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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153907305
Report Date: 03/05/2024
Date Signed: 03/05/2024 12:03:17 PM


Document Has Been Signed on 03/05/2024 12:03 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:GARCIA FAMILY CHILD CAREFACILITY NUMBER:
153907305
ADMINISTRATOR:GARCIA, LOURDESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 770-8555
CITY:ARVINSTATE: CAZIP CODE:
93203
CAPACITY:14CENSUS: 2DATE:
03/05/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:03 AM
MET WITH:Lourdes Garcia TIME COMPLETED:
12:15 PM
NARRATIVE
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On 03/05/24 Licensing Program Analyst (LPA) Beneroso conducted an inspection at Garcia Family Child Care Home. The purpose of the inspection was ton conduct a Case Management- Deficiencies Visit to review the deficiency cited on 01/24/24. LPA met with Licensee Lourdes Garcia and toured the facility.

The following was observed:
During the visit, LPA Beneroso observed two off limits areas of the home being accessible to children. LPA observed Bedroom #1 with the door fully open and with one infant inside of the room. LPA also observed a child safety gate being open and one of the children present on the off limits side of the gate. This is a repeat violation from the citation that was given on 01/24/24. Facility has been cited a Type B citation. Please see LIC809-D. An immediate $250 civil penalty will be accessed.

During visit, LPA also observed that no Infant Sleep logs were kept for the infant present in the home. This is a repeat violation from the citation that was given on 01/24/24. Facility has been cited a Type B citation. Please see LIC809-D. An immediate $250 civil penalty will be accessed.

Exit interview conducted, an electronic copy of this report, appeal rights, and Notice of Site Visit was sent to licensee, Lourdes Garcia.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:
DATE: 03/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/05/2024
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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Document Has Been Signed on 03/05/2024 12:03 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551


FACILITY NAME: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 153907305

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/05/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/05/2024
Section Cited
CCR
102417(g)

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Operation of A Family Child Care Home 102417(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to:
This requirement is not met as evidenced by:
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Licensee will ensure off-limits are made inaccesible to children in care. LPA observed licensee lock bedroom #1 and lock Child safety gate during inspection.
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Based on observations, on 03/05/2024, LPA observed a child safety gate opened and one child on the off-limits area of the home. LPA also observed a child in the offlimits bedroom#1, which poses/posed a potential health, safety or personal rights risk to persons in care.
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Type B
03/08/2024
Section Cited
CCR102425(j)(1)

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102425(j)(1) Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes.

This requirement is not met as evidenced by:
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Licensee will ensure Infant Sleep logs are kept for all infants enrolled. Licensee understands a 15 minute check must be completed for all napping children. Licensee agrees to send proof of Infant Sleep Logs no later than 03/08/24.
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On 03/05/2024 LPA Beneroso requested proof of Sleep Logs during inspection. Per licensee, she does not keep a Safe Sleep Log for Infants, which poses/posed a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Barbara BenerosoTELEPHONE: (661) 202-3411
LICENSING EVALUATOR SIGNATURE:
DATE: 03/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/05/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2