197700914-2-12-2025-12-CC-JDMO-DDTTVQ-20250212140419

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700914
Report Date: 02/12/2025
Date Signed: 02/12/2025 02:05:10 PM

Document Has Been Signed on 02/12/2025 02:05 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:	CORTES FAMILY CHILD CARE		FACILITY NUMBER:	197700914
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	02/12/2025
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:07 AM
MET WITH:	Melany Cortes and Hector Cortes		TIME VISIT/ INSPECTION COMPLETED:	01:40 PM

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On February 12, 2025, at 9:07 A.M., Licensing Program Analyst (LPA) Joselito L. Del Mundo, conducted a Pre-Licensing inspection with applicants, Melany Cortes and Hector Cortes to ensure the facility meets basic licensing requirements set forth by Title 22, (FCCH) with a capacity of eight children. Currently living in the home are the applicants and three adults (one of the applicant’s brother, mother, and stepdad). LPA toured the home indoor and out to ensure it meets FCCH requirements. The applicants are requesting to provide care for children ages three months old to 12 years of age. Applicants are requesting the days and hours of operation will be Monday to Friday, from 6:30 A.M. to 5:00 P.M.

The home is described as follows:

This is a one-story home with four bedrooms, three bathrooms, living room (main care), kitchen, dining area, laundry area, and back yard. 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. Off-limits areas: bedrooms #2, #3, and #4, bathrooms #2 and #3, kitchen, dining area, laundry area, and backyard. On limits: living room, bathroom #1, and bedroom #1.

Indoor:

On limits:

Bedroom #1: LPA observed television, drawer, 2 cribs, diaper changing table, and a massage chair. Applicant was advised to put a cover on the fireplace. Outlets are covered.
Living room (Main care): LPA observed couches, kitchen set toy, television, massage chairs, and a fireplace. The fireplace is covered with a mesh screen and a glass. Per applicants, they will use the massage chairs to block the fireplace to make it inaccessible to children in care. Outlets are covered.
Bathroom #1: LPA observed toilet, shower, faucet, and sink and are in operable conditions. LPA observed

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025

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: CORTES FAMILY CHILD CARE	FACILITY NUMBER: 197700914
	VISIT DATE: 02/12/2025

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shampoos placed on the shampoo holder under the shower head. Applicant was advised to make the shampoos inaccessible to children. The outlets are covered.
Electrical outlets: Outlets in on-limit areas have child safety plastic plugs.

Off-limit area
Bedroom # 2 (Adjacent to the bathroom #1 and Living room): Bedroom #2 was equipped with a full-sized bed, closet, couch, drawer, cabinets, and other personal belongings. There is a child safety lock for the doorknob on bedroom #2.
Bedroom # 3 (Adjacent to the dining area and Living room): Bedroom #3 was equipped with a queen-size bed, small drawer, vanity set, closet, and other personal furnishings. There is a child safety lock for the doorknob in bedroom #3.
Bedroom # 4 (Adjacent to the kitchen area and laundry area): equipped with a full-sized bed, walking closet, couch, drawer, television, and other personal belongings. Applicant stated that his brother-in-law (Adult #1, A#1) owns a firearm. LPA checked and observed the firearm and ammunitions are stored on a separate box.
Bathroom #2 (Adjacent to the bedroom #3): LPA observed toilet, shower, faucets, and sinks and are in operable conditions.
Bathroom #3: LPA observed toilet, shower, faucet, and sink and are in operable conditions.
Dining area and kitchen: (Adjacent to bedrooms #3, #4 and Living room). LPA observed an island, dining table, chairs, stove, refrigerators, dishwasher, and microwave oven. Outlets in the kitchen are covered. LPA observe kitchen stove knobs have child safety lock. Knives are stored inside the upper kitchen cabinets and drawers and secured with child safety lock. Per applicant, meals and snacks will also be provided to children in care. LPA told the applicant that if food was brought from children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated.
Laundry area: has washer and drier.
Backyard and Side yards (Outdoor play area): LPA observe body of water at the backyard with no fence installed. Per applicants, the backyard will be currently off-limits to children in care and the fence will be installed no later that Friday, February 14, 2025. LPA advised the applicants to install the pool fence in accordance with the proper specifications provided to the applicants.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025

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: CORTES FAMILY CHILD CARE	FACILITY NUMBER: 197700914
	VISIT DATE: 02/12/2025

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The outdoor is made up of concrete and grass. LPA observed a pool house and tool shed at the backyard. The pool house will be use as an office of the applicants.

