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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700406
Report Date: 08/23/2024
Date Signed: 08/23/2024 02:52:22 PM

Document Has Been Signed on 08/23/2024 02:52 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:BOBADILLA FAMILY CHILD CAREFACILITY NUMBER:
197700406
ADMINISTRATOR/
DIRECTOR:		BOBADILLA, GABRIELAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 272-9647
CITY:PALMDALESTATE: CAZIP CODE:
93550
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
08/23/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:58 PM
MET WITH:Gabriela Bobadilla, Licensee TIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 08/23/2024, Licensing Program Analyst (LPA) Justeene Tamayo met with Licensee Gabriella Bobadilla, who guided analyst on a tour of the facility for the One Year Required inspection. Upon arrival, LPA observed 3 infants, and 5 preschool age children in care, along with assistant #1 and licensee. The home consists of 4 bedrooms, 2.5 bathrooms. Adults living in the home are Licensee and licensee’s husband. Hours of operation are Monday-Sunday, 24 hours a day as needed. Incidental Medical Services (IMS) policy was discussed.

Physical Plant: Main care is provided in the first level of the home in the living room. Children use the bathroom in first floor hallway. Children have access to the children's living room, bedroom #1, Bathroom #1, and back yard. Children use the bathroom #1 through the hallway. Children have access to the main care areas and the back yard. Off limit areas include all upstairs area, bedroom #2-4, bathroom #2.5, front yard, and garage. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons. Cleaning supplies (hallway closet with safety latch), medications(hallway closet with safety latch) and sharp items such as knives (located on second floor) are inaccessible to day care children in care.

Safe and age-appropriate toys, play equipment and materials were observed. LPA Tamayo tested the smoke detector and carbon monoxide detector and observed both to be in operable condition. Fire extinguisher was found to be in operable condition and located near the daycare entrance. Electrical outlets were inaccessible. No recalled and or prohibited toys or play equipment were observed on the premises. There is a designated area for ill children as necessary.

Bathroom: Children use the restroom located through the hallway of the first floor. LPA observed toilet and faucet to be clean and operable. No hazardous materials or items were observed to be accessible in bathroom #1. LPA observed shampoos, soaps, and cleaning supplies under the sink with operable safety latch and inaccessible to children in care. LPA reminded applicant the children's bathroom must be free of accessible shampoos, mouthwash, medication, perfumes, razor, air freshener, nail polish and polish remover.

Continued on 809-C

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: BOBADILLA FAMILY CHILD CARE
FACILITY NUMBER: 197700406
VISIT DATE: 08/23/2024
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Kitchen: The kitchen is off limits to children in care. Sharp utensils are stored in an off limits area and inaccessible to children in care. The home has a clean and fully stocked refrigerator/freezer. Breakfast, lunch, snacks, and dinner are provided. Licensee stated she is participant in a food program.

Outdoor: Children play in the back yard. Licensee stated the children are currently not playing in the back yard due to ongoing landscaping and heat. LPA reminded Licensee, once landscaping is complete, the back yard and must be free of garden tools, poisonous plants, thorn trees, cactus, or lawn mower inaccessible to children. The play area is clear and clean of debris, play area is fenced and gated all around. LPA observed age-appropriate play equipment for children. There is a swing and slide set to be in stable condition. There is one dog on the premises.

Pools/Spas/Bodies of Water: There are no pools, spas, or bodies of water in the home.

Advisory/Other: First Aid kit was observed in near the entrance with supplies readily available. Licensee’s First Aid/CPR certification has expired as of 08/14/2024. Licensee will retake her CPR/First Aid, and send proof of completion to LPA Tamayo no later than 09/27/24. Facility has been cited a Type B Citation. Please see LIC809-D for deficiency page.

Mandated reporter training for licensees expires on 3/10/2025. LPA reminded licensee mandated reporter training and CPR must be completed every 2 years. Per Licensee, there are no guns, weapons, or firearms in the home. Per Licensee, there is no smoking in the home. Last fire/disaster drill was completed on 08/19/2024.

Licensee’s annual fees are current. LPA observed all required facility postings on premises. Licensee had the following required posted documents: Notice of Parent's Rights Poster (PUB 394), Facility License (LIC 203) and Emergency Disaster Plan (LIC 610A), Earthquake Preparedness Checklist (LIC 9148) and Fire/Disaster Log.

Documents Provided and or Discussed: Fire Drill Log, required postings, Employee's and Children's records, Safe Sleep PIN 20-24-CCP and Individual Sleeping Plan (LIC9227). Licensee currently does not have childcare insurance.

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.

Continued on LIC 809-C

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

DATE: 08/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2024
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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: BOBADILLA FAMILY CHILD CARE
FACILITY NUMBER: 197700406
VISIT DATE: 08/23/2024
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Prior to making alterations or additions to a family child care home or grounds, the Licensee shall notify the Department of the proposed changed, including, but not limited to, the following: Conversion of a garage (either attached or detached) into a "child care" room; Room additions to the family child care home. Any change from an area of the family childcare home previously identified as "off limits" to an area where care and supervision will be provided to children in care. Licensee shall provide the Department with a copy of an inspection report when an inspection is required by the local building inspector as a result of the alteration, addition or construction.

Licensee advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department (email address on the website: www.unusualincidentreport@dss.ca.gov. A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep. More information on Infant Safe Sleep procedures can be found online on the CDSS web page 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

An exit interview was conducted, a copy of this report was reviewed and provided to licensee along with the appeal rights and Notice of Site Visit.

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

DATE: 08/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/23/2024 02:52 PM - It Cannot Be Edited


Created By: Justeene Tamayo On 08/23/2024 at 01:44 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: BOBADILLA FAMILY CHILD CARE
FACILITY NUMBER: 197700406

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/23/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. Licensee's CPR/First Aid expired on 08/14/2024, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/27/2024
Plan of Correction
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Licensee will send her current CPR/First Aid to LPA Tamayo no later than 09/27/24.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: 08/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/23/2024


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