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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493203
Report Date: 08/29/2024
Date Signed: 08/29/2024 02:22:12 PM

Document Has Been Signed on 08/29/2024 02:22 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:PERALTA GARCIA FAMILY CHILD CAREFACILITY NUMBER:
197493203
ADMINISTRATOR/
DIRECTOR:		PERALTA GARCIA, ANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 547-4954
CITY:PALMDALESTATE: CAZIP CODE:
93550
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
08/29/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:20 PM
MET WITH:Ana Peralta Garcia, Licensee TIME VISIT/
INSPECTION COMPLETED:
02:40 PM
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On 08/29/2024, Licensing Program Analyst (LPA) Justeene Tamayo conducted an unannounced annual inspection and met with licensee, Ana Peralta Garcia who guided LPA Tamayo on a tour of the facility. LPA observed 2 preschool children in care, along with the licensee. Family members residing in the home include 2 adults (Licensee, licensee's husband) and 2 minor children. Operating hours are Monday to Friday 6:00 am to 6:00 pm.

This is a one story 3 bedroom, 2 bathroom home with kitchen/dining, living room, laundry room, enclosed patio, and garage. The garage is used for storage only and no childcare activities are conducted there. Areas off limits to children include bedrooms #1-3, bathrooms #2, garage, laundry room, and front yard.

LPA Tamayo inspected the facility for safety, comfort, cleanliness, ventilation and working phone (cell phone). For ventilation, LPA Tamayo observed central AC and the vents located on the ceiling. LPA observed the furniture, children’s materials, to be in good condition and age appropriate. LPA observed a fireplace in the living room to be barricaded by a safety gate.

Cleaning compounds items are stored in the garage with key lock and is inaccessible to day care children in care. LPA observed the knives and sharp objects in an upper kitchen cabinet out of reach to children in care. Per licensee, breakfast, lunch, and snacks are provided. LPA informed licensee any food brought from the children's homes, the container shall be labeled with the child's name and properly stored or refrigerated. Licensee stated she currently does not have any children with severe food allergies nor on medication. Licensee is not a participant in a food program, but cooks for the day care children.

Continued on LIC 809-C

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/29/2024
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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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: PERALTA GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 197493203
VISIT DATE: 08/29/2024
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Fire/Disaster Drill is complete and maintained current. Last Fire/Disaster Drill was completed on 04/24/2024.

Roster complete and maintained current.

Bathroom: Shower/tub are free of hazards (child care bathroom). LPA did not observe any hazardous items in the children's bathroom. Toilet and faucet are clean and operable. LPA reminded licensee and personal items (ex; shampoo, toothpaste, mouthwash, or items that fall into that category) must be made inaccessible to children.

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.

Outdoor: The backyard is safe for children. The backyard is completely fenced (with wooden fencing). There is no body of water. LPA observed age appropriate toys. Per licensee, there is one dog on the premises. LPA reminded licensee, barbecue pits must remain in off limits area when day care children utilize the backyard. Per licensee, the day care children have not been going outside in the backyard due to the heat.

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expires 11/19/2024. Mandated Reporter expires 10/27/2025. There are no window cords accessible to children.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
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: PERALTA GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 197493203
VISIT DATE: 08/29/2024
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Documents Provided and or Discussed: Fire Drill Log, Roster, Postings, Safe Sleep PIN 20-24-CCP, Individual Sleeping Plan (LIC9227), and Safe Sleep Log. Licensee stated currently does not have child care insurance.

Licensee Peralta Garcia 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 Peralta Garcia 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.

No deficiencies have been cited at this time.

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 Ana Peralta Garcia, along with her appeal rights and Notice of Site Visit.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
LIC809 (FAS) - (06/04)
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