367700007-7-11-2019-12-CC-JNEL-BDYST9-20190711140910

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 367700007
Report Date: 06/26/2019
Date Signed: 07/11/2019 02:09:17 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME:	RODRIGUEZ FAMILY CHILD CARE		FACILITY NUMBER:	367700007
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 7	DATE:	06/26/2019
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Adriana Rodriguez		TIME COMPLETED:	03:15 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	Licensing Program Analyst (LPA) Neal met with Licensee, Adriana Rodriguez for the purpose of a Case Management - licensee initiated inspection for a Capacity Increase. There were 7 child care children present during this inspection. The home was inspected for safety, comfort, cleanliness, telephone service, central air and heat and ventilation. Also for inaccessibility to poisons, detergents, cleaning compounds, medicines, and other hazardous items that can pose a danger to children. Fire clearance was granted on 6/12/2019. Fireplace is located in the living room and is screened and child locked. Child care activities are conducted in the living room/dining room. Children will use the bathroom on the left side of the hallway. Laundry room and garage are both padlocked. Garage is used for storage only. Off limits areas include all bedrooms (padlocked), master bathroom, garage and padlocked areas of the backyard. Knives are kept in a child locked cabinet in the gated kitchen. Medications are kept in the off limits master bedroom. Cleaning compounds and detergents are kept under the child locked kitchen sink cabinet and in the padlocked laundry room. Parent board was observed at the entrance with all required documents posted. LPA observed age appropriate toys and equipment. There is no pool, spa or bodies of water on the premises. Upcoming regulations on safe sleep were discussed. Safe sleep concepts were discussed.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 06/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 367700007
	VISIT DATE: 06/26/2019

NARRATIVE

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**Licensee is aware if she or assistant is alone with any children, she then reverts to a small family child care. Licensee also understands the ratio and capacity requirements of the small and large family child care license. Licensee understands that any adult alone caring for children must have a background check clearance, immunizations, current Pediatric 1st Aid and CPR certificates and current Mandated Reporter training with certificate on file.
Applicant has current Pediatric CPR/First Aid certification, set to expire 1/20/2020. Children will play outside in the backyard.
There is a trampoline that has been made inaccessible by a padlocked fence.

Advised licensee to research and navigate through the Departments web site: www.ccld.ca.gov to review Title 22 regulations and the California Health & Safety Codes for a Family Child Care Home.

No deficiencies were cited during this inspection.

LIC 9213- Notice of Site Visit was posted. Notice of Site Visit must remain posted for 30 consecutive days. Failure to do so will result in an immediate civil penalty assessment of $100.

The increase of capacity for a Large Family Child Care Home will be submitted for approval. Exit interview was conducted, report was read and a copy of the report was given to the licensee.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 06/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019

LIC809 (FAS) - (06/04)

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