157700047-3-22-2021-12-CC-EROZ-BZD33Y-20210322175420

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 157700047
Report Date: 03/22/2021
Date Signed: 03/22/2021 05:54:32 PM

Document Has Been Signed on 03/22/2021 05:54 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	JAIME FAMILY CHILD CARE		FACILITY NUMBER:	157700047
ADMINISTRATOR:	AYDE JAIME		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 436-9414
CITY:	ARVIN	STATE: CA	ZIP CODE:	93203
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	03/22/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	12:49 PM
MET WITH:	Ayde Jaime		TIME COMPLETED:	02:47 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	On 03/22/2021, at 12:49 PM Licensing Program Analysts (LPA) Esequiel Rodriguez made an announced virtual televisit inspection with Applicant, Ayde Jaime for the purpose of conducting a facility Pre-Licensing Inspection prior to relocation licensure for a Large Family Child Care Home, and to ensure the facility meets basic licensing requirements set forth by Title 22, Health and Safety and statutory requirements. The LPA met with Ms. Jaime and stated the purpose for the inspection. The physical plant of the facility is a two story unit. The home consists of a living room, dining room, kitchen, a master bedroom, five rooms, three full bathrooms, laundry room. There is no fire place and there are no pets. The general area use for daycare is the first floor, in particular: the daycare play room; the designated daycare kitchen; designated daycare dining room and day care rear yard (outside playground) The kitchen area and the stairs leading to the second floor are properly child proofed. All items that may create a safety and/or healthy hazard are inaccessible to children. Off limit areas are the top floor, laundry room area, garage and a back yard area were there is grass and trees. Per licensee, the children in care are properly supervised at all times, and the appointed person caring for them utilize appropriate risk assessment and situational awareness appropriate to the children age and development. Currently, the adults individuals living in the home are the Licensee, Ref-1 and Ref-3. See Confidential Names list (LIC811) dated 03/02/21. The hours of operation are from Monday thru Saturday from 05:00 AM- 06:00 PM. However, per Licensee, as needed it, she can operate from 05:AM to Midnight, and will provide daycare services on weekends if needed or necessary to help parents meet their work demands. COVID-19 State of Emergency

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Esequiel Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2021

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: JAIME FAMILY CHILD CARE	FACILITY NUMBER: 157700047
	VISIT DATE: 03/22/2021

NARRATIVE

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The fire extinguisher is at least a 2A:10BC and is fully charged. The smoke alarms and carbon monoxide
monitor are present and in good working conditions. There is a working and available telephone. The first aid kit is complete and available, and is store out of the reach of children. All poisons are locked, and hazardous materials are kept inaccessible to children. Outdoor play areas are free from defects or dangerous conditions; the small outdoor play area is fenced and per applicant there will always be active supervision. Play equipment is secure and age appropriate. The LPA advise applicant that in addition to having the kitchen cabinets and drawers secure with child proof items, that it is recommended (if possible) to add a child proof gate and/or corral at the each entrance of the kitchen.

Toys and playthings are safe, clean, and appropriate for the age of the children; all sharp utensils and cutlery, cleaning supplies, medicines; drawers and cabinets with plastic bags, and sharp things or small things children can swallow; shampoo, mouthwash, toothpaste, medicines, perfumes/lotions/cosmetics, solvents, etc., are inaccessible to children in care; the refrigerator dishwasher, stove, microwave, etc., are clean. Toilet and faucets are clean, safe and operable; bathtub and shower are free of hazard. All electrical outlets are inaccessible to children.

The home has appropriate materials for napping (cots, mats, cribs and/or playpens) are available. All windows are free of cracks, bugs and debris. Hanging window blinds cords are inaccessible to children. The home has a designated area for children showing signs of illness and a plan to act accordingly. Smoking is prohibited in the facility premises. Per applicant, if food is brought from the children’s homes, the containers will be labeled with child’s name and properly stored or refrigerated.

There are no bodies of water in the premises of the home. Baby walkers, bouncers, jumpers, inclined sleepers and similar items will not be used for children in care and are kept inaccessible. Per applicant, there are no firearms, ammunition or any other item that can be constructive as a weapon in the home.

