197700272-2-21-2024-12-CC-JDMO-D2P3FW-20240221171324

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700272
Report Date: 02/21/2024
Date Signed: 02/21/2024 05:13:45 PM

Document Has Been Signed on 02/21/2024 05:13 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:	HERNANDEZ FAMILY CHILD CARE		FACILITY NUMBER:	197700272
ADMINISTRATOR:	HERNANDEZ, NANCY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 839-8941
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93535
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 6	DATE:	02/21/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	02:40 PM
MET WITH:	Nancy Hernandez		TIME COMPLETED:	05:10 PM

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On 02/21/2024, at 2:40 P.M., Licensing Program Analyst (LPA) Joselito L. Del Mundo conducted an unannounced annual inspection at Hernandez Family Child Care Home to assess its ability to meet compliance with California Code of Regulations (CCR) Title 22, Health, and Safety requirements. LPA Del Mundo met with Licensee, Nancy Hernandez and stated the reason for the inspection. The LPA provided copies of the LIC 126 Entrance Checklist Form, LIC 311D Forms/Records to Keep in the Family Child Care Home, and all records/forms that need to be maintained in the facility. Licensee guided the analyst on a tour of the day care areas. The day care takes place in the following area of the home: living room #1 (main day care) and #2, bedroom #1, kitchen, dining area, bathroom #1, and side yard (left).

Licensee states the day care hours of operation is Monday to Friday from 7:30 A.M. to 6:00 P.M. Currently living in the home is licensee, licensee’s spouse, and two minor children (6 and 3). Licensee and licensee’s assistant are currently providing transportation to children in care. During this visit, LPA observed six children present in the facility with the licensee providing care and supervision.

Physical Plant: The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds, medicines and hazardous items that can pose a danger to children. The smoke detector and carbon monoxide detector are in operable conditions (tested at 4:01 P.M.). The facility has a fully charge fire extinguisher with a 2-A:10-B:C classification (reading in green, checked at 3:43 P.M.). Licensee stated that she owns no firearms, and no one smoke in the facility. LPA observed cleaning products and detergents are stored inside the cabinets under the kitchen sink and secured with child safety lock. Knives and other sharp items are stored in the kitchen drawers. LPA observed household medications are stored in the upper cabinets of the kitchen. Per licensee, zero medications are currently being provided for the current children in care. Licensee stated that she is not a member of the food program, but she is providing meals and snacks to children in care.

The facility is a one-story house. There is a fireplace located in living room #1 which is made inaccessible to

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024

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

FACILITY NAME: HERNANDEZ FAMILY CHILD CARE	FACILITY NUMBER: 197700272
	VISIT DATE: 02/21/2024

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children with a screen/glass barrier and is also covered with a bookshelf. The home has central heating and air conditioning units.

Based on records review, licensee conducted the fire/earthquake drills on February 12, 2024, at 9:28 A.M., and is conducted once a month.

LPA observed safe and age-appropriate toys, kitchen set toy, grocery set toy, puzzles, cubbies, tables, chairs, children’s books, colors, numbers, shapes, small couch, arts and crafts, and other age-appropriate toys. Licensee provides three playpens and eleven sleeping cots for children to use during napping.

LPA observed first aid kit boxes are stored in a paper towel holder above the diaper changing table in the dining area. LPA observed electrical outlets are covered with a safety plug to prevent access by children in care.

Licensee is advised that baby bouncers, saucer chairs, or any recalled and or banned toys or sleep/ play equipment are prohibited on the premises. Licensee is advised to check for fixture, furniture and equipment that have been banned or recalled by the United States Consumer Product Safety Commission.

Bathroom: Toilet, sink and faucet were clean and operable. During the inspection, LPA observed a step stool and a potty chair inside the bathroom. LPA did not observed mouthwash, medications, perfumes, air freshener, nail polish and nail remover that will pose a health and safety risk to children in care. LPA observed cleaning compounds for the bathroom are stored under the bathroom sink and secured with child safety lock.

Currently, the licensee has eight children enrolled in the facility. Licensee stated that when a child shows signs of illness, he/she is separated from other children in living room #2 of the facility. Licensee added that parents of the child that has symptoms are called immediately.

Outdoor: The facility has no body of water on the premises. The outdoor play area has age-appropriate toys and play equipment. The outdoor space is covered with turf. LPA observed small slides, toy cars, small basketball, climbing and swinging rope. The outdoor play space was enclosed. The trees standing beside

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024

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

FACILITY NAME: HERNANDEZ FAMILY CHILD CARE	FACILITY NUMBER: 197700272
	VISIT DATE: 02/21/2024

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the outdoor play area were also trimmed. Per licensee, she supervised children while playing outside.

At the time of inspection, Licensee is aware of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing on the day of the incident and/or 24 hours of incident by telephone, fax and/or in writing to the Department. Licensee is familiar with the Unusual Incident Report form, LIC624B. The report on unusual incident/injuries can also be mailed to unusualIncidentreport@dss.ca.gov

Review of records to be maintained: LPA reviewed with licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. LPA reviewed five children’s files, licensee, and assistants’ files. Based on records review, children’s files are complete; licensee and assistants have current mandated reporter trainings completed on 06/08/2023 and 08/12/2022; CPR/First Aid trainings were completed on 07/22/2023 and 11.29/2022. Licensee and assistant have proof of immunization against measles and pertussis. Licensee and assistant declined to take the influenza vaccine. Licensee and assistant have TB skin test on file.

Licensee and adult working at and associated to the facility have received criminal record clearance.

The following was discussed with the licensee:

The licensee was reminded that 100% supervision is always required for children in care. Licensee was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care. Licensing must always have the facility’s phone number; if the phone number is changed, licensing must be notified.

The regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare home and in those areas of the family day care home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exersaucers, and any other items that fall into that category.

Licensee 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 and discussed the Child Care Licensing Safe Sleep

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024

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

FACILITY NAME: HERNANDEZ FAMILY CHILD CARE	FACILITY NUMBER: 197700272
	VISIT DATE: 02/21/2024

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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.

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 advised to visit the CCL website (www.ccld.ca.gov) to obtain updates on courses and updates/changes to the regulations. Our Quarterly updates come out every 3 months and are also in Spanish. Please log in to the CCLD website, or you can email our advocates to have the quarterly updates sent directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

The Licensee is informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 AM to 5:00 PM.

The facility is in compliance per Title 22 regulations. During today's inspection, LPA Del Mundo did not observe deficiencies that may hinder the health and safety of the children in care. No deficiencies were cited during this inspection. An exit Interview and discussion of observations were conducted with the licensee.

Notice of Site Visit: A Notice of Site Visit (LIC 9213 was given and must remain posted for 30 days.
Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100. A copy of this Report was reviewed, and Appeal Rights were also provided to Licensee, Nancy Hernandez.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024

LIC809 (FAS) - (06/04)

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