LPA also observed garden tools such as rake, shovel, lawn mower, and poisons like weed killer, paint, and lawn solutions.
Per applicants, they will store the items inside the tool shed.

Applicant agrees that the swimming pool fencing making the pool inaccessible to children will remain in place, pool alarm will be operable and daily documentation on the pool inspection log whenever licensed care is provided.

Garage: LPA did not observe a garage.

Napping equipment: LPA observed 2 cribs. Applicants will purchase the cots.

Weapons or Firearms: Per applicants, Adult #1 has a firearm or weapon. LPA observe firearm in bedroom #4 with ammunitions stored separately in a box.

Knives: Stored inside the upper kitchen cabinet and drawer with child safety lock.
Poisons, Detergents and Cleaning compounds: Poisons such as weed killer, paint, and lawn solutions were observed at the backyard. Applicants were advised to make the poisons inaccessible to children.
A smoke detector and a carbon monoxide detector: Tested at 11:10 A.M. Carbon monoxide detector and smoke detector is in operable condition.
Fire extinguisher (2-A:10-B:C): The fire extinguisher is a 2-A:10-B:C type and meets the State Fire Marshall standards.
First Aid Kit: LPA observe the first aid kit mounted on the wall beside the fireplace in the living room.
Pets: LPA observe a dog (pug) inside the home and has vaccination records.
Medications: Per applicants, they don’t have any medications.
Documentation:
Applicants completed the Prevented Health and Safety Training (8 hours) with the nutrition and lead components on November 14 and 22, 2024. Applicants has completed the pediatric CPR and First Aid Trainings on November 24, 2024, and mandated reporter trainings on January 15, 2024, and December 27,

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025

LIC809 (FAS) - (06/04)

Page: 3 of 9

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: CORTES FAMILY CHILD CARE	FACILITY NUMBER: 197700914
	VISIT DATE: 02/12/2025

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2024. Applicants have fingerprint clearance, required immunizations (Pertussis and Measles), Flu vaccination for the applicants, and TB skin test.

The other adults living in the home have fingerprint clearance and TB skin test.

The applicants provided proof of control of property which is the Annual Secured Property Tax Information Statement for the fiscal year July 1, 2024, to June 30, 2025.

Per Applicant, transportation will be provided.

The following was discussed with the applicant:

1. The following items are zero tolerance by Licensing: Refused Entry to a Facility or Any Part of a Facility is a violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both.

2 Pediatric First Aid and CPR: American Heart Association or American Red Cross or Emergency Medical Services Authority (EMSA) approved in-person Pediatric First Aid and CPR must be present. Certification must be renewed every two years.

3. Applicant was informed that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

4. In the absence of the licensee a qualified adult must be present, supervising the children; a qualified adult is an individual who has a valid and current Pediatric first aid/ CPR-adult-child- infant certification (EMSA approved), a valid criminal record clearance associated to the facility license, immunizations (MMR, TDAP, and Influenza or Influenza declination), TB results, AB 1207 Child Abuse Mandated Reporter Certificate.

5. A current roster of children enrolled must be available and maintained for a period of 3 years, even after children are no longer attending the facility.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025

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: CORTES FAMILY CHILD CARE	FACILITY NUMBER: 197700914
	VISIT DATE: 02/12/2025

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6. Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the license shall be terminated.

7. The fire extinguisher type 2-A:10-B:C must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.

8. Fire and safety drills must be performed every six (6) months and documented for review by the Department.

9. Regulation prohibits the smoking of any kind during the operation of the day care.

10. Children and staff records must be maintained and updated as needed and be available for review by the Department.

11. Immunization Requirement: H&S 1597.622: 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.

12. Inspection Authority: All adults living and working in the home shall be made of aware of the Department’s right to inspecting the home, which includes, but is not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.

13. The facility license number must be on all advertisements, publications, or announcements with the intent to attract clients.

14. Isolation for Ill children: When a child is ill, he/she shall be separated from other children (reference 102417(e) Operation of a Family Child Care Home). The bedroom #1 will use as an isolation area.

15. Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information. Licensee is planning to have a liability insurance.