Emergency supplies are maintained in the home. Emergency drills will be conducted every six months or more often depending on the date of enrollment of the children and a written log will be maintain.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Esequiel Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2021

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: JAIME FAMILY CHILD CARE	FACILITY NUMBER: 157700047
	VISIT DATE: 03/22/2021

NARRATIVE

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Ms. Jaime is well aware about current Safe Sleep Awareness information. The Licensee is approved, under previous license # 153909287 to provide Incidental Medical Services (IMS) to administer inhaled medication only. The American with Disabilities Act (ADA) and California disability laws were discussed.

Ms. Jaime has current Mandate Reporter certificate and has current pediatric first aid and CPR. Posted on parent’s board are the Emergency Disaster Plan (LIC 610A); the Earthquake Preparedness Checklist (LIC
9148), Notification of Parents' Rights Poster (PUB 394.) When licensed, the Facility License, (LIC 203) will also be posted in an area of the home where it can be easily seen. LPA explained that the Notice of Site Visit (LIC 9213) must remain posted for 30 days (during the hours that children are in care) after each site visit by a licensing representative. Also, any licensing report documenting a type “A” citation must be posted for 30 days during the hours that children are in care, and any licensing report or other document verifying compliance or non-compliance with the Department’s order to correct a Type “A” deficiency must be posted for 30 days during the hours that children are in care. Ms. Jaime acknowledged.

All adults in the home have and other person assocaited to the facility have current appropriate background clearance and child abuse central index (CACI) check. Requirements for fingerprint clearances/associations and the new electronic data system the Guardian were discussed.

LPA Rodriguez explained and went over the LIC 311D (Forms and Record to Keep in Your Family Child Care Home form) and told applicant that during future home inspections, the Licensing Program Analyst will also review all the required forms and information that you must keep on file in your home. The LPA reminded Ms. Jaime to continue to familiarize with the guidelines established by the American Academy of Pediatrics to help reduce the risk of Sudden Infant Death Syndrome (SIDS) when caring for infants.

Ms. Jaime was advised to continue to often review Community Care Licensing (CCL) Child Care section of the public Community Care Licensing web site at https://www.cdss.ca.gov/inforesources/child-care-licensing because it contains the most current up-to-date information regarding CCL Quarterly Updates, forms, regulations, Corona virus Disease (COVID-19) and Provider Information Notices (PINS).

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Esequiel Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2021

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: JAIME FAMILY CHILD CARE	FACILITY NUMBER: 157700047
	VISIT DATE: 03/22/2021

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The LPA told the Licensee that it is the licensee responsibility to know the regulations as well as anyone who assists in providing care. Also that the inaccessibility of hazards and active supervision must be constantly reassessed depending on the children in care. In addition, CCLD has established a dedicated e-mail address to receive public inquiries related to COVID-19, cclcovid-19info@dss.ca.gov

Ms. Jaime was told of the requirement to maintain a current contact phone number and to submit written reports of unusual incidents and/or LIC 624B report (UIR) by telephone, fax, mail or email within the next business day following the occurrence during the operation of family day care home. Additionally, if reported to CCL by telephone, submit written report within seven (7) calendar days of the event. Describe what happened and be specific. Include Child's name, date of birth/age, sex and date of admission; date and nature of the event; Attending physician's name and findings and treatment, if any, and Disposition of the case; enter date, month and when the child's authorized representative was notified, etc. If available, it preferable to use the Unusual Incident/Injury Report - Family Child Care Home form LIC624B. Keep a copy of the report submitted to CCL in the (affected) child's record. If possible, e mail the report to unusualincidentrepor@dss.ca.gov.

At the time of this Prelicensing inspection, the home/facility is neat, clean, safe and sanitary and in compliance with Title 22 regulatory requirements; therefore, ready for licensure. Additionally, the required Covid-19 Teleinspection was conducted. The LPA reminded

LPA Esequiel Rodriguez inform Ms. Jaime that a copy of the original Facility Evaluation Report (LIC 809) will be scanned and email it to her for signature, and to keep a copy for her files. Once the she signs the complete report it will be scanned, and e-mailed back to this LPA for filing.

Exit Interview conducted.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Esequiel Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2021

LIC809 (FAS) - (06/04)

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