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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364817877
Report Date: 09/19/2023
Date Signed: 09/19/2023 12:49:37 PM

Document Has Been Signed on 09/19/2023 12:49 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:ROSALES FAMILY CHILD CAREFACILITY NUMBER:
364817877
ADMINISTRATOR:SAUL & LETICIA ROSALESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 265-5708
CITY:APPLE VALLEYSTATE: CAZIP CODE:
92307
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
09/19/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Leticia Rosales,Licensee TIME COMPLETED:
01:10 PM
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On 09/13/2023, Licensing Program Analyst (LPA) Justeene Tamayo met with Licensee, Leticia Rosales who guided analyst on a tour of the facility for the One Year Required inspection. This is a two story, 4 bedroom, 2 bathroom home with kitchen/dining room/dining pool Table room, living room, family/day care room, laundry room and attached garage There is an in ground swimming pool on the premises. Upon arrival LPA observed no day care children at the time of inspection, however one file was reviewed. Family members residing in the home include 6 adults (licensee, licensee's husband and 4 adult children) and no minor children. Facility operation are Monday-Friday 11AM-6PM for less than 24 hours a day. Incidental Medical Services (IMS) policy was discussed.

Physical Plant: Main care is provided in the family room area. Children use the bathroom in hallway on the right near the family room. Children have access to the family/day care room, bathroom #1, dining room, pool room, and backyard. Off limit areas include the living room, all bedrooms (key locked), bathroom #2, laundry room(key locked), and garage. The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (laundry room with key lock), medicines (upper kitchen pantry and laundry room) and hazardous items (sharp knives in upper kitchen cabinet) that can pose a danger to children. Fireplace is screened. Safe and age appropriate toys, play equipment and materials were observed. The smoke detector and carbon monoxide detector, Fire Extinguisher (2A10BC) are in operable condition. Per Licensee no one smokes in the home. Electrical outlets are inaccessible, no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/ play equipment were observed on the premises. There is a designated area for ill children as necessary near kitchen area or backyard. Per Licensee there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (cell).
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/13/2023
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: ROSALES FAMILY CHILD CARE
FACILITY NUMBER: 364817877
VISIT DATE: 09/19/2023
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Fire/earthquake drills complete and maintained current. Last fire/earthquake drill was completed on 08/13/2023. Roster complete and maintained current. There are age appropriate napping cot equipment. Children nap on cots in family room area.

Bathroom: Shower/tub are free of hazards (child care bathroom). LPA did not observe any hazardous items in the children's bathroom. Toilet and faucet are clean and operable.

Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. If food is brought from the children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. The home has a clean and fully stocked refrigerator/freezer. Breakfast, lunch, snacks, and dinner are provided. Licensee currently does not have a food program.

Outdoor: LPA observed an in ground swimming pool barricaded by a mesh fence. The mesh fence opens away from the swimming pool and has a key lock for inaccessibility and measures at 5 ft high. LPA observed an area for the day care children where their is turf for outdoor play. LPA observed 6 dogs on the premises and two sheep, and 1 cat.

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expires 04/20/2024. Mandated Reporter training expires 12/19/2024 . There are no window cords accessible to children.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: ROSALES FAMILY CHILD CARE
FACILITY NUMBER: 364817877
VISIT DATE: 09/19/2023
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Documents Provided and or Discussed: Fire Drill Log, Roster, Postings, Safe Sleep Log, Safe Sleep PIN 20-24-CCP, and Individual Sleeping Plan (LIC9227). Licensee stated currently does not have child care insurance.

Licensee Rosales 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.

LPA discussed the safe sleep regulations with licensee Rosales and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/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.

No deficiencies have been cited at this time.

A notice of site visit was given to licensee and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100

Exit interview conducted and report was reviewed with the licensee Leticia Rosales, along with her appeal rights and Notice of Site Visit.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
LIC809 (FAS) - (06/04)
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