197414307-3-21-2023-12-CC-JTAO-CQ5VJD-20230321162833

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197414307
Report Date: 03/21/2023
Date Signed: 03/21/2023 04:28:45 PM

Document Has Been Signed on 03/21/2023 04:28 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:	MENENDEZ FAMILY CHILD CARE		FACILITY NUMBER:	197414307
ADMINISTRATOR:	MENENDEZ, MARIA A.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 992-1224
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93536
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 13	DATE:	03/21/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Maria Menedez, Licensee		TIME COMPLETED:	04:45 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 03/21/23, Licensing Program Analyst (LPA) Justeene Tamayo met with Licensee, Maria Menendez, who guided analyst on a tour of the facility for the One Year Required inspection. This is a two story, 5 bedroom, 3 bathroom home with kitchen/dining, family room, living room, laundry room and garage. There is no pool/spa or body of water on the premises. Upon arrival LPA observed 12 preschool children and 1 infant in care. Family members residing in the home include 6 adults (licensee and 5 adults (background cleared) and no minor children. Facility operation are Monday-Sunday for less than 24 hours. Incidental Medical Services (IMS) policy was discussed. Physical Plant: Main care is provided in the living room, family room, classroom area near the front entrance and playroom/game room- garage (has permit). Children use the bathroom in hallway on the right near the classroom area. Children have access to the living room, family room, classroom, and playroom/gameroom. Off limit areas include all bedrooms, entire upstairs (barricaded by safety gate), bathrooms #2 and #3 (upstairs), and laundry room (upstairs). The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (under kitchen sink with safety latch), medicines ( upper kitchen cabinet inaccessible to children ) and hazardous items (sharp knives in upper kitchen cabinet unreachable to children in care) that can pose a danger to children. LPA observed the fireplace in the living room to be screened. Safe and age appropriate toys, play equipment and materials were observed. The smoke detector and carbon monoxide detector, Fire Extinguisher (2A10BC) are in operable condition. Per Licensee no one smokes in the home. Electrical outlets are inaccessible, no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/ play equipment were observed on the premises. There is a designated area for ill children as necessary in children's classroom. Per Licensee there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (landline and cell).

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: MENENDEZ FAMILY CHILD CARE	FACILITY NUMBER: 197414307
	VISIT DATE: 03/21/2023

NARRATIVE

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Fire/Disaster Drill is complete and maintained current. Last fire/disaster drill was completed on 03/05/23

Roster complete and maintained current.

During children's file review, some children were missing their proof of immunization's. This can pose a potential risk to children in care. Facility has been cited a Type B Citation. Please see LIC809-D.

Bathroom: Shower/tub are free of hazards (child care bathroom). LPA did not observe any hazardous items in the children's bathroom. LPA observed the cabinet under the kitchen sink to be safety latched. Toilet and faucet are clean and operable.

Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. If food is brought from the children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. The home has a clean and fully stocked refrigerator/freezer. Cleaning supplies are under the kitchen sink with safety latch. Breakfast, lunch, snacks and dinner are provided. Naps are provided on cots and cribs in the living room and family room area

Outdoor: The backyard is safe for children. The backyard is completely fenced (with block cement). There is no body of water. There is an outdoor air conditioner inaccessible to children with barricaded fence on the side of the home. LPA observed age appropriate toys and play equipment, as well as turf for outdoor play. Per licensee, there are no pets on the premises.

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expire 07/23/2024. Licensee could not find her mandated reporter training. Licensee will send proof of certificate to LPA no later than 03/24/23. There are no window cords accessible to children.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

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: MENENDEZ FAMILY CHILD CARE	FACILITY NUMBER: 197414307
	VISIT DATE: 03/21/2023

NARRATIVE

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Documents Provided and or Discussed: Fire Drill Log, Roster, Postings, Safe Sleep PIN 20-24-CCP,Individual Sleeping Plan (LIC9227). Licensee stated currently does not have child care insurance.

Licensee Menendez was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee Menendez 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 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.

A notice of site visit was given to licensee and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Maria Menendez along with her appeal rights and notice of site visit.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/21/2023 04:28 PM - It Cannot Be Edited

Created By: Justeene Tamayo On 03/21/2023 at 04:07 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: MENENDEZ FAMILY CHILD CARE	FACILITY NUMBER: 197414307
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/21/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102418(g)

Immunizations

(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. Some children were missing their proof of immunzations in their file, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/25/2023
	Plan of Correction
1 2 3 4	Licensee will submit proof of immunizations to LPA Tamayo no later than 04/25/23.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Ramon

LICENSING EVALUATOR NAME:

Justeene Tamayo

LICENSING EVALUATOR SIGNATURE:

DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

LIC809 (FAS) - (06/04)

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