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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700119
Report Date: 01/18/2022
Date Signed: 01/19/2022 08:27:00 AM

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:ROJAS FAMILY CHILD CAREFACILITY NUMBER:
367700119
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 1DATE:
01/18/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Richelle RojasTIME COMPLETED:
10:45 AM
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On 1/18/2022, Licensing Program Analysts (LPAs) Carol Heath conduct an Capacity Increase Pre-Licensing inspection with The Licensee, Richelle Rojas to ensure the facility meets basic licensing requirements set forth by Title 22, Health and Safety and statutory requirement. The Licensee is requesting to provide care for a Large family childcare home for the capacity of 14 children. Currently, there are 2 adult (The Licensee and Her husband ) and 3 children (17 yrs, 13 yrs, 9yrs) living in the home. LPA toured the home indoor and out to ensure it meets FCCH requirements. The Licensee is requesting the days and hours of operation will be Monday through Sunday 23 hours.

The home is described as follows:

This is a One story home consists of 4 bedrooms, 2 bathrooms, kitchen, living room, Dinning Room, laundry room, The home has central heating and air conditioning. All windows are free of cracks, bugs and debris. Hanging window blinds are cordless are inaccessible to the children.


Indoor:
Main area: Main care is provided in the Dinning Room area. Children use the bathroom in the hallway. Children have access to the backyard.
Bathroom #1: Children will use the bathroom #1 down the hall .The bathroom #1 was toured, and inspected medicine cabinet/toilet are in operable condition. Toilet and faucets are clean, safe, and operable; bathtub and shower area free of hazard. No medications storage in the medicine cabinet.
Kitchen: The All sharp utensils, cutlery, cleaning supplies, medicines; drawers and cabinets with plastic bags, and sharp things or small things children can swallow; are accessible to children without child safety gate. The refrigerator dishwasher, stove, microwave, etc., are clean. The kitchen was clean, orderly, and free of hazardous items. All lower cabinets in the kitchen have child locks. Medications are stored in off limits bedroom.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2022
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: ROJAS FAMILY CHILD CARE
FACILITY NUMBER: 367700119
VISIT DATE: 01/18/2022
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Outside: The backyard was inspected. The backyard is completely surrarred by a fence Children will play outside in the backyard. There is an artificial grass area for active play. LPA observed toys and play equipment in good condition. LPA observed a trampoline on the premises enclosed by a secure net around it, to prevent accessibility, in the off-limits gated portion of the backyard. Trampoline will not be used by child care children (Declaration obtained). Gated storage area observed with padlock. Licensee has 6 dogs and 2 cat. There is a separately gated dog run on the right side of backyard.

Off-limit area:
Bedrooms with door lock: Master bedroom #1, Bedroom #2, #3 and #4 have safety lock to make the room inaccessible to the children.
Bathroom #2 (Master Bathroom): The bathroom was toured, and inspected medicine cabinet/toilet is in operable condition.
Laundry room: The clean supplies and poison are in the laundry room. There is safety lock which made inaccessible to children. Laundry room is through a door (key locked & child locked) at the end of the hallway to the left. Cleaning compounds and detergents are in the laundry room.
Garage: LPA inspected the garage. According to The Licensee, the garage is off-limit for the children with the safety door lock. Garage is accessed through the laundry room and no child care activities will be conducted there.
· Other:
Napping equipment (8 cots): LPA observed 8 napping equipment. Per licensee, the children will nap on cots in the daycare area with adult supervisor.
Electrical outlets: All unused electrical outlets are plugged in and made inaccessible to children.
The First Aid kit is located in daycare area near the front door inaccessible to children.
Weapons or Firearms: Per The Licensee, there are no weapons or firearms. LPA did not observe any weapons or firearms.
Cleaning compounds are stored away in the laundry area with safety door lock inaccessible to children
A smoke detector and a carbon monoxide detector tested operable.
Fire extinguisher (2A10BC) There is a fully charged fire extinguisher (2A10BC); which meets fire marshal standards. 8/25/2021
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2022
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: ROJAS FAMILY CHILD CARE
FACILITY NUMBER: 367700119
VISIT DATE: 01/18/2022
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Incidental medical Services (IMS): According to The Licensee, she will Not provide the IMS to the children. LPA shared the information and website for The Licensee.
Pet: 6 dogs and 2 cats are in this facility but not with daycare children.
· Documentation:
A The Licensee has current CPR, First Aid Training with the expiration dates of 03/2023, and Prevented Health and Safety Training completed: 5/18/2019. The Licensee has her fingerprint clearance and TB exam. The Licensee has proof of being immunized against influenza, pertussis, and measles. The Licensee has proof of Mandated Reporting Training dated 06/25/2021. Per licensee, she will provide transportation. Per The Licensee meals and snacks will be provided for children.

The following was discussed with The Licensee:
Mandatory Forms for the children’s files and provider’s files, Requirements for fire drills, earthquake drills, and documentation for both. Role and responsibilities of being a mandated reporter.

The Licensee reminded that 100% supervision is required at all times to children in care. The Licensee was advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov. The Licensee was made aware that it is he/her responsibility to know the regulations as well as anyone who assists in providing care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified



The regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare home and in those areas of the family day care home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exersaucers, and any other items that fall into that category.
·On January 1, 2018, or before March 30, 2018, a person who is a licensed childcare provider, administrator, or employee of a licensed child day care facility shall complete the online mandated reporter training and shall complete renewal mandated reporter training every two years. @www.mandatereporterca.com

**Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements
Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed childcare facility are aware of situations that present the greatest danger to children.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2022
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: ROJAS FAMILY CHILD CARE
FACILITY NUMBER: 367700119
VISIT DATE: 01/18/2022
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Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). Family childcare homes shall post during hours of operation. Failure to meet the posting requirements shall result in an immediate $100.00 civil penalty In addition; all parents of currently enrolled children and any newly enrolled child for the following 12 months shall receive a copy of report and sign the LIC 9224 acknowledging receipt. Civil Penalty assessments will be assessed if all above requirements are not adhered to.

§1597.622 Employees or volunteers at family day care home; immunization requirements; records; exemptions (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year



**Incidental medical Services (IMS) policy was discussed. The Licensee will wait until facility opens to determine IMS needs. 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

·Safe Sleep in Child Care: Resources can be found on our website at http://www.cdss.ga.gov/inforesources/Child-Care-Licensing/Public-Information-and-Resources/Safe-Sleep

Lead Poisoning: For more information, go to the California Childhood Lead Poisoning Prevention Branch’s website at www.cdph.ca.gov/programs/clppb,or call them at (510) 620-5600.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2022
LIC809 (FAS) - (06/04)
Page: 5 of 5
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: ROJAS FAMILY CHILD CARE
FACILITY NUMBER: 367700119
VISIT DATE: 01/18/2022
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The Licensee advised visit www.shotsforschool.org for Immunization information.

Child Care Advocates: You can now sign up for Quarterly Updates and PINs for one or more programs through our DSS website at www.ccld.ca.gov. Click on “Receive Important Updates” located in the right middle part of the page, immediately above the Quick links. Put your email address and choose which program(s) you would like to subscribe to and click “subscribe”.


**As a result of this inspection, the home does meet Title 22 Regulations. The applicant is ready for licensure pending the manager's approval.


An exit interview was conducted and the report was reviewed with the facility representative Richelle Rojas.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2022
LIC809 (FAS) - (06/04)
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