364844539-9-7-2023-12-CC-KZIS-CVFTWG-20230907150530

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364844539
Report Date: 09/07/2023
Date Signed: 09/07/2023 03:05:44 PM

Document Has Been Signed on 09/07/2023 03:05 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:	GARCIA FAMILY CHILD CARE		FACILITY NUMBER:	364844539
ADMINISTRATOR:	GARCIA, DEBORAH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(909) 965-9534
CITY:	SAN BERNARDINO	STATE: CA	ZIP CODE:	92404
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 3	DATE:	09/07/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Licensee Deborah Garcia and Facility Representative Maria Tafolla		TIME COMPLETED:	03:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On September 7, 2023, at 01:00 p.m., Licensing Program Analyst (LPA) Kendal Zirbes met with Licensee Deborah Garcia and Facility Representative Maria Tafolla. The purpose of the inspection was to conduct a required one year inspection at the licensed facility. LPA disclosed the purpose of the inspection to the Licensee. When LPA arrived to the facility, the Licensee and facility representative were providing supervision to three children. Currently living in the home are four adults and three minor children (11, 6, 5) All adults are associated and have eligible clearances. Current days and hours of operation are Monday through Friday 6:00am - 6:00 pm. Physical Plant: 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. The home has central heating and air conditioning. 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. According to Licensee all cleaning products are stored the cabinet under the kitchen sink. The cabinet was equipped with a child safety locks. Sharp knives were stored in a high kitchen cabinet that was inaccessible. Household medications are in a kitchen cabinet equipped with a child safety lock. Per recorded documentation Fire/earthquake drills were last completed in August 2023. The fire extinguisher was services in September 2022. Safe and age appropriate toys, play equipment and materials were present. Smoke detector and carbon monoxide detector were observed in the facility. 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. The living room is the designated area for ill children in the child care. Report continued on page two

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: GARCIA FAMILY CHILD CARE	FACILITY NUMBER: 364844539
	VISIT DATE: 09/07/2023

NARRATIVE

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Report continued from page one
Bathroom (located down the hallway): Toilet, sink, faucet, shower were clean and operable. The following were inaccessible: Sharp items, mouthwash, shampoo, razor, nail polish.

Outdoor: 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. The pool is surrounded by a 5’ removable mesh fence that is mounted into concrete. The gate opens away from the pool and is equipped with a self-closing, self-latching mechanism on top of the gate. 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.

Per Licensee, there is one dog on the home who does or does not interact with the child care children.

Review of records to be maintained: LPA reviewed with facility representative the LIC 311D, Fire Drill Log, Roster, Postings, Safe Sleep.

File Review: LPA reviewed four child files. Based on LPAs review child files maintained all required information. During the inspection, LPA observed the facility representative completing the 15 minute safe sleep checks. LPA asked to review previous days documenting the safe sleep checks. Per conversation with the facility representative, safe sleep checks are being documented each day. Facility representative stated the documentation is thrown away each day. LPA advised the Facility that documentation of the 15 minute checks had to be retained for three years. A copy of the Safe Sleep FAQ's were emailed to the facility. An advisory notice was issued.
Staff files were complete and contained all required information.

Report continued on page three

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: GARCIA FAMILY CHILD CARE	FACILITY NUMBER: 364844539
	VISIT DATE: 09/07/2023

NARRATIVE

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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

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

Licensee 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 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.

Report continued on page four

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: GARCIA FAMILY CHILD CARE	FACILITY NUMBER: 364844539
	VISIT DATE: 09/07/2023

NARRATIVE

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To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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 record review and observations there was one technical advisory notice issued today.

A notice of site visit was given 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 facility representative Maria Tafolla.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

LIC809 (FAS) - (06/04)

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