:10 PM
MET WITH:	Julia Ceron Applicant		TIME COMPLETED:	03:35 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	At 2:10 pm, Licensing Program Analyst (LPA) Steven Montoya met with Applicant, Julia Ceron, who guided analyst on a tour of the family child care home for a subsequent prelicensing inspection which was initially completed on 6-23-2022. Changes by the applicant facility sketch were made due fire inspection clearance. Applicant was able to bring in child care in from garage, into the home. Fire inspection has been completed and filed with Palmdale RO LIS. Family members residing in the home include 1 adult (applicant) and licensee elderly father and no children. Days/hours of operation are Monday through Friday 6AM to 5PM. Physical Plant: Main care is provided in the living room (at entrance). Children use the bathroom in the hallway on the left which is gated off from bedrooms. Off limit areas include all Bedrooms (#1 , #2 , #3, bathroom #2 and #3), pantry (safety knob), laundry and garage (safety latch). The hallway is off limits (safety gate). Backyard is accessible which is gated. The new home came with a facility sketch is complete and current, there is working telephone (landline, cell). The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation. There are safe age appropriate toys, play equipment and materials. Poisons, detergents/cleaning compounds (garage and laundry), medicines (off limits bedroom) and hazardous items (sharp knives inside pantry, tight fitting container) that can pose a danger to children were inaccessible.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven Montoya	TELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022

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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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: CERON FAMILY CHILD CARE	FACILITY NUMBER: 367700003
	VISIT DATE: 08/09/2022

NARRATIVE

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There are one fireplaces which was properly screened). There are safe age appropriate toys, play equipment and materials. The smoke detector and carbon monoxide detector, Fire Extinguisher (2A10BC) are in operable condition. Per Applicant no one smokes in the home. Electrical outlets are inaccessible, no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/play equipment were observed on the premises.

Applicant was advised, the On RO Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm.

Applicant will be licensed effective: 8-9-2022.

This report was read and translated for spanish speaking applicant. Exit interview conducted, inspection report and notice of site visit was reviewed with Applicant.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven Montoya	TELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022

LIC809 (FAS) - (06/04)

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