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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700054
Report Date: 09/29/2023
Date Signed: 09/29/2023 02:01:18 PM

Document Has Been Signed on 09/29/2023 02:01 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:REYES FAMILY CHILD CAREFACILITY NUMBER:
367700054
ADMINISTRATOR:REYES, RASHONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 559-1592
CITY:APPLE VALLEYSTATE: CAZIP CODE:
92307
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
09/29/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:19 PM
MET WITH:Rashon Reyes, Licensee TIME COMPLETED:
02:10 PM
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On 09/29/2023, Licensing Program Analyst (LPA) Justeene Tamayo conducted a Case Management inspection at the above facility. LPA met with licensee Rashon Reyes. Upon initial walk through, LPA observed 4 infants and 7 preschool children in care, along with staff #1 and staff #2. LPA observed staff #1 and staff #2 assisting with day care children without a complete fingerprint clearance and is in process status. Licensee is aware that all adults 18 and over must be fingerprint cleared and associated before assisting with children.

The Facility has been cited a Type A deficiency according to the California Code of Regulations of Title 22 . Please see Facility Evaluation Report 809-D for deficiencies.

Upon receipt of a Type A deficiency licensee shall post the report for 30 days in addition to the Notice of Site Visit and provide copies of the licensing report to parents/guardians of children in care at the facility. This report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months and licensee will obtain a signed acknowledgment of Licensing Reports (LIC9224) from parent/guardian and place it in each child's file. If these requirements are not met, civil penalties will be assessed.

An exit interview was conducted with licensee, a copy of this report was read, discussed and provided to the licensee, along with her appeal rights and notice of site visit.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2023
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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Document Has Been Signed on 09/29/2023 02:01 PM - It Cannot Be Edited


Created By: Justeene Tamayo On 09/29/2023 at 12:26 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: REYES FAMILY CHILD CARE
FACILITY NUMBER: 367700054

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/29/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type A
09/29/2023
Section Cited
CCR
102370(d)(1)

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Criminal Record Clearance 102370(d)(1): All individuals subject to a criminal record review pursuant to Health and Safety Code...shall prior to working, residing, or volunteering in a licensed facility: Obtain a California clearance or a criminal record exemption as required..
This requirement is not met as evidence by:
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Licensee is aware all adults must have a fingerprint clearance before working or assisting with day care children. Licensee will have staff #1 and staff #2 re-fingerprinted and cleared before staff #1 and staff #2 assists with day care children.
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Based on initial walk through, LPA Tamayo observed staff #1 and staff #2 assisting with day care children without a fingerprint clearance and is in process status, which poses an immediate health and safety risk to children in care.
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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:Mariela Ramon
LICENSING EVALUATOR NAME:Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:
DATE: 09/29/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/29/2023


LIC809 (FAS) - (06/04)
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