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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700363
Report Date: 10/19/2022
Date Signed: 10/19/2022 03:31:12 PM

Document Has Been Signed on 10/19/2022 03:31 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:VILCAPOMA FAMILY CHILD CAREFACILITY NUMBER:
197700363
ADMINISTRATOR:VILCAPOMA, CHARITY & ELVIRFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 341-6054
CITY:VALENCIASTATE: CAZIP CODE:
91354
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
10/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:44 PM
MET WITH:Vilcapoma Charity TIME COMPLETED:
03:50 PM
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Licensing Program Analysts (LPA) Andrew Alemoh met with Licensee Vilcapoma Charity who guided analyst on a tour of the facility for the One Year Required Inspection. This is a two story 4-bedroom, 2 and a half bathroom home with kitchen, dining room area, family room, and garage. There is no pool on the premises. Upon arrival LPA observed 11 children and 1 infant with the licensee and Assistant #1. Licensee operation hours are 6:30am to 6pm .

Physical Plant: Main care is provided in the living room. Children use the bathroom in hallway near the kitchen on the left. Children have access to the family room, children's bathroom, dining area, kitchen and backyard. Off limit area includes 4 of the home’s bedrooms, upstairs bathroom, front yard,and garage. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (top cabinet above refrigerator),no medications and hazardous items (sharp knives inaccessible in top kitchen cabinet) that can pose a danger to children. Their is a fireplace that is screened and covered. The home has safe and age-appropriate toys, play equipment and materials. The smoke detector and carbon monoxide detector, and Fire Extinguisher (2A10BC) are in operable condition. Per Licensee no one smokes in the home. No baby bouncer’s 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 or dining room. Per Licensee there are no weapon/firearms in the home. LPA advised licensee that all electrical outlets must be inaccessible.

The last documented fire/earthquake drill was completed 07/11/2022, LPA advised licensee to conduct and document disaster drills every six months. Roster complete and maintained current.

Bathroom:Toilet and faucet are clean and operable.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE: DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/19/2022
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: VILCAPOMA FAMILY CHILD CARE
FACILITY NUMBER: 197700363
VISIT DATE: 10/19/2022
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Kitchen: Sharp utensils are inaccessible. Per licensee breakfast, lunch, and PM snack are provided. LPA reminded licensee If food is brought from the children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. Cleaning supplies are locked above the top kitchen cabinet. No chemicals in the kitchen were observed to be accessible.

Outdoor: The backyard is completely fenced and safe for children. Per licensee children do not use the homes front yard. The outdoor area has concrete areas for children to play. LPA observed the toys in the backyard to be in safe condition.

Advisory/Other: First Aid kit was readily available. CPR/First Aid expire 12/14/2022. Mandated Reporter was completed 09/21/19. Children nap on cots and cribs in the living room. LPA observed no dogs on the premises.

Documents discussed: Title 22 Personal Records 102416.1, Safe Sleep PIN 20-24-CCP, LIC 9227 and Infant Sleep Log.

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 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.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
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: VILCAPOMA FAMILY CHILD CARE
FACILITY NUMBER: 197700363
VISIT DATE: 10/19/2022
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A notice of site visit was given 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

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Andrew Alemoh
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
LIC809 (FAS) - (06/04)
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