Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197407897
Report Date: 02/12/2019
Date Signed: 02/12/2019 03:27:53 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME:RIVERA FAMILY CHILD CAREFACILITY NUMBER:
197407897
ADMINISTRATOR:EDITH RIVERAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 287-1691
CITY:NEWHALLSTATE: CAZIP CODE:
91321
CAPACITY:14CENSUS: 2DATE:
02/12/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Edith RiveraTIME COMPLETED:
03:40 PM
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On 2/12/2019 at 1:23 p.m., Licensing Program Analyst (LPA) Brianna Reynoso was greeted by above facility’s licensee, Edith Rivera. LPA was at the facility to conduct an unannounced random annual inspection. LPA disclosed the purpose of the visit and was granted entry to the facility by licensee, who guided LPA on a tour of the facility. Present during today's inspection was also Adult 1 and Staff 2.

Upon entering the facility, LPA observed two napping children in care. The facility's operating hours are Monday through Friday 7:00 a.m. to 6:00 p.m. Per the licensee, there are no pets in the facility and they do they transport children. Licensee provides breakfast, snack, and lunch for the children in care, and is not enrolled in any food program.

This is a single story, three bedroom, two bathroom home with an attached garage. Main care is provided in the living room, two of the three bedrooms, the indoor patio, and bathroom located to the left of the hallway. The backyard is used for outside play. The off limits areas include the master bedroom, master bathroom, and the attached garage.

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. There are age appropriate toys and equipment on the premises. Per the licensee there are no weapons or firearms of any kind in the facility at this time, nor did the LPA observe any weapons during the inspection. Licensee stores sharp knives and medication in a cabinet above the kitchen counter, which is inaccessible to children in care. The facility also has a fire place located inside of the living room, which was properly screened and inaccessible to children in care.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Brianna ReynosoTELEPHONE: (661) 568-8179
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2019
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
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: RIVERA FAMILY CHILD CARE
FACILITY NUMBER: 197407897
VISIT DATE: 02/12/2019
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The licensee was informed that all adults living in or having access to the home are required to have fingerprint clearances with Department of Justice, FBI and Child Abuse Index prior to having contact with children. If the aforementioned is not adhered to, a Civil Penalty of up to $500, per non-cleared adult will be assessed immediately. Please advise your analyst of any person who will be visiting regularly or for longer than one week.

Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com.



The licensee was reminded it is his/her responsibility to visit the departments website to obtain licensing forms, Quarterly Updates, and Provider Information Notices (PINs): www.ccld.ca.gov

Child Care Advocates:
To sign up for our Quarterly Updates please email the Child Care Advocates at
childcareadvocatesprogram@dss.ca.gov & (916) 654-1541.

The facility was in compliance per Title 22 regulations, and a no deficiencies were cited today.

An exit Interview was conducted, a copy of this report, and notice of site visit was provided to licensee, Edith Rivera.












SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Brianna ReynosoTELEPHONE: (661) 568-8179
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2019
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
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: RIVERA FAMILY CHILD CARE
FACILITY NUMBER: 197407897
VISIT DATE: 02/12/2019
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The outside backyard is used by the children for outside play. The backyard is gated all around. The outdoor play area was inspected and play equipment was observed to be free of hazards, loose and sharp parts. There are no bodies of water at the family day care home. LPA observed age appropriate toys inside and outside of the home.

The facility’s fire extinguisher (2A10BC) met the State Fire Marshal standards, and licensee provided LPA with a receipt that indicated it had been purchased within the last twelve months. LPA found that the dual smoke and carbon monoxide located in the hallway were in operable condition. The facility annual fees are current. The parent board was reviewed and had all of the required forms posted and accessible to parents.

At 2:30 p.m., LPA reviewed children and staff files and found them to be complete. The facility roster and emergency disaster drills were up to date, with the last disaster drill having been conducted on 2/8/2019. All individuals living the family child care home have been fingerprinted and associated to the facility. LPA verified proof of immunizations against measles, pertussis, and TB for both licensee and Staff 2. The licensee has a current CPR and Pediatric First Aid certification, which expires on 2/24/2020.



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 were discussed: There is an effective 24/7 ban on smoking tobacco in a home that is licensed as a family day care home, and in those areas of the family day care home where children are present. Baby walkers, baby jumpers, baby exersaucers, baby bouncers/rockers and any other item that falls into that category are not permitted in the facility. The LPA also discussed earthquake safety and necessity of drills, required forms for children’s files, facility files and posting requirements.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Brianna ReynosoTELEPHONE: (661) 568-8179
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2019
LIC809 (FAS) - (06/04)
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