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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700040
Report Date: 03/05/2020
Date Signed: 03/05/2020 04:16:47 PM

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:VALDEPENA FAMILY CHILD CAREFACILITY NUMBER:
367700040
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 3DATE:
03/05/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:59 PM
MET WITH:Guendolyn ValdepenaTIME COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Victoria Hunt met with licensee Guendolyn Valdepena who guided analyst on a tour of the facility for an annual random inspection. During the time of this inspection licensee had four children in care. Three children were observed to be sleeping and one child was observed to be actively playing on a small electronic tablet. Residing in the residence includes licensee, her spouse, and minor children.

Per LIS, facility annual fees are current. All adults living in the home have been background cleared. Licensee was operating facility within ratio during the time of inspection. Licensee was observed providing adequate supervision at the time of the inspection.

The home was inspected as follows: Living room, family room, kitchen, dining room, laundry room and garage, bedrooms and bathrooms in the home; long with the backyard area.



This family child care facility is a two story home with 5 bedrooms, 3 bathrooms. There is a kitchen, living room, dining room, family room, laundry room, and an attached garage. The garage was inspected during this inspection. The garage was observed to locked during the time of this inspection by a child proof security knob that was located on the door. The garage is used for storage only, the garage is off limits to children.

This 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. Per licensee, there are no weapons or firearms on premises; LPA did not observe any firearms during this inspection. There were no bodies of waters or pools observed on premises.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Victoria HuntTELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 4
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: VALDEPENA FAMILY CHILD CARE
FACILITY NUMBER: 367700040
VISIT DATE: 03/05/2020
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All electrical outlets were covered in the home. There is a first aid kit on premises. LPA observed that applicant has a fire extinguisher 2A10BC which meets fire marshal standards. Smoke detector was tested and is in operational condition. Licensee has at least one working carbon monoxide detector located in the playroom. Licensee Pediatric CPR & First Aid is valid until: 9/2020 as indicated on the certificate. Licensee has the required immunization's : Measles , pertussis and declined the flu. Per licensee, disaster/fire drills are conducted every six months. LPA observed disaster/fire drill log as current. Children records were reviewed and complete during this inspection.

All off limits area include: All bedrooms and bathrooms upstairs , the garage and laundry room.

The backyard was inspected, the backyard is dirt landscaping surrounded by wood and brick fencing. There is a trampoline in the backyard, licensee states day-care children do not utilize the trampoline only her children. The manufacturing requirements and age restrictions on the trampoline states: ( No children under the age of 6 years old are recommended to play on the apparatus). There are four small play structures/ slides on the backyard for children that are of preschool age. The play structures are in good condition free and clear of cracks or loose parts. AC/Heating Unit is located on the left side of the home it has a screen on top to prevent children from accessing the unit. There is a small dog on premises, that is vaccinated.

Licensee is not be providing medication to children. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Victoria HuntTELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: VALDEPENA FAMILY CHILD CARE
FACILITY NUMBER: 367700040
VISIT DATE: 03/05/2020
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The following was discussed: Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being in the home. Individuals within one month of their 18th birthday must be fingerprinted immediately or at least within 30 days or less of turning 18.
LPA reviewed children records, records were complete.

There shall be no smoking, no infant walkers, johnny jumpers, exersaucers and any other item that falls into that category. Also discussed were earthquake, fire & disaster drills shall be documented at least once every six months.

Posting requirements were discussed such as the posting of the Parent’s Rights poster in a visible location for the children’s authorized representatives. Children records requirements, mandated child abuse and injury/ death reporting, background check clearance transfer requirements, SIDS, Infants Safe Sleep on Back, and Never Shake A Baby were all discussed. Licensee agrees children shall be positioned for sleep on their back.

Licensee and staff have the required immunizations for pertussis, measles, and influenza. Licensee and staff have also completed the 1207 Mandated Reporter Training.

**Licensee informed to review updates/regulations for 2016/2017/2018 on the department website: www.ccld.ca.gov ; AB 1207 - all child care employees must complete mandated reporter training beginning January 1, 2018; AB 1387 - and AB 2236 process to request a formal review of deficiency and establishes an appeal process for civil penalties; SB 792 - requires all staff and volunteers to show proof of immunization against influenza, pertussis and measles, and TB clearance, beginning September 1, 2016; AB 2231 Effective July 1, 2017 - Civil Penalty Amount changes. LPA reviewed and discussed Proposed Safe Sleep Guide and Regulations and during this visit license was provided with an updated Parents Rights Notification.

No deficiencies were cited today, this facility was found to be operating in substantial compliance of Title 22 Regulations. A copy of this report was discussed and left with licensee.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Victoria HuntTELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020
LIC809 (FAS) - (06/04)
Page: 4 of 4
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: VALDEPENA FAMILY CHILD CARE
FACILITY NUMBER: 367700040
VISIT DATE: 03/05/2020
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Main care is conducted in the living room, family room, and a room downstairs. In the living room, (playroom) LPA observed a changing table for infants. The changing table has a vinyl pad that is at least 3 inches thick; the changing table was clean, sanitary and in good condition. Age appropriate furniture was observed to be on premises. There are small tables and chairs available for children to use. There are cubbies in which children can store their belongings and toys were observed to be store in plastic containers on shelves.

Books, games and toys are on premises of this facility and in good condition and free of cracks or repairs. There are mats on the floor that have educational/learning activities on them. The mats were observed to be clean and in sanitary condition. Educational/Learning activities are posted throughout the walls of the playroom.

The family room was inspected, in the family room a fireplace was observed and to be inaccessible to children, Children utilize a bathroom located in the dining/kitchen area. The bathroom was inspected there is an operational sink and toilet. Cabinets were inspected and are free and clear of debris. The bathroom sink was observed to have a child proof latch on the door that was good condition. There is a pantry next to the bathroom used for storage only it was observed to have a child proof latch on the door.


The kitchen was inspected for proper storage of all cleaning detergents, medications, and sharp pointed objects. During the inspection of the kitchen LPA observed sharp knives and other sharp objects on top of the refrigerator. All lower cabinets in the kitchen were observed to have child proof latches that were in good condition.

There is a bedroom downstairs by the kitchen that is used as an additional area for napping of small children. In this room LPA observed napping equipment which the children will utilized. There was (1) play yard and (3)cots and other cots and play yards were observed to be in the playroom. The napping equipment was in good condition and sanitary.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Victoria HuntTELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020
LIC809 (FAS) - (06/04)
Page: 2 of 4