367700093-2-6-2023-12-CC-KZIS-CNSQ5Y-20230206105244

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 367700093
Report Date: 02/06/2023
Date Signed: 02/06/2023 10:52:56 AM

Document Has Been Signed on 02/06/2023 10:52 AM - 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:	BARRAZA FAMILY CHILD CARE		FACILITY NUMBER:	367700093
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 6	DATE:	02/06/2023
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Licensee, Karina Barraza		TIME COMPLETED:	11:05 AM

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 2/6/2023 Licensing Program Analyst (LPA) Zirbes, conducted a Case Management inspection with Licensee, Karina Barraza. The purpose of the case management inspection was to assess the home for a capacity increase and ensure the facility meets basic licensing requirements set forth by Title 22, Health and Safety and statutory requirement. 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 1/31/2023. During the inspection, six children were present (two infants and four preschool age children). The Licensee and adult 2 (A2) were providing supervision at the time of the inspection. Per licensee, currently residing in the home is licensee, Licensees spouse and two minor children ( 4,1). The home is described as follows: This is single story home with three bedrooms, two bathrooms, kitchen, dining room, living room, attached garage and front and back yards. Per License, the living room, dining room, bedroom 2, kitchen and the bathroom located in the hallway are utilized for child care activities and back yard. The off-limits areas include: Bedroom 1 (primary bedroom), primary bathroom, bedroom 3 and the garage. The off limits areas were inaccessible via child safety gates, key locked doors, and child safety covers on the door knobs. The home has a fire place in the living room. Currently the couch was placed in front of the fireplace therefore the fire place was inaccessible. The home has central heating and air conditioning. Indoor: (On limits) Living room: This area was furnished with two couches, fireplace, rocking chair, television and dramatic play corner, child size table and chairs and two high chairs. LPA observed a variety of toys for the child in care. Dining Room: Furnished with a table and six chairs. LPA observed a play yard and mats for sleeping as well. Per Licensee a portion of this room will be utilized for nap time. Report continued on page two

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2023

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: BARRAZA FAMILY CHILD CARE	FACILITY NUMBER: 367700093
	VISIT DATE: 02/06/2023

NARRATIVE

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Report continued from page one

Kitchen: All sharp utensils, knives, were inaccessible to the children in care. 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.

Bedroom 2: located off of the hallway. The bedroom was furnished with bed, crib and personal belongings. Per Licensee, this bedroom will be utilized during nap time.

Bathroom 2: Located off the hallway. The bathroom was equipped with a toilet, sink, bathtub, and shower. No hazards items were in the bathroom at the time of this inspection. The bathroom was clean and orderly.

Outside: The outdoor space consists a covered patio, grassy area and a large climbing structure placed on wood chips. The outdoor play space was enclosed. There was a locked shed in the backyard.

Napping equipment: LPA observed two play yards and five mats. LPA observed each of the children bedding was stored in individual plastic bags. Per Licensee, the children will nap in the dining room, bedroom 2 and living room. 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.

Cleaning compounds: Stored in the off limits garage. The items in the garage were inaccessible via a key lock.
The smoke detector and a carbon monoxide detector: located in the hallway of the home. The home has a pull down fire alarm in the entrance way.
Fire extinguisher (2A10BC) There was a fully charged fire extinguisher (2A10BC); which meets fire marshal standards.
Pet: The family has one dog and chickens in the backyard. Per Licensee, the dog does not interact with the child care children. Report continued on page three

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2023

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: BARRAZA FAMILY CHILD CARE	FACILITY NUMBER: 367700093
	VISIT DATE: 02/06/2023

NARRATIVE

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Off Limit areas:
Bedroom #1 (Master Bedroom and Bathroom) (Off limits): Located off of the hallway. The bedroom was furnished with bed, and personal belongings. The door leading to the master bedroom was equipped with a child safety lock.
Bedroom #3: (Off limits): located off of the hallway. The bedroom was furnished with bed, and personal belongings. The door knob leading to the bedroom was equipped with a child safety door knob cover.

Garage (Off limits): Located off the dining room. The garage held household items such as tools, chemicals, cleaning products and additional toys. The garage door was inaccessible via a key lock at the time of this inspection.

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 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. Report continued on page four

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: BARRAZA FAMILY CHILD CARE	FACILITY NUMBER: 367700093
	VISIT DATE: 02/06/2023

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Report continued from page three

LPA reviewed the Licensee file, A2 file and one child file. All required forms were within the files at the time of this inspection. Per LPAs review the Licensee CPR/First Aid expires 03.20.2023 and mandated reporter training expires on 9.1.23 .

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 no deficiencies cited today. As a result of this inspection, the home does meet Title 22 Regulations. Capacity increase is pending final approval from the Licensing Program Manager.

Exit interview conducted and report was reviewed with the licensee Karina Barraza.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2023

LIC809 (FAS) - (06/04)

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