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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198013675
Report Date: 04/04/2024
Date Signed: 04/04/2024 04:24:26 PM

Document Has Been Signed on 04/04/2024 04:24 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:MORAN FAMILY CHILD CAREFACILITY NUMBER:
198013675
ADMINISTRATOR/
DIRECTOR:		MARTHA MORANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 768-6020
CITY:SUN VALLEYSTATE: CAZIP CODE:
91352
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
04/04/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:07 PM
MET WITH:Martha MoranTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
NARRATIVE
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On Thursday April 4, 2024 Licensing Program Analyst (LPA) Evelyn Garcia conducted an unannounced annual inspection and met with Martha Moran who guided LPA Garcia on a tour of the facility. There were 9 children in care participating in meal time. Operating hours are Monday- Friday, 7:00am- 6:00pm. Residing in the home are licensee, spouse and 2 other adults, all who have been fingerprinted and cleared. This facility is a two-story home that consists of 5 bedrooms, 3 bathrooms, kitchen, living area, dining room, attached garage, and front yard and backyard fenced.

Areas off limits to children include- whole 2nd story of the home (barricaded with a safety gate to prevent access to the children) kitchen, family room, bedroom #1 (hallway), garage, in-ground pool.

Areas on limits for the children include living room (children’s play space), dining room, bedroom#2 (Infant napping), bathroom #1(hallway on the right).

LPA Garcia inspected the facility for safety, comfort, cleanliness, ventilation and working phone (landline). For ventilation, LPA Garcia observed central AC and the vents located on the ceiling. LPA observed the furniture, children’s materials, to be in good condition and age appropriate. LPA observed cots for nap time and for pre-school aged children takes place in the Living room, where main day child care takes place. The infants nap in the bedroom #2.

LPA Garcia observed cleaning compounds items stored under the bathroom cabinet sink. Knives are stored in a high kitchen cabinet that is out of reach to the children. The kitchen is off limits and is barricaded with a wooden gate to prevent access to the children. For water drinking, licensee stated they provide filtered water and use individually labeled cups and disposable cups and licensee currently does participate in a food program (CDA).

LPA Garcia entered the bathroom accessible to the children and observed the toilet, hand washing sink, hand soap and cleaning materials were observed to be inaccessible to children in care.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Evelyn Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/04/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 04/04/2024 04:24 PM - It Cannot Be Edited


Created By: Evelyn Garcia On 04/04/2024 at 03:17 PM
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: MORAN FAMILY CHILD CARE
FACILITY NUMBER: 198013675

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/04/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(5)(A)
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: (5) All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence. (A)Fences shall be at least five feet high and shall be constructed so that the fence does not obscure the pool from view. The bottom and sides of the fence shall comply with Division 1, Appendix Chapter 4 of the 1994 Uniform Building Code. In addition to meeting all of the aforementioned requirements for fences, gates shall swing away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate. Pool covers shall be strong enough to completely support the weight of an adult and shall be placed on the pool and locked while the pool is not in use.

This requirement is not met as evidenced by:
Deficient Practice Statement
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 The LPA inspected the swimming pool fence and observed the gate not self-closing and self-latching. This is a Type A violation and it poses an immediate risk to the health and safety of children in care. An immediate civil penalty of $500 is assessed.
POC Due Date: 04/05/2024
Plan of Correction
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The Licensee shall ensure the swimming pool gate self-closes and self-latches to render it inaccessible to children in care. The license stated that she will repair the swimming pool gate to ensure the gate self-closes and self-latches no later than 04/05/24 and will ensure children do not have access to the backyard.

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:Evelyn Garcia
LICENSING EVALUATOR SIGNATURE:
DATE: 04/04/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/04/2024


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Document Has Been Signed on 04/04/2024 04:24 PM - It Cannot Be Edited


Created By: Evelyn Garcia On 04/04/2024 at 03:17 PM
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: MORAN FAMILY CHILD CARE
FACILITY NUMBER: 198013675

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/04/2024

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
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Based on observation, interview, record review,, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care. Licensee stated that attempts had been made to conduct the appointment however has been unsuccessful.
POC Due Date: 04/18/2024
Plan of Correction
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Licensee will provide a copy of vaccination records as soon as they are given from the clinic.
Type B
Section Cited
CCR
102425(c)(2)
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. The Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be maintained in the infant’s file and shall be available to the Department for review.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care. Per licensee she was unaware that the log was to be completed for children under 12 months of age, although she had been informed by previous LPA and was documented.
POC Due Date: 04/18/2024
Plan of Correction
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Licensee will have the sleep plan filled completely and begin implemation immediately.
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:Evelyn Garcia
LICENSING EVALUATOR SIGNATURE:
DATE: 04/04/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/04/2024


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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: MORAN FAMILY CHILD CARE
FACILITY NUMBER: 198013675
VISIT DATE: 04/04/2024
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 LPA observed personal hygiene items that are considered hazardous to the children in the shower and a mirror cabinet which was not secured with a safety latch. LPA informed licensee that those items cannot be accessible to children during hours of operation. Licensee removed the items and relocated them to the cabinet that did have a safety lock. LPA observed the restroom to be in operable condition.

