197700634-2-8-2023-12-CC-BBEO-CNUQNB-20230208111852

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700634
Report Date: 02/08/2023
Date Signed: 02/08/2023 11:19:21 AM

Document Has Been Signed on 02/08/2023 11:19 AM - 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:	CRUZ FAMILY CHILD CARE		FACILITY NUMBER:	197700634
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS:	DATE:	02/08/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Diana Cruz		TIME COMPLETED:	11:45 AM

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On 02/08/23 Licensing Program Analyst (LPA) Barbara Beneroso conducted a Pre-licensing Inspection with Applicant Diana Cruz, who guided LPA on a tour of the facility.

This is a two-story house with 5 bedrooms, 3 bathrooms, living room (main care area), dining area, kitchen, laundry room area and attached garage. There is also a backyard completely covered by a brick wall. Family members residing in the home include 3 adult (Applicant, applicant’s husband and applicant’s adult son) and 3 minor child.

The facility will operate Monday through Friday from 6AM-7PM for less than 24 hours and story with a license capacity of 8 children. LPA went over the child care ratios for a small family home with applicant, and provided applicant a copy.

Main care will be provided in the living room/dining area and kitchen. Children will eat in the dining area. The day care children will utilize the hallway bathroom on the left-hand side. Children will use rear yard for outdoor play. The front yard, bedroom downstairs, entire upstairs (barricaded by safety gate), laundry room, and garage area are off limits to the day care children.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023

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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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: CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 197700634
	VISIT DATE: 02/08/2023

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LPA observed day care area to be clean and orderly, central air and heating properly working and age appropriate toys and play equipment.

LPA did not observe any hazardous items in the child care bathroom. LPA reminded applicant the children's bathroom must be free of shampoos, mouthwash, medication, perfumes, razor, air freshener, nail polish and polish remover. LPA observed a clean, safe and operable toilet and faucet.

LPA observe a fully charge 2A10BC fire extinguisher during the inspection located in the kitchen area (Pantry). The home has a clean and fully stocked refrigerator/freezer. Cleaning supplies are in the bathroom, locked and not accessible to children. Kitchen cabinets are also inaccessible to children in care. First aid kit is stored in the dining room area. LPA observed the medications to be stored in the master bedroom in off limit area upstairs and in the pantry (inaccessible).

Laundry room cannot be accessed since it is located in the second floor. Laundry room and garage are off limits.

Kitchen: The following are inaccessible: Sharp items are stored in the upper kitchen cabinet on top of the microwave inaccessible to children in care. LPA observed the refrigerator and freezer to be clean. LPA reminded applicant, sharp utensils, open bottles or alcohol must remain inaccessible. If food is brought from the children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. Applicant plans to have a food program. Breakfast, lunch, and snacks will be provided.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023

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: CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 197700634
	VISIT DATE: 02/08/2023

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LPA toured the backyard and observe it to be free of garden tools, poisonous plants, thorn trees cactus, or lawn mower inaccessible to children. The backyard is barricaded by brick wall. Applicant will move bikes in the backyard to a barricaded area. There are two pets in the home, one dog and one cat.

Applicant 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.

Documents Provided and or Discussed: The following were provided to comply with Title 22 requirements: Fire Drill Log, roster, Safe Sleep PIN 20-24-CCP, Individual Sleeping Plan LIC 9227, water lead poster, required postings and list of CCLD forms required for child file each child in care (LIC 311D). Applicant stated currently does not have childcare insurance. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

Applicant was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within 24 hours of incident by telephone and in writing within 7 day of incident to the department. Applicant was informed all suspected Child Abuse should be reported to the Child Abuse Hot-line at 1-800-540-4000. The above incident should be reported on the form LIC624B per the regulation. The form should be email to unusualincidentreport@dss.ca.gov

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023

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: CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 197700634
	VISIT DATE: 02/08/2023

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Advisory/Other: LPA observed a first Aid kit with emergency supplies and a thermometer in the dining room area. Applicant First Aid/CPR are current. Preventative Health & Safety training is completed. Electrical outlets are inaccessible to children. Children will nap on cots in bedroom #1. Applicants aware no infant shall be swaddled, and car seat shall not be used for sleeping. Applicant is aware to supervise infants while they are sleeping by physically checking every 15 minutes and documenting the infant’s status. Applicant should refer to regulation 102425(J) for documentation requirement. If the infant’s Individual Infant Sleeping Plan [LIC 9227 (3/20)] does not have Section C completed, the provider shall return the infant to their back for sleeping. LPAs discussed the safe sleep regulations with applicant, including Safe Sleep PIN 20-24-CCP 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. LPAs also informed applicant 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.

Applicant inform smoking is prohibited, applicant stated no one smokes in the home, LPAs discussed Health Section 1596.846(b) and (c)–102417 (g)(10) and provided applicant with a visual copy of prohibited items. LPA did not observe prohibited items during the inspection. Per applicant no firearms are present in the home. Applicant was informed her cell phone shall be available and charged at all times during daycare hours.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023

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: CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 197700634
	VISIT DATE: 02/08/2023

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Incidental Medical Services (IMS) policy was discussed, informing applicant when any IMS is provided, a plan for providing IMS must be submitted to the Department prior to providing care to a child that need IMS. The plan shall state the type of IMS the facility will be offering, stating the person providing care has been trained to provide the named IMS. The plan will also provide the steps that will be taken when IMS is provided to a child.

The following information regarding ADA was discuss and the following information 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

LPA is currently waiting for:

1. Remove or cover BBQ grills

2. Place a lock on 2 storage unit

3. Obtain cots for napping

4. Install dual smoke alarm and carbon dioxide alarm

5. Remove bikes from accessible area

6. Barricading baby gate to be attached to the wall

7. Barricading or block the control panel of wall heater

Exit interview conducted copy of this report was provided to applicant along with notice of site visit.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023

LIC809 (FAS) - (06/04)

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