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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700093
Report Date: 07/16/2024
Date Signed: 07/16/2024 03:15:15 PM

Document Has Been Signed on 07/16/2024 03:15 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:BARRAZA FAMILY CHILD CAREFACILITY NUMBER:
367700093
ADMINISTRATOR/
DIRECTOR:		BARRAZA, KARINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 810-9360
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 9DATE:
07/16/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Licensee Karina Barraza TIME VISIT/
INSPECTION COMPLETED:
03:35 PM
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On July 16, 2024, at 11:30 a.m., Licensing Program Analyst (LPA) Zirbes met with Licensee Karina Barraza who guided analyst on a tour of the home for the Annual/Random inspection. Upon arrival, LPA observed nine children in care with the Licensee and staff 1 (S1) providing supervision. Based on LPA observation, the child care was meeting the staffing/ratio requirements at the time of this inspection. According to the Licensee currently living in the home are the Licensee, Adult 1, and three minor children (5, 2 and 8 weeks). All adults are associated and have eligible clearances. Current hours of operation are Monday to Saturday 3am - 2am.
Physical Plant: This is a single story house with three bedrooms, two bathrooms, kitchen, living room, dining room, attached garage, front yard and backyard. Per Licensee the on limit areas are the living room, dining room, kitchen, bathroom 2 (located in hallway), bedroom 2 and the backyard. The off-limit areas of the home are bedroom 1, bedroom 3, bathroom 1 (located in bedroom 1), and the garage. The off limit areas of the home were inaccessible via child safety door knob covers and locked doors.
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. During the inspection, LPA did not observe cleaning products or medications in the on limit areas. Per Licensee, cleaning products and medications are stored in the off limit garage and bedroom 1. Per Licensee, zero medications are currently being provided to the child care children. Knives and sharp items were stored in a locked container under the kitchen sink, therefore the sharp items were inaccessible to the children in care. LPA observed a smoke detector in the dining room and the hallway of the home. A carbon monoxide detector was also located in the hallway of the home. The detectors were tested and found to be in working order at the time of this inspection. The home has a fireplace in the living room. The fireplace was inaccessible via a fire place screen which was secured to the wall. LPA did not observe baby bouncers/saucer chairs, or any recalled and or prohibited toys on the premises. Per Licensee, there are zero firearms or weapons stored in the home.
Report continued on page two
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE: DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/16/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 9
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: 07/16/2024
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Report continued from page one

According to the documentation the fire extinguisher was serviced in August 2023. Therefore the fire extinguisher meets the state fire marshal standards.

At the time of this inspection, the exit doors of the Large Family child care were not single action. LPA advised the Licensee of the requirement and requested the Licensee comply with the regulation within 30 days.
Bathroom: (located in the hallway of the home). Toilet, sink, shower/tub were clean and operable. At the time of this inspection LPA did not observe cleaning products or personal hygiene materials in accessible areas to the children.
Outdoor: The backyard consist of a covered patio, grass area, and a climbing structure placed on wood chips and was secured to the ground. The outdoor play space was enclosed. There were two locked sheds in the backyard. The climbing structure was secured to the ground and was placed on wood chips.

Per Licensee, the home has two chickens in a cage in the backyard. There are no other pets on the property according to the Licensee.

LPA reviewed five child files, the Licensees file and two assistants file. Based on LPA record review one of one infant file reviewed did not have documentation of the 15 minute safe sleep checks. Licensee reported the safe sleep checks were being documented however the documentation was thrown away at the end of each week. LPA advised the Licensee of the requirement to have documentation of the 15 minute checks available for the department to review and advised the Licensee of the requirement to keep records for three years after a child exits the program. A technical advisory notice was issued.
Per LPA review of the personnel records, one of three personnel files reviewed did not complete the renewal of the mandated reporter training every two years as required. In addition, one of three personnel files reviewed was missing documentation of the required immunizations (pertussis, measles and influenza). Furthermore, based on LPA review, three of three personnel records, had current pediatric cardiopulmonary resuscitation and pediatric first aid cards which did not have the documentation that the training program was provided by a approved Emergency Medical Services Authority pursuant to Section 1797.191 as required. Three technical advisory notices were issued. Report continued on page three
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2024
LIC809 (FAS) - (06/04)
Page: 5 of 9
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: 07/16/2024
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Report continued from page two

Review of records to be maintained: LPA reviewed with licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. The following was discussed with the licensee:


Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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-andresources/
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.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Report continued on page three
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Kendal Zirbes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2024
LIC809 (FAS) - (06/04)
Page: 6 of 9
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: 07/16/2024
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Report continued from page three

During the exit interview, the Licensee Karina Barraza, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

As a result of this inspection, five technical advisory notices were issued.

A notice of site visit was given and must remain posted for 30 days. 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: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2024
LIC809 (FAS) - (06/04)
Page: 7 of 9