367700040-10-30-2020-12-CC-VHUT-BUVTP4-20201030145344

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 367700040
Report Date: 08/26/2020
Date Signed: 10/30/2020 02:54:41 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 CARE		FACILITY NUMBER:	367700040
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 14	DATE:	08/26/2020
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	05:01 PM
MET WITH:	Guendolyn Valdepena		TIME COMPLETED:	06:00 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) Victoria Hunt conducted a Tele-Visit with licensee Guendolyn Valdepena, who guided analyst on a tour of the facility for a case management a capacity increase inspection for a large family child care. This visit was held virtually due to COVID-19 Emergency Response. This facility currently has a waiver to operate as a large family daycare. This family child care home has 5 bedrooms, and 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 is used for storage only, and is off limits to children. The garage was observed to locked during the time of this inspection by a child security knob. 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 is a pool on premises at this home.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Victoria Hunt	TELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2020

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: VALDEPENA FAMILY CHILD CARE	FACILITY NUMBER: 367700040
	VISIT DATE: 08/26/2020

NARRATIVE

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Main care is conducted in the living room, family room, a bedroom downstairs. The living room which is designated as a playroom LPA observed age appropriate toy and furniture that the child have access to. Small tables along with chairs were observed in the playroom. Also observed, are cubbies in which children can store their belongings, toys store in plastic containers located on shelves and a small changing station located in the room. The changing table was observed he changing table was clean, sanitary and in good condition. The table was observed to have a vinyl pad that is at least 3 inches thick.

Books, games and toys are on premises of this facility and in good condition and free of cracks or repairs. Mats on the floor were clean and sanitary and provided educational/learning activities for the children. Educational postings posted on the walls throughout 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 near the dining and kitchen areas. The bathroom was inspected and the bathroom was observed to have a operational sink and toilet. The bathroom sink was observed to have a child proof latch on the door in good condition at the time of the inspection. There is a next to the bathroom used for storage only it; the pantry has 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.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Victoria Hunt	TELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2020

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: VALDEPENA FAMILY CHILD CARE	FACILITY NUMBER: 367700040
	VISIT DATE: 08/26/2020

NARRATIVE

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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 and assistant have a 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. This facility has an above ground pool that is located on the backyard. The above ground pool is surrounded by a mini chain linked fence at least 5 feet in height. There is a self self-latching device located no more than six inches from the top of the gate. The gate the swings away from the pool, closing without assistance.

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 Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Victoria Hunt	TELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2020

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: VALDEPENA FAMILY CHILD CARE	FACILITY NUMBER: 367700040
	VISIT DATE: 08/26/2020

NARRATIVE

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

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.

LPA discussed licensing capacity requirements. Licensee understands the ratio and capacity requirements. Licensee understands that any cleared adult left alone caring for children must have a background clearance check and current Pediatric 1st Aid and CPR certificates. Licensee advised that children residing in the home under the age of 10 count towards capacity/ratio.

If licensee is operating a large family child day care and no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home. Therefore, the large family childcare reverts to small capacity requirements of (8) children.

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.

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. A copy of this report was discussed and read to licensee. Fire Clearance was granted by fire inspector for a Large Family Child Care Home. Capacity increase to 14 children has been approved and is effective 08/26/20.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Victoria Hunt	TELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2020

LIC809 (FAS) - (06/04)

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