16. Dog(s) and/or pets are recommended to be isolated from children in care.

17. No baby bouncers, no infant walkers, no Johnny jumpers, no saucer chairs, and any other items that

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025

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: CORTES FAMILY CHILD CARE	FACILITY NUMBER: 197700914
	VISIT DATE: 02/12/2025

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falls into this category are not permitted in the facility.

18. The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.
Mandatory licensing forms such as LIC 311D Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted in the family child care home; Role and responsibilities of being a mandated reporter were reviewed; The applicant was reminded that 100% supervision is required at all times to children in care; Applicant was made aware that it is 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 applicant was made aware of the requirement to report unusual incidents and/or injuries to the parent/guardian and to the Department on the day of the incident and/or 24 hours of incident by telephone, fax and/or in writing to the Department. The applicant was informed to utilize the Unusual Incident Report/Injury Report form (LIC624B) when sending the report to the department. The report on unusual incident/injuries can also be mailed to unusualIncidentreport@dss.ca.gov

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.

Applicant was informed that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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: 02/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025

LIC809 (FAS) - (06/04)

Page: 6 of 9

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: CORTES FAMILY CHILD CARE	FACILITY NUMBER: 197700914
	VISIT DATE: 02/12/2025

NARRATIVE

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LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage: atttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

LPA 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.

The applicant was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days whenever a licensing inspection is conducted. If a Type A deficiency is cited, a copy of the licensing report must also be posted for 30 days. The same report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months & licensee must obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file. Copies of the reports must be provided to each parent when a Type A violation is cited along with

Acknowledgment of Receipt of Licensing Reports LIC 9224. If these requirements are not met civil penalties per violation will be assessed.

Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors, and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com.

Prior to making alterations or additions to a family childcare home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: Building an in-ground or above-ground swimming pool, conversion of a garage (either attached or detached) into a "childcare" room; Room additions to the family childcare 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. The 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.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025

LIC809 (FAS) - (06/04)

Page: 7 of 9

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: CORTES FAMILY CHILD CARE	FACILITY NUMBER: 197700914
	VISIT DATE: 02/12/2025

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Lead Flyer Requirement Health and Safety Code 1596.7996 mandated that effective January 1, 2019, CCC's and FCCH's are required to provide parents and guardians of children enrolling or reenrolling in care with written information on the risks and effects of lead exposure, blood lead testing requirements and recommendations, and options for locations of affordable blood lead tests as specified. A Lead Poisoning Facts Flyer was created, in partnership with the California Department of Public Health (CDPH), to satisfy this requirement.

The applicant was advised it is her responsibility to visit the department's website to access licensing forms, Quarterly Updates and Provider Information Notices (PINs): www.ccld.ca.gov

To improve the quality and value of the new inspection process, a survey may 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 CARE 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 CCLD website at: https://www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Applicants was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

LPA checked Megan’s Law website and confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

As a result of this inspection, the home does not meet Title 22 Regulations. Final approval is pending the following:

1. Physical Plant – 102417(g)(5): Pool fence shall be installed to make the pool inaccessible to children in care. Applicants will purchase a pool alarm (must be compliant with ASTM International Standard F2208), rescue pole with a hook (minimum length is 12 feet), and a life ring with a minimum exterior diameter of at least 17 inches and labeled as approved by the United States Coast Guard

2. Physical Plant – 102417(g)(1): Fireplace will be block with the massage chairs as additional security for children in care.
3. Physical Plant – 102417(g)(4): Poisons located at the backyard shall be made inaccessible.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025

LIC809 (FAS) - (06/04)

Page: 8 of 9

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: CORTES FAMILY CHILD CARE	FACILITY NUMBER: 197700914
	VISIT DATE: 02/12/2025

NARRATIVE

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4. Physical Plant – 102417(g)(4): Child safety lock for the oven.
5. Physical Plant – 102417(g)(4): Shampoos inside bathroom #1 shall be made inaccessible.
6. Advisory/Other: Garden tools such as rake, shovel, and lawn mower shall be made inaccessible, poisons such as weed killer, lawn solutions, and paint shall be made inaccessible.

Applicant will submit pictures of the corrections on February 19, 2025, to LPA.

An exit interview was conducted, and a copy of this report and appeal rights were discussed with the Applicants, Melany Cortes and Hector Cortes.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2025

LIC809 (FAS) - (06/04)

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