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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364802946
Report Date: 12/02/2022
Date Signed: 12/02/2022 12:27:01 PM

Document Has Been Signed on 12/02/2022 12:27 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:ESPINOZA FAMILY DAY CAREFACILITY NUMBER:
364802946
ADMINISTRATOR:ESPINOZA, OTILIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 951-7313
CITY:VICTORVILLESTATE: CAZIP CODE:
92395
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
12/02/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Otilia Espinoza, LicenseeTIME COMPLETED:
01:00 PM
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On 12/2/2022 Licensing Program Analysts (LPAs) Beneroso and Villa, met with licensee, Otilia Espinoza who guided analyst on a tour of the facility for the One Year Required inspection. Upon arrival LPAs observed 0 children in care. Family members residing in the home include the licensee only. Facility hours of operation are Monday - Friday 6AM- 6 PM. Incidental Medical Services (IMS) policy was discussed.

Physical Plant: This is a one story three-bedroom and two-bathroom home. Main care is provided in the living room. The children use the bathroom located at the end of the hallway. The off-limits areas are bedrooms #2 and #3, second restroom, dining room, garage, and kitchen. The home was inspected inside and out for safety, comfort, cleanliness, orderliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds which are kept in the garage and under the kitchen sink with an operable safety latch, medicines are kept in licensee's bedroom and hazardous items (sharp knives are kept in the kitchen in a lower cabinet with an operable safety latch and are inaccessible to children). Children nap on mates in bedroom #1.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Annelise Villa
LICENSING EVALUATOR SIGNATURE: DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/02/2022
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: ESPINOZA FAMILY DAY CARE
FACILITY NUMBER: 364802946
VISIT DATE: 12/02/2022
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Safe and age appropriate toys, play equipment and materials were observed. The smoke detector, carbon monoxide detector and Fire Extinguisher (3A40BC) are all in operable condition. Electrical outlets are inaccessible. No recalled and or prohibited toys or sleep/ play equipment were observed on the premises. There is a designated area for ill children as necessary in the kitchen near pickup area. Per Licensee, there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (land line and cell).

Fire/Disaster drills are maintained current. Last fire disaster drill was completed on 6/28/2022.

Bathroom: LPAs observed toilet and faucet are clean and operable. There are no shampoos or cleaning products in bathroom #1.

Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. The home has a clean and fully stocked refrigerator/freezer. Cleaning supplies are in the garage which is locked during business hours. Breakfast, lunch, and snacks are provided. Licensee stated she currently is a participant in a food program.

Outdoor: The front yard and side yards are off limits. The backyard is completely fenced in with a chain wall. There is a gate separating the children’s play area from the off limits portion of the backyard. There is one dog in the premises. LPAs observed age appropriate toys, well secured and safe for children.

Pools/Spas/Bodies of Water: There are no bodies of water in the premises.

Advisory/Other: First Aid kit was observed in the living room with supplies readily available. CPR/First Aid expires 08/2024. Mandated Reporter expires on 08/10/2024. LPAs reminded licensee; mandated reporter and CPR/ First Aid training must be completed every 2 years.

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

DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022
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: ESPINOZA FAMILY DAY CARE
FACILITY NUMBER: 364802946
VISIT DATE: 12/02/2022
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Documents Provided and or Discussed: Fire Drill Log, Postings, Employee's and Children's records, Safe Sleep PIN 20-24-CCP and Individual Sleeping Plan (LIC9227). Licensee currently does not have child care insurance.

Licensee Espinoza 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.

LPAs discussed the safe sleep regulations with licensee Espinoza and discussed the Child Care Licensing Safe Sleep 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.

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: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022
LIC809 (FAS) - (06/04)
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