367700229-12-8-2022-12-CC-DMAX-CLWS7Q-20221208123756

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 367700229
Report Date: 12/08/2022
Date Signed: 12/08/2022 12:38:13 PM

Document Has Been Signed on 12/08/2022 12:38 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:	CENDEJAS FAMILY CHILD CARE		FACILITY NUMBER:	367700229
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 3	DATE:	12/08/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Krystal Cendejas		TIME COMPLETED:	12:52 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

Licensing Program Analyst (LPA) Maddox met with Licensee, Krystal Cendejas for the purpose of conducting an unannounced inspection. Present today was licensee, her spouse, and 3 day care children. This is a two-story home with 3 bedrooms, 3 bathrooms, kitchen, dining area, living room, family room, garage and laundry room. The main area of care is conducted in the living room, children use 1 bathroom located downstairs, and the front yard (licensee states she takes children for daily walks).

Physical Plant: Home is clean and orderly, there is a fireplace in the family room (off limits to children under 5), the fire place is inaccessible via glass door(with key per applicant the key will always be removed during operation), LPA observed a working smoke detector and carbon monoxide detectors , fully charged 2A10BC Fire Extinguisher. Per licensee no one smokes in the home. There is a designated area for ill child(ren) as necessary, no weapon/firearms in the home, off limit areas include all the upstairs three bedrooms, garage, laundry room, and Pool area. There is a working telephone (cell phone),

Kitchen/bathroom: The following are inaccessible: Sharp items (above kitchen counter in a cabinet), medications in the off-limits area upstairs, chemicals poisons and cleaning items above the kitchen cabinet. Toilets and faucets are clean and operable.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2022

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 8

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: CENDEJAS FAMILY CHILD CARE	FACILITY NUMBER: 367700229
	VISIT DATE: 12/08/2022

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
26
27
28
29
30
31
32

Outdoor: The off-limits areas of the backyard includes the pool area which is surrounded with mesh fencing and the entrance gate opens away from the pool with a self latching device in place.

There is a fully stocked First Aid kit readily available. CPR/First Aid expire 06/12/2023. The electrical outlets are covered, children will nap in the play area and living room.

Pets: Per licensee there are no pets in the home. LPA did not observe any pets during this Annual inspection.

LPA reminded Licensee all adults living/residing in the home are fingerprint cleared and associated.

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: Mandatory licensing forms for the children’s files (LPA distributed form LIC 311D), facility forms/records, and information to be posted in the family child care home; Requirements to conduct fire and disaster drills once every six months and record it (form printed out during this inspection);

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2022

LIC809 (FAS) - (06/04)

Page: 2 of 8

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: CENDEJAS FAMILY CHILD CARE	FACILITY NUMBER: 367700229
	VISIT DATE: 12/08/2022

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
26
27
28
29
30
31
32

Role and responsibilities of being a mandated reporter were reviewed (mandated reporter must be renewed every 2 years.; Licensee reminded that 100% supervision is required at all times to children in care.

Licensee states she does not care for Infants.

Licensee made aware that it is her/their responsibility to know the regulations as well as anyone who assists in providing care; CCL must have the facility’s current phone number at all times; Regulation prohibits the smoking of any kind during the operation of the day care.

Licensee advised of the requirement to report Unusual Incidents. A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. The Licensee was informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department.

Licensee emailed LPA a copy of her current roster during this inspection.

Exit interview conducted and a copy of this report was given to Licensee KRYSTAL CENDEJAS.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Donna Maddox
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2022

LIC809 (FAS) - (06/04)

Page: 3 of 8