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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364844539
Report Date: 09/13/2022
Date Signed: 09/13/2022 03:57:18 PM

Document Has Been Signed on 09/13/2022 03:57 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:
364844539
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 9DATE:
09/13/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Licensee, Deborah Garcia TIME COMPLETED:
04:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Zirbes met with Licensee, Deborah Garcia who guided analyst on a tour of the facility. The purpose of the unannounced inspection was to conduct the One Year Required inspection and a case management inspection to assess the home for a capacity increase. The licensee is requesting to provide care for a Large family childcare home (FCCH) for the capacity of 14 children. Fire clearance was granted on 9/9/2022. During the inspection, nine children (three infants, and six additional children ages 2-4) were present, due to an emergency. The Licensee was providing supervision at the time of the inspection. Based on LPAs observation, record review and interview with the Licensee the FCCH is being provided with a technical violation reminding the FCCH that the home must meet the capacity and ratio regulations. During the inspection LPA reviewed the capacity and ratio regulations for a Small FCCH and Large FCCH. LPA advised the Licensee to submit an unusual incident report regarding the emergency. Per licensee, currently residing in the home is licensee, four adults, and four minor children (17, 10, 7, 2)
The home is described as follows:
This is single story home with five bedrooms, three bathrooms, kitchen, living room, laundry room, front/backyard with a pool and detached garage. Per Licensee the kitchen, one bathroom (located down the hallway), living room, and backyard are utilized for the family child care activities. The off-limits areas consists of: all five bedrooms, two bathrooms, laundry room, detached garage. The off limits areas were inaccessible via doors and child safety door knobs covers. The home has a fire place in the living room. The fireplace had a mesh screen at the time of this inspection. LPA advised the Licensee that the fireplace screen had to be a secured barrier which prevented the children from having access to the fireplace. The home has central heating and air conditioning.
Indoor:
Living room: This area was furnished with a couch, fireplace, TV, child size table and chairs, dramatic play toys, books, and various materials for play. The children eat at the table in the room and sleep in this area. Report continued on page two
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 09/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/13/2022
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 09/13/2022 03:57 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 09/13/2022 at 02:14 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: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 364844539

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/13/2022

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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Based on LPAs observation, the licensee did not comply with the section cited above when the gate leading to the in gourd pool did not self latch. In addition two of the poles were not secured into the concrete. This poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 09/14/2022
Plan of Correction
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Per Licensee, the pool repair person will be at the home on 9/14/2022 to install a new latch and new poles. The children will not play in the outdoor area until the pool meets the requirements. The Licensee will continued to monitor the pool fence to ensure compliance.

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:Carissa Bell
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 09/13/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/13/2022


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Document Has Been Signed on 09/13/2022 03:57 PM - It Cannot Be Edited


Created By: Kendal Zirbes On 09/13/2022 at 02:14 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: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 364844539

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/13/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in the Licensee CPR.First aid was completed online. Online courses do not meet Health and Safety Code Section 1596.866. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/13/2022
Plan of Correction
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Per Licensee, she will sign up for a CPR/First aid course that meets the requirements.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Carissa Bell
LICENSING EVALUATOR NAME:Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:
DATE: 09/13/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/13/2022


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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: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 364844539
VISIT DATE: 09/13/2022
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Report continued from page one

Kitchen/ Dining area: All sharp utensils, knives, medications, were in high inaccessible cabinets equipped with child safety latches. The refrigerator, dishwasher, stove, microwave, etc., are clean. The kitchen was clean, orderly, and free of hazardous items. The Licensee prepares meals and snacks for the children in care. A table and four chairs were present.
Bathroom: (located down hallway): Bathroom, had a shower, bathtub, wto sinks and toilet. The area was clean and sanitary. All cleaning products and personal hygiene materials were stored in cabinets equipped with child safety latches.

