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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700549
Report Date: 01/24/2024
Date Signed: 01/24/2024 02:55:37 PM

Document Has Been Signed on 01/24/2024 02:55 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:YANEZ FAMILY CHILD CAREFACILITY NUMBER:
197700549
ADMINISTRATOR:MARISELA YANEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 878-4089
CITY:PALMDALESTATE: CAZIP CODE:
93551
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 14DATE:
01/24/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Marisela Yanez, LicenseeTIME COMPLETED:
03:30 PM
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On January 24, 2024, Licensing Program Analyst (LPA) Annelise Villa met with Licensee Marisela Yanez, who guided analyst on a tour of the facility for the Three Year Required inspection. Upon arrival, LPA observed 3 school age children, 10 preschool age children and 1 infant in care with Licensee and Licensee's husband caring for them. Family members living in the home are Licensee, Licensee’s husband, and 4 minor children. Hours of operation are 6:30 am to 6:00 pm, Monday through Thursday, and 6:30 am to 5:30 pm on Fridays. Incidental Medical Services (IMS) policy was discussed.

Physical Plant: This is a two-story 4 bedroom, 2.5 bathroom home with kitchen/dining, family room, living room, laundry room, and garage. Main care is provided in the living room and family room. The children use the bathroom located to the right of the front entrance. The off-limits areas are all upstairs areas including all bedrooms, bathrooms #2-3, laundry room and garage which are kept locked during business hours. The children use the bathroom located near the entrance on the right side of them home. 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, and medicines. Hazardous items (sharp knives are located in and cleaning detergents/compounds are kept an upper kitchen cabinet and inaccessible to children).

Safe and age-appropriate toys, play equipment and materials were observed. LPA tested the smoke detector and carbon monoxide detector and observed both to be in operable condition. Fire extinguisher (2A10BC) was found to be in operable condition located in the kitchen. 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.

Continued on LIC 809-C

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Annelise Villa
LICENSING EVALUATOR SIGNATURE: DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/24/2024
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: YANEZ FAMILY CHILD CARE
FACILITY NUMBER: 197700549
VISIT DATE: 01/24/2024
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Bathroom: Children use the restroom located on the right side of the front entrance. LPA observed toilet and faucet to be clean and operable. Bathroom #1 is a half bathroom with no shower and no tub. LPA reminded applicant the children's bathroom must be free of accessible shampoos, mouthwash, medication, perfumes, razor, air freshener, nail polish and polish remover.

Kitchen: The kitchen was observed to be clean and orderly. Sharp utensils are stored in a, upper kitchen cabinet and inaccessible to children in care. The home has a clean and fully stocked refrigerator/freezer. Breakfast, lunch, and snacks are provided. Licensee stated she is not a participant in a food program.

Outdoor: The children use the back yard outdoor play. The backyard is fenced all around. The outdoor play area was observed free of hazards and loose and sharp parts. There are both grass and concrete areas for active play. The front yard is off limits to children.

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

Advisory/Other: First Aid kit was observed in the living room area with supplies readily available. Licensee’s First Aid/CPR is valid and expires on 2/17/2024. Mandated reporter training for licensees expires on 1/16/2026. 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. There are 2 dogs on the premises. Last fire/disaster drill was completed on 1/8/2024.

Licensee’s annual fees are current. LPAs 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, Earthquake Preparedness Checklist (LIC 9148), Safe Sleep PIN 20-24-CCP and Individual Sleeping Plan (LIC9227).

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: Annelise Villa
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
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: YANEZ FAMILY CHILD CARE
FACILITY NUMBER: 197700549
VISIT DATE: 01/24/2024
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Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The Licensee shall permit the Department to inspect the family childcare home, and to privately interview children or staff, to determine compliance with or to prevent violations of family child care laws or regulations, also enter and inspect any place providing personal care, supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.

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.

LPAs 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. LPAs 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

No citations were issued as a result of this inspection. An exit interview was conducted, a copy of this report was reviewed and provided to licensee along with the appeal rights.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Annelise Villa
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3