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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364810655
Report Date: 08/13/2025
Date Signed: 08/13/2025 01:23:18 PM

Document Has Been Signed on 08/13/2025 01:23 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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:DE HARO FAMILY CHILD CAREFACILITY NUMBER:
364810655
ADMINISTRATOR/
DIRECTOR:		DE HARO, FLAVIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 886-0254
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 1DATE:
08/13/2025
TYPE OF VISIT:Annual/RandomANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:31 AM
MET WITH:Licensee Flavia De Haro TIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On August 13, 2025, at 10:31am, Licensing Program Analyst (LPA) Kendal Zirbes conducted an unannounced Annual/Random inspection and met with Licensee, Flavia De Haro. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. Zero children were present when LPA arrived to the family child care. One preschool child arrived to the home while LPA was present. Licensee accompanied LPA inside and out of the facility during this inspection. Currently living in the home is the Licensee. Current days and hours of operation are Monday to Thursday 24 hours a day and Friday 12am- - 7pm. LPA and Licensee discussed the requirement that the family child care may not provide care for more than 23 hours per child per day.
Physical Plant: Per Licensee, the living room, dining room, kitchen, bedroom 1 (down hallway and across from bathroom), bedroom 2 (to the right of the bathroom), bathroom 1 (located in the hallway) and the backyard are utilized for child care activities. Off limit areas include master bedroom, bedroom 4 (connected to bedroom 2), detached garage and detached storage area. The off limits areas were made inaccessible via locked doors. 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. Per LPAs observations and conversation with Licensee all cleaning products are stored the off limits areas of the home and in cabinets equipped with magnetic child safety locks. Sharp knives were stored in a cabinet equipped with a magnetic child safety lock. Kitchen items containing sharps edges were stored in drawers equipped with magnetic child safety locks. During the inspection of the home with the Licensee, LPA observed vitamins and medications stored in the door of the refrigerator. LPA advised the Licensee that all medicines and products labeled keep out of reach of children had to be inaccessible to the children in care. LPA advised the Licensee to obtain a locked container for the refrigerator if the medications were required to be stored in the refrigerator. Report continued on page two
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/13/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DE HARO FAMILY CHILD CARE
FACILITY NUMBER: 364810655
VISIT DATE: 08/13/2025
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Report continued from page one
All products were relocated to a kitchen cabinet equipped with a magnetic lock. Due to zero children being in care at the time of the tour, LPA issued an technical advisory notice Per recorded documentation Fire/earthquake drills were last completed in July 31, 2025. LPA observed a 3A10BC fire extinguisher located in the kitchen. Per documentation the fire extinguisher was serviced in 2025. Safe and age appropriate toys, play equipment and materials were present. The carbon monoxide detector was located in the kitchen. When the carbon monoxide detector was tested an audible beep was heard therefore the item was in working order at the time of this inspection. When LPA and Licensee completed the tour of the home. LPA heard the smoke detectors beeping in the two playrooms. LPA asked the Licensee how long the smoke detectors had been beeping, Licensee responded that she could not remember when the beeping started. Licensee tested the smoke detectors and an audible beep was heard. LPA advised the Licensee to change the batteries in the smoke detectors by 8/15/2025 and to notify LPA when the batteries had been changed, Licensee agreed.
Baby bouncers, saucer chairs, or any recalled and or prohibited toys or sleep/ play equipment were not observed on the premises. The living room is the designated area for ill children in the child care.
Per Licensee, there zero firearms stored in the home. The home does not have a fireplace or open face heaters. The home has central heating and window air conditioning units.
Bathroom: Toilet, sink, faucet, shower were clean and operable. The following were inaccessible: Sharp items, mouthwash, shampoo, razor, nail polish.
Outdoor: The backyard was completely fenced. LPAs observed one climbing structures in the backyard, dramatic play area and child size tables and chairs. The large climbing structure had two swings and a slide. Climbing equipment was secured to the ground and placed on recycled rubber. LPAs observed the detached garage and detached storage shed (identified as a rental property on facility sketch) in the backyard. Both areas were inaccessible via locked doors at the time of this inspection. Per Licensee no one resides in the rental property.

LPA observed three dogs in the backyard. According to the Licensee the dogs are current on shots and licensing. Per Licensee, the dogs do not interact with the childcare children.

LPA reviewed four child files, and the Licensees file. Per LPA review, all files were complete and contained the required documentation.



Report continued on page two
NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: DE HARO FAMILY CHILD CARE
FACILITY NUMBER: 364810655
VISIT DATE: 08/13/2025
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Report continued from page two

LPA discussed the safe sleep regulations with facility representative 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 facility representative 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 22-02-CCP. 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/.

Facility representative 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, Licensee Flavia De Haro confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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.

Based on LPAs observation there were two advisory notices issued today.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee Flavia De Haro

NAME OF LICENSING PROGRAM MANAGER: Lady King
NAME OF LICENSING PROGRAM ANALYST: Kendal Zirbes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025
LIC809 (FAS) - (06/04)
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