197412232-9-26-2023-12-CC-IORA-CW2TGC-20230926144256

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197412232
Report Date: 09/26/2023
Date Signed: 09/26/2023 02:43:01 PM

Document Has Been Signed on 09/26/2023 02:43 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:	LUNA & DOROTEO FAMILY CHILD CARE		FACILITY NUMBER:	197412232
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 8	DATE:	09/26/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:34 PM
MET WITH:	Teodula Doroteo		TIME COMPLETED:	03:01 PM

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On 9/26/2023 LPA Isabel Ortega conducted a Case Management inspection as Licensee is requesting to increase her capacity from 8 children to 14 children. LPA announced the purpose of the inspection and was granted entry by Licensee. A tour of the facility was completed. Upon arrival LPA observed 8 children in care and two staff providing care and supervision.

Licensee was initially licensed on 6/22/2005 as a Small Family Child Care Home. The Fire Department has inspected the home and granted a fire clearance for 14 children effective 9/19/2023. Family Child Care Home operates Monday through Friday from 6:30 a.m. to 6:00 p.m. The facility provides breakfast, morning snack, lunch, and afternoon snack.

The facility’s fire extinguisher (2A10BC) is reading in green and met the State Fire Marshal standards(purchased 9/2023). Licensee has a smoke and carbon monoxide detector operating properly. The facility annual fees are current. The parent board was reviewed and had all the required forms posted and accessible to parents. Fire and disaster drills are conducted every six-month Last drill recorded 3/11/2023 at 10:00 a.m. As of 9/26/2023 emergency drills shall be completed monthly.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: LUNA & DOROTEO FAMILY CHILD CARE	FACILITY NUMBER: 197412232
	VISIT DATE: 09/26/2023

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Licensee is reminded with a capacity increase she must have a qualified assistant present whenever she has more than 8 children in care. Licensee was provided with a capacity and ratio handout pertaining to large Family Child Care Homes and the various age groups that can be under care at one given time. Licensee provided a valid pediatric CPR/First Aid training certificate card which does not expire until 6/11/2024. Child Care Provider Mandated Reporter training (AB1207) is required to be maintained every two-year.

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 Licensee was reminded with a capacity increase she must have a qualified assistant present whenever she has more than 8 children in care.

Licensee has met Title 22 regulations; Fire clearance was granted 9/19/2023, therefore, a Large Family Child Care Home License capacity of 14 children has been granted effective today 9/26/2023.

An exit interview was conducted, and a copy of this report, appeal and notice of site visit was provided to Licensee on this day. All Licensing reports are recommended to be kept on file for minimum three years.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023

LIC809 (FAS) - (06/04)

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