197700481-7-17-2023-12-CC-JDMO-CTTQXF-20230717123327

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700481
Report Date: 07/17/2023
Date Signed: 07/17/2023 12:33:44 PM

Document Has Been Signed on 07/17/2023 12:33 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:	ARANDA FAMILY CHILD CARE		FACILITY NUMBER:	197700481
ADMINISTRATOR:	ELBA ARANDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 678-8125
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93535
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 10	DATE:	07/17/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Elba Aranda		TIME COMPLETED:	12:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 07/17/2023, at 9:00 A.M., Licensing Program Analyst (LPA) Joselito L. Del Mundo conducted an unannounced annual inspection at Aranda 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, Elba Aranda 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 maintain in the facility. Licensee guided the analyst on a tour of the day care areas. The day care take place in the following area of the home: dining room, bedroom #1, living room #1, living room #2, hallway bathroom #1 and backyard (outdoor play area). Licensee states the day care hours of operation is Monday to Saturday from 6:30 A.M. to 6:30 P.M. Currently living in the home is the licensee, licensee’s spouse, and adult son. Licensee is currently providing transportation to children in care. During this visit, LPA observed ten children present in the facility. 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. LPA observed all cleaning products and detergents are stored underneath the kitchen sink and secured with a child safety lock. Kitchen is off limits and has a retractable mesh baby gate to prevent access to children. Knives, cutleries, and other sharp items are stored in the first and second shelves of the cabinet of the kitchen (off limits) and secured with a safety lock. Per licensee, household medications are stored inside the closet of the licensee’s room and zero medications are currently being provided for the current children in care. Licensee stated that she is a member of the food program, and she is providing breakfast, morning snacks, lunch, afternoon snacks, and dinner. The facility is a two-story house. There is a fireplace in the facility and is cover with a heavy wood and a wooden kitchen set toy. The home has a swamp cooler and 3 fans. Per licensee, CCRC head start will

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2023

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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Document Has Been Signed on 07/17/2023 12:33 PM - It Cannot Be Edited

Created By: Joselito DelMundo On 07/17/2023 at 11:38 AM

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: ARANDA FAMILY CHILD CARE	FACILITY NUMBER: 197700481
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/17/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee’s assistant did not have an immunization records on measles which posed a potential Health, Safety or Personal Rights risk to persons in care.
	POC Due Date: 07/31/2023
	Plan of Correction
1 2 3 4	Licensee will email copies of immunization records on measles of Assistant #1 to LPA.

Type B

Section Cited

CCR

102425(c)

Infant Safe Sleep

An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not maintain a copy of LIC9227 Individual Sleeping Plan Consent for child #2 which posed a potential Health, Safety or Personal Rights risk to persons in care.
	POC Due Date: 07/31/2023
	Plan of Correction
1 2 3 4	Licensee will email a copy of signed parents LIC9227 Individual Sleeping Plan for child #2 to LPA.

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:

Lady King

LICENSING EVALUATOR NAME:

Joselito DelMundo

LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2023

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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: ARANDA FAMILY CHILD CARE	FACILITY NUMBER: 197700481
	VISIT DATE: 07/17/2023

NARRATIVE

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provide a new air conditioning unit.

Based on records review, fire/earthquake drills were conducted last June 7, 2023, at 2:25 P.M. and is conducted once every three months. The facili5ty has a fully charge fire extinguisher with a 2-A:10-B:C classification (reading in green, checked at 9:20 A.M. Safe and age-appropriate toys, children’s books, tables, chairs, cubbies, numbers, calendar, kitchen set toys, ABCs, puzzles, games, Legos, solar system, play pen and writing tables were observed during the inspection. Licensee provides napping equipment like cots (5) for children to use.

Licensee has first aid kit box stored in the upper shelf of the cabinet of the kitchen. The smoke detector and carbon monoxide detector are in operable condition (checked at 10:30 A.M.). LPA observed electrical outlets are covered with a plastic cover to prevent access to children in care. Licensee stated that she owns no firearms, and no one smoke in the facility.

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 did not observed razors and/or sharp objects, shampoos, mouthwash, medications, perfumes, air freshener, nail polish and nail remover that will pose a health and safety risk to children in care. LPA also observed a step stool, 3 potty chairs, 1 potty seat, and information about brushing teeth and washing hands inside bathroom #1 during the inspection.

Currently, the licensee has 14 children enrolled in the facility. Licensee stated that when a child shows signs of illness, he/she is separated from other children in bedroom #1 (infants’ room) of the facility. The infants’ room has two cribs, one small bed, shelves for diapers, one small extra bed, and a diaper changing table.

Outdoor: The facility has no body of water on the premises. The outdoor play area has a covered porch and age-appropriate toys and play equipment. LPA observed slides, tables, chairs, rideable toy cars,

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2023

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

FACILITY NAME: ARANDA FAMILY CHILD CARE	FACILITY NUMBER: 197700481
	VISIT DATE: 07/17/2023

NARRATIVE

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basketballs, and other toys . 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 and the Licensee file. Based on records review, one child’s file is incomplete; licensee and assistant have current mandated reporter training and CPR/First Aid training certificates. Licensee and assistant have proof of immunization against measles, pertussis, and influenza. Licensee and assistant have TB skin test on file

Licensee and other adults living in the home, working at and associated to the facility have received criminal record clearance.

The following was discussed with the licensee:

Licensee reminded that 100% supervision is required at all times to children in care. Licensee was made aware that it is he/her responsibility to know the regulations as well as anyone who assists in providing care. Licensing must have the facility’s phone number at all times; 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.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2023

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: ARANDA FAMILY CHILD CARE	FACILITY NUMBER: 197700481
	VISIT DATE: 07/17/2023

NARRATIVE

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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.

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

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

The facility is not in compliance per Title 22 regulations. During today's inspection, LPA Del Mundo observed deficiencies that may hinder the health and safety of the children in care. Type B deficiencies were cited during this inspection. An exit Interview and discussion of observations were conducted with the licensee.

A copy of this Report was reviewed, Notice of Site Visit (LIC 9213) and Appeal Rights were provided to Licensee, Elba Aranda.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2023

LIC809 (FAS) - (06/04)

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