<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700128
Report Date: 04/19/2022
Date Signed: 04/19/2022 10:33:18 AM


Document Has Been Signed on 04/19/2022 10:33 AM - 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:RIVAS FAMILY CHILD CAREFACILITY NUMBER:
367700128
ADMINISTRATOR:BRANDIE RIVASFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 644-6689
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY:14CENSUS: 3DATE:
04/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Brandie Rivas Licensee TIME COMPLETED:
10:38 AM
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 (LPAs) Steven Montoya conducted an unannounced Required 1 Year inspection at the above facility. Upon arrival, the LPA met licensee Brandie Rivas, who guided the LPA to tour of the facility. Licensee resides in the home 1 adults (licensee) and 2 minor children. Per LIS, facility annual fees are current. All adults living in the home have been background cleared. Per licensee, the hours of operation are Monday through Sunday 4:00 a.m. to 3:00 a.m.

The Home is set up as follows:
This is a single story house with 4 bedrooms, 2 bathrooms, kitchen/dining room, family/daycare room, living room, and attached garage. Per Licensee the living room, and family room/kitchen, 1 bathroom are utilized for the family child care activity area. Per licensee off-limit areas of the home is the 3l bedrooms including master bathroom, laundry room, and garage. The home was inspected for safety, comfort, cleanliness, telephone service, central air and heat and ventilation.

Main Area: Main care will be conducted in the living room. Napping: Children will nap in the designated nap areas(living room) with adult supervision. Licensee stores napping equipment in the bedroom. Licensee has a crib for babies for napping and playpen. LPAs discussed Safe Baby Sleep and provided web information to Licensee. The First Aid Kit observed complete with supplies and a first aid manual.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven MontoyaTELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2022
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 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: RIVAS FAMILY CHILD CARE
FACILITY NUMBER: 367700128
VISIT DATE: 04/19/2022
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
26
27
28
29
30
31
32
Family room/ Daycare area: In the Family room which is the designated playroom, LPA observed age-appropriate toys and furniture for the children. A small table was observed with a total of eight chairs. Several plastic storage bins were observed in which games and toys are stored for the children. There are games and books on the premises of this facility. There are mats on the floor that have educational/learning activities on them. The mats were observed to be in good condition. The home has central heating and air conditioning. All windows have screens and are free of cracks, bugs, and debris. Hanging window blinds cords are inaccessible to children.

Facility Roster: LPA observed Child Care Facility Roster. Licensee has posted as required the Facility License, Emergency Disaster plan, and Parents Rights Poster. The facility roster is not current. there are no current facility earthquake/fire drills documents observed during the time of this inspection.

The following information was discussed with the licensee:
ü Mandatory Forms for the children’s files and provider’s files.
ü Requirements for fire drills, earthquake drills, and documentation for both.
ü The role and responsibilities of being a mandated reporter were discussed.
ü The licensee is reminded that 100% supervision is required for children at all
times.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven MontoyaTELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022
LIC809 (FAS) - (06/04)
Page: 2 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: RIVAS FAMILY CHILD CARE
FACILITY NUMBER: 367700128
VISIT DATE: 04/19/2022
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
26
27
28
29
30
31
32
Family Room: In the family room a fireplace was observed that was properly screened via mirror glass doors and inaccessible to children. In the family room, there were additional toys observed to be in the room stored on cubbies.

Kitchen The kitchen was inspected to ensure hazardous and dangerous items were inaccessible to children (Safety latches). LPAs inspected the kitchen and observed all lower cabinets and drawer have child proof latches are in good condition.

Bathroom #1: Children utilize a bathroom is in the hallway. Bathrooms were toured, and inspected sink/toilet are in operable condition. Toilet and faucets are clean, safe, and operable. All poison and medications are made inaccessible to children with child safety latches on the sink cabinet.

Backyard: The backyard was inspected; LPAs observed a swimming pool or bodies of water on the premises, which was completely covered with a green mesh tarp. For added security licensee is adding a pool fencing directly around pool. Licensee reports backyard is inaccessible to children until the May 10, 2022. Children have limited access to the backyard (through the locked sliding glass door). Licensee ensured the children are always supervised while outside in the backyard.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven MontoyaTELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022
LIC809 (FAS) - (06/04)
Page: 3 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: RIVAS FAMILY CHILD CARE
FACILITY NUMBER: 367700128
VISIT DATE: 04/19/2022
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
26
27
28
29
30
31
32
Fire extinguisher (2A10BC): LPA observed there is a required fire extinguisher (3A40BC) few years back and located in the kitchen inaccessible to children. Smoke Detectors and Carbon Monoxide: The smoke detectors and carbon monoxide devices tested operable.
Electrical outlets: All unused electrical outlets are plugged in and made inaccessible to children. Medications and cleaning solutions are stored in locked cabinets in the off-limits area (Master Bedroom).
Weapons or Firearms: Per licensee, there are no weapons or firearms. LPA did not observe any weapons or firearms. Transportation: The licensee will transport daycare children. Incidental Medical Services (IMS): 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. The Licensee will not be providing medication to children.

Documentation:
CPR/First Aid: LPA observed licensee has current Pediatric CPR and First Aid Training with expiration date (08/10/2023) 1 hour of nutrition training, (8) hours of Preventive Health and Safety Training.
· Immunization: The licensee has the required immunization. The licensee provided a written statement declining the influenza vaccination.
· Mandated Reporter Training: The licensee has completed the online mandated reporter training at www.mandatedreporterca.com, and need to renew by 09/16/2021
·
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven MontoyaTELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022
LIC809 (FAS) - (06/04)
Page: 4 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: RIVAS FAMILY CHILD CARE
FACILITY NUMBER: 367700128
VISIT DATE: 04/19/2022
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
26
27
28
29
30
31
32
Transportation: The licensee does provide transportation for children. The licensee has a valid California driver's license with an expiration date of 08/14/2026. Licensee has valid vehicle insurance with the expiration date of 04/30/2022 and vehicle registration dated 04/26/22.
·
Fire Drill and Disaster Drill: Per the licensee, fire and disaster drills are conducted every 6 months; the last drill was documented and conducted on 02/20/2022.

Safe Sleep: LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

ü 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.

No Deficiencies cited. Exit interview conducted and report was reviewed with the licensee Brandi Rivas. Notice of Site Visit: A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Steven MontoyaTELEPHONE: (661) 202-4701
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022
LIC809 (FAS) - (06/04)
Page: 5 of 5