LPA Garcia observed a small dog on premises who remains isolated from the children in care and asked the licensee if there were any poisons, firearms, weapons. The licensee stated there are no poisons, no firearms, and no weapons. LPA did not observe poisons, firearms, or weapons. The license was informed that if any poisons (ex; Drano, rat poison or items that fall into that category), firearms and weapons are purchased, it is required to be locked with a key or combination lock and firearm and ammunition must be stored separately.



LPA Garcia inspected the backyard and observed the in ground swimming pool enclosed by a 5-foot-high black metal fence. The pool is enclosed on two sides by the metal gate, and the other two sides are made up of the property wall that is half concrete brick and half wooden panels that are above 5’0. During the inspection, LPA tested the gate and observed that it opened away from the body of water. However, the gate did not automatically self-close and self-latch as required by the California Title 22 Regulations. LPA informed licensee of the pool gate not functioning correctly also informed the licensee that the pool gate will have to be repaired immediately.

LPA Garcia observed the required 2A10BC fire extinguisher located in the daycare living room with the valve on the green area indicating fully charged and serviced on 7/24/23. LPA observed carbon monoxide detector near the double door that give access to outdoor and smoke alarm located near the entrance of the home. The licensee tested the carbon monoxide and smoke alarm. LPA Garcia heard the sounds and are operable. LPA observed the first aid complete. For ill isolation, licensee stated the Living room is used for ill isolation until parents pick up the child.

LPA Garcia inspected the play outdoor area which includes the back yard that is utilized by children for safety, comfort, and cleanliness. LPA observed the play equipment to be age appropriate and in a safe condition, free of sharp, no lose or pointed parts. The surface of the outdoor activity space (concrete) is maintained in a safe condition and is free of hazards. For outdoor water drinking, licensees bring out individual water cups or disposable and refill as needed.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Evelyn Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024
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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: MORAN FAMILY CHILD CARE
FACILITY NUMBER: 198013675
VISIT DATE: 04/04/2024
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LPA Garcia observed licensee Pediatric First Aid/ CPR certification dated 2/3/24. Health and Safety certification dated 5/13/27, Child Abuse Mandated Reporter (AB 1207) 5/2/23 and 5/3/23. Proof of immunization against Pertussis, Measles, TB, and Influenza and influenza declination were not provided for staff#1. Licensee was advised that the mandated reporter training must be completed every 2 years, and is available at www.mandatedreporterca.com

LPA observed the following required postings: LIC 610A Emergency Disaster Plan, Pub 394 Notification of Parents Rights, Emergency Disaster Plan, and Facility Sketch.

The following was also discussed with the licensee:


1. 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, immunization's (MMR, TDAP, TB and Influenza or Influenza declination), AB 1207 Child Abuse Mandated Reporter Certificate.

2. 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.

4. 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.

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

6. Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.



7. Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing (refer to LIC 624B). Mandated reporter requirements were reviewed and explained.

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

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Evelyn Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024
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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: MORAN FAMILY CHILD CARE
FACILITY NUMBER: 198013675
VISIT DATE: 04/04/2024
NARRATIVE
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9. Smoking is prohibited in the family childcare home.

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. The licensee and all adults working with children have proof of immunizations.

12. Inspection Authority: All adults living and working in the home shall be made of aware of the Department’s right to inspection 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).

15. Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information.

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

14. No baby bouncers, no infant walkers, no Johnny jumpers, no saucer chairs, and any other item that falls into this category is not permitted in the facility.



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 email inquiries 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/inspection-process.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Evelyn Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024
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: MORAN FAMILY CHILD CARE
FACILITY NUMBER: 198013675
VISIT DATE: 04/04/2024
NARRATIVE
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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 PIN 22-02CCP. 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: https://www.ada.gov/resources/child-care-centers/.

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

During the exit interview, the Licensee, Martha Moran confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

One Type A deficiency will be sited today for regulation section 102417 (g)(5)(A) in which Fences shall be at least five feet high and shall be constructed so that the fence does not obscure the pool from view. The bottom and sides of the fence shall comply with Division 1, Appendix Chapter 4 of the 1994 Uniform Building Code. In addition to meeting all of the aforementioned requirements for fences, gates shall swing away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate. Pool covers shall be strong enough to completely support the weight of an adult and shall be placed on the pool and locked while the pool is not in use.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Evelyn Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024
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: MORAN FAMILY CHILD CARE
FACILITY NUMBER: 198013675
VISIT DATE: 04/04/2024
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Two Type B deficiencies are being issued today for regulation section 102425(c)(2) for Safe Sleep Plan in addition to Section 1597.622(a)(1) for Vaccines.

Upon receipt of the Type A Violation, the licensee shall post the report for 30 days in addition to the Notice of Site Visit & provide copies of the licensing report to parents/guardians of children in care at the facility by the close of business the following day or the next day child returns to the facility. The same report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months & licensee will obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from the parent/guardian and place it in each child's file.


Please see attached LIC 809-D’s for citation and civil penalties assessed.

An exit interview was conducted, and a signed copy of this report was provided to the licensee.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Evelyn Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024
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