Outside: The backyard is divided into off limit and on limit areas. The on limit area is enclosed by a fence that is at least 4 feet in height. The on limit area has a large grass area. One empty shed was in on limit play area. LPA advised the Licensee that children must be constantly supervised when transitioning between the on limit outdoor space and the off limit areas. There is a in ground pool in the back yard. The pool is surrounded by a 5’ removable mesh fence that is mounted into concrete. The gate opens away from the pool. There are no items around the perimeter of the fence that would allow the fence to be climbable. The licensee/applicant understands and agrees that the fence will remain in place whenever licensed care is provided. During the inspection, LPA opened the gate in order to verify the gate is self closing and self latching. When the gate leading to the in ground pool was opened and allowed to freely close, the gate did not self latch after opening. In addition, two of the poles holding the mesh fence were not secured into the cement. Based on LPAs observation the pool does not meet regulation 102417(g)(5)(A) Physical Plant. A Type A citation was issued as this posses an immediate risk to the children in care. An immediate civil penalty was issued.
Napping equipment: LPA observed the children sleeping on cots in the living room. In addition, per Licensee the home has two pack-n-plays. Licensee stated they are willing to purchase additional napping equipment if necessary to met the needs of the children in care.
Electrical outlets: All unused electrical outlets are plugged in and made inaccessible to children.
Weapons or Firearms: Per Licensee, there are no firearms in the home.


Report continued on page three
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022
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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: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 364844539
VISIT DATE: 09/13/2022
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Report continue from page two
Cleaning compounds: Stored in the off limits laundry room under the kitchen sink and in the bathroom. The cabinet containing the cleaning compounds had child safety latches. LPA reminded the Licensee that the child care license allows the provider to care for children up to the age of 12. Therefore, the licensee had to ensure all cleaning products were inaccessible to children of all ages.
The smoke detector and a carbon monoxide detector: located throughout the home. The home has a pull down fire alarm in the living room. Items were operable.
Fire extinguisher (2A10BC) There was a fully charged fire extinguisher (2A10BC); which meets fire marshal standards.
Pet: The family has one dog who is current on shots. Per Licensee, the dog does not interact with the child care children.
Off limit areas:
Laundry room (Off limits): located off of the kitchen. The laundry was made inaccessible to the children in care via a door.
Bedroom #1 (Master Bedroom and Bathroom) (Off limits): The bedroom was furnished with bed, and personal belongings. The door leading to the master bedroom and bathroom was inaccessible.
Bedroom #2: (Off limits): The bedroom was furnished with two beds, and personal belongings. The door leading to the bedroom was locked equipped with a child safety knob.
Bedroom #3: (Off limits): The bedroom was furnished with bed, and personal belongings. The door leading to the bedroom was a child safety knob.
Bedroom #4: (Off limits): The bedroom was furnished with bed, and personal belongings. The door leading to the bedroom was a child safety knob.
Bedroom #5: (Off limits): The bedroom was furnished with bed, and personal belongings. The door leading to the bedroom was a child safety knob.
Bathroom #2: (off limits): located off the kitchen. Furnished with a toilet and shower. A door prevented the children from entering this area.
LPA reminded the Licensee that all off limits areas must remain inaccessible during operating hours.
LPA reviewed the Licensee and household members file and seven child files. Per LPAs review the Licensees CPR/First Aid was completed as an online course. Online course do not meet Health and Safety Code Section 1596.866. Based on LPAs record review, a type B citation was issued for regulation 102416(c) as this poses a potential risk to the children in care. Report continued on page four
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022
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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: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 364844539
VISIT DATE: 09/13/2022
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Report continued from page three
The following was discussed with the licensee:
Licensee reminded that 100% supervision is required at all times to children in care. Licensee was made aware that it is he/her responsibility to know the regulations as well as anyone who assists in providing care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified
The regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare home and in those areas of the family day care home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exersaucers, and any other items that fall into that category.

On January 1, 2018, or before March 30, 2018, a person who is a licensed childcare provider, administrator, or employee of a licensed child day care facility shall complete the online mandated reporter training and shall complete renewal mandated reporter training every two years. @www.mandatereporterca.com

**Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements
Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed childcare facility are aware of situations that present the greatest danger to children.

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 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.

SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022
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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: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 364844539
VISIT DATE: 09/13/2022
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Report continued from page three

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm



LPA and Licensee discussed the large family home capacity regulations. LPA also discussed the personal requirements for the new staff person.

There were citations issued today regarding physical plant and records. Refer to LIC 809D for further information. LPA Zirbes informed licensee Deborah Garcia that this report dated September 13, 2022, documents one Type A citation, which shall be posted for 30 consecutive days as there are immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPA Zirbes informed the facility representative Deborah Garcia to provide a copy of this licensing report dated September 13, 2022 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Capacity increase is pending corrections of the cited deficiencies and final approval from Licensing Program Manager.

Exit interview conducted and report was reviewed with the licensee Deborah Garcia.

SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022
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