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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493349
Report Date: 03/02/2023
Date Signed: 03/02/2023 01:07:48 PM

Document Has Been Signed on 03/02/2023 01:07 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:NEVAREZ FAMILY CHILD CAREFACILITY NUMBER:
197493349
ADMINISTRATOR:NEVAREZ, DEBRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 234-4762
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
03/02/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:41 AM
MET WITH:Debra Nevarez, LicenseeTIME COMPLETED:
01:15 PM
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On 03/02/23 Licensing Program Analyst (LPA) Justeene Tamayo met with Licensee, Debra Nevarez, who guided analyst on a tour of the facility for the One Year Required inspection. This is a one story, 4 bedroom, 1 den, 3.5 bathroom home with kitchen/dining, family room, living room, laundry room and garage. There is an in ground swimming pool on the premises. Upon arrival LPA observed 9 preschool children and 2 infants in care. Family members residing in the home include 2 adults (licensee and licensee's daughter) and 2 minor children. Facility operation are Monday-Friday 24 hours. Incidental Medical Services (IMS) policy was discussed.

Physical Plant: Main care is provided in the family room. Children use the bathroom in hallway on the right. Children have access to the living room, family room, and dining room area. 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 (master bedroom in off limit area) and hazardous items (sharp knives in upper kitchen cabinet unreachable to children in care) that can pose a danger to children. LPA observed a fireplace in the home 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 living room. Per Licensee there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (cell and landline).
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/02/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: NEVAREZ FAMILY CHILD CARE
FACILITY NUMBER: 197493349
VISIT DATE: 03/02/2023
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Last Fire/Disaster drill is maintained current. Last Fire/Disaster Drill was completed on 02/06/23.

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.

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 a safety latch. Breakfast, lunch, and snacks are provided. Licensee currently has a food program. Naps are provided in the den room.

Outdoor: The backyard is safe for children. The backyard is completely fenced (with block cement). LPA observed a mesh fence barricading the in ground swimming pool. The mesh fence follows Title 22 regulations. There are two outdoor air conditioner inaccessible to children with barricaded wire fence on the side of the home. LPA observed age appropriate toys. Per licensee, there are two pets on the premises.

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expire 04/30/2023. Mandated reporter expired in 2020. Licensee will retake her mandated reporter training at www.mandatedreporterca.com. There are no window cords accessible to children.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
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: NEVAREZ FAMILY CHILD CARE
FACILITY NUMBER: 197493349
VISIT DATE: 03/02/2023
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Documents Provided and or Discussed: Roster, Postings, Safe Sleep PIN 20-24-CCP and Emergency Disaster Plan. Licensee stated currently does not have child care insurance.

Licensee Nevarez 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 Nevarez 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 Debra Nevarez, along with her appeal rights and Notice of Site Visit.

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

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
LIC809 (FAS) - (06/04)
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