<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198009556
Report Date: 07/08/2022
Date Signed: 07/08/2022 12:07:14 PM

Document Has Been Signed on 07/08/2022 12:07 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:GARCIA FAMILY CHILD CAREFACILITY NUMBER:
198009556
ADMINISTRATOR:GARCIA, ROSA MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 768-7549
CITY:SUN VALLEYSTATE: CAZIP CODE:
91352
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
07/08/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:28 AM
MET WITH:Rosa Garcia, Licensee TIME COMPLETED:
12:44 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 07/08/22, Licensing Program Analyst (LPA) Liana Stepanyan conducted an unannounced comprehensive annual random site visit to ensure the health & safety standards as required by regulations governing family childcare homes. LPA met with licensee, also present was licensee’s husband and 4-day care children. Licensee has all appropriate forms posted. First Aid/CPR certificate is valid thru 12/2022. LPA confirmed with licensee that all adults residing/working in the home have criminal record/TB clearances. Children’s records were reviewed and found to be in order. Licensee has practiced fire/emergency drills with daycare children in May 2022.

This 1 story, 3-bed, 2-bath home was toured, the following areas are used for daycare: living/dining/family room, hallway bathroom, bedroom #1 and #2, kitchen and front yard. Off limit areas include: master bedroom, garage, laundry room and backyard. Drawers and lower cabinets in kitchen/bathroom are either latched or do not contain any hazardous items, however, LPA observed cleaning compounds in the hallway bathroom and kitchen area accessible to children which poses an immediate health and safety risk to children in care. There is an operational smoke alarm and fire extinguisher maintained in the home. The home has electrical outlet covers throughout and maintains a First Aid Kit in family room. There are adequate age appropriate toys, books, games, and napping mats. There are no firearms present on the premises as stated by licensee. Furthermore, there are no bodies of water. The outdoor play area is a fenced backyard and front yard, which is free of hazards and has sufficient toys. There are no pets in the home. Per licensee, operating hours are from 6am-7pm, Monday thru Friday.

LPA reviewed the following: required departmental documents, regulation highlights, community resources, capacity limitations, supervision, clearances, emergency drills, heat-related illness, child passenger law, unusual incidents, mandated reporting, SIDS, Shaken Baby Syndrome, and Megan's law. Licensee is reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats shall never be permitted during daycare operation.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Liana Stepanyan
LICENSING EVALUATOR SIGNATURE: DATE: 07/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/08/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
Document Has Been Signed on 07/08/2022 12:07 PM - It Cannot Be Edited


Created By: Liana Stepanyan On 07/08/2022 at 11:14 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: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 198009556

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/08/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above, LPA observed cleaning compounds accessible to children in the hallway bathroom and kitchen area which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 07/08/2022
Plan of Correction
1
2
3
4
Licensee immediately removed the cleaning compounds in the bathroom and kitchen area. Licensee is aware now even during cleaning while daycare children are present cleaning compounds can not be accessible to the children.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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:Liana Stepanyan
LICENSING EVALUATOR SIGNATURE:
DATE: 07/08/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/08/2022


LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 07/08/2022 12:07 PM - It Cannot Be Edited


Created By: Liana Stepanyan On 07/08/2022 at 11:14 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: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 198009556

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/08/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the licensee did not comply with the section cited above, LPA did not observe a written disaster plan. Per licensee she does not have one and she needs to update the disaster plan which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/22/2022
Plan of Correction
1
2
3
4
LPA provided the Disaster Plan LIC610A form. Licensee will fill it out and send a copy to LPA by the POC due date.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the licensee did not comply with the section cited above, LPA did not observe the mandated reporter training. Per licensee she has not completed the mandated reporter training in a while which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/22/2022
Plan of Correction
1
2
3
4
Licesensee will completed mandated reporter training online by POC due date and email the LPA the certificate of completion.
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:Liana Stepanyan
LICENSING EVALUATOR SIGNATURE:
DATE: 07/08/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/08/2022


LIC809 (FAS) - (06/04)
Page: 3 of 4
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: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 198009556
VISIT DATE: 07/08/2022
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
26
27
28
29
30
31
32
For licensing regulations/updates/forms, go to webpage http://www.ccld.ca.gov

There were items found in non-compliance per CCR, Title 22, Division 12, Chapter 3; see deficiencies cited on LIC809D. Facility is being cited for Type A and Type B deficiencies. Discussed appeal rights with licensee. Be aware that Notice of Site Visit must be posted for 30 days. Furthermore, upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

An exit interview is conducted, copy of the report was provide to licensee along with appeal rights and notice of site visit.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Liana Stepanyan
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4