157700024-9-1-2023-12-CC-BBEO-CV9NS7-20230901104241

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 157700024
Report Date: 09/01/2023
Date Signed: 09/01/2023 10:43:14 AM

Document Has Been Signed on 09/01/2023 10:43 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:	CONTRERAS FAMILY CHILD CARE		FACILITY NUMBER:	157700024
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS:	DATE:	09/01/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Maria Contreras		TIME COMPLETED:	11:00 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 09/01/2023, Licensing Program Analyst (LPA) Beneroso conducted an unannounced Required 1-Year inspection at the Contreras Child Care Home. Upon arrival, the LPA met with licensee, Maria Contreras who guided LPA on a tour of the facility. Family members residing in the home include 2 adults (licensee and licensee’s spouse) and licensee’s 3 minor children. All adults living in the house have been background cleared. Per the Licensee, hours of operation are a day Monday through Saturday 4am to 4 pm. Per licensee, no overnight care is provided at the moment. Upon arrival, LPA observed 6 children in care and 1 adult providing care and supervision. Licensee is within the ratio for a large facility. Incidental Medical Services (IMS) were discussed. Physical Plant: This is a one-story, 4-bedrooms, 2-bathrooms home with a kitchen, living room, family room (playroom), dining area, backyard and garage. The home was inspected for safety, comfort, cleanliness, telephone service, central air, and heat and ventilation. The house has central heating and air conditioning. All windows are free of cracks, bugs, and debris. All electrical outlets are covered. Main Care Area: Main care is provided in the in the family room. Children use the bathroom located on the hallway on the right-hand side. LPA observed age-appropriate toys and furniture for the children. There are age-appropriate games and books on the premises of this facility. Per licensee, there is a designated area for ill/sick children in the living room area. Children nap in the day care room area in mats that are properly stored.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2023

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: CONTRERAS FAMILY CHILD CARE	FACILITY NUMBER: 157700024
	VISIT DATE: 09/01/2023

NARRATIVE

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Children's bathroom: Children use the bathroom located in the hallway on the left-hand side. The bathroom was clean, sanitized, and in good repair. The bathroom was toured and inspected sink and toilet which is in operable condition.

Kitchen/Dining Room: The kitchen is does not have a physical barrier. Sharp items are kept in an upper cabinet. Cleaning compounds are stored in the garage, locked and secured with a safety doorknob. Per licensee, she does currently have a food program. Meals offered: Breakfast, AM snack, Lunch, and PM Snack

Backyard/Outdoor areas: The backyard is completely fenced (cement blocks). The backyard has play equipment that is safe and in well repair. The backyard was found to be clean, free of debris or harmful materials. There are no pets in the home.

Off-limits: Off-limit areas include all the bedrooms of the home, bathroom #2 and garage. LPA observed all doors of off-limit bedrooms to have a safety doorknob.

Care and Supervision: Licensee is within the ratio for a small facility.

Fire/Health/Safety: There is a cell phone kept charged and on the Licensee at all times.
Smoke Detectors and Carbon Monoxide were observed to be in operable conditions.
The First Aid kit was observed to be complete with supplies including thermometer, tweezers, scissors, gauze, bandages, cleansing pad/solution, and a first aid manual. LPA observed a required fire extinguisher (2A10BC) reading in Green and currently serviced.

Medications/ Hazardous Materials: Medications are stored in the master bedroom, made off-limits and secured with a safety doorknob. Cleaning compounds were observed to be kept in the garage, locked and secured with safety doorknob. Per licensee, there are No Firearms at the facility at this time. The facility currently does not have childcare insurance.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2023

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: CONTRERAS FAMILY CHILD CARE	FACILITY NUMBER: 157700024
	VISIT DATE: 09/01/2023

NARRATIVE

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Incidental Medical Services (IMS): 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 Licensee will not be providing IMS to the children at this time.

Records: Children’s and infant’s records were observed to be complete and current.
Licensee’s CPR/First Aid is maintained current, it expires on 03/30/2025. Mandated reporter is maintained current, it expires 05/12/2024. Per Licensee, fire and disaster drills are conducted every 6 months; the last drill was documented and conducted on 04/11/2023. Per LPA’s observations, the Facility License, Emergency Disaster plan, Earthquake Preparedness and Parents Rights Poster were posted.

Documents Provided and or Discussed: Fire Drill Log, Roster, Postings, Safe Sleep PIN 20-24-CCP and LIC 9227 (Individual Sleeping Plan). The Licensee was reminded that supervision is always required for children in care.

Child Care Advocates: You can now sign up for Quarterly Updates and PINs for one or more programs through our DSS website at www.ccld.ca.gov Click on “Receive Important Updates” located in the right middle part of the page, immediately above the Quick links. Put your email address and choose which program(s) you would like to subscribe to and click “subscribe. Applicant was advised that all LIC forms can be found at: https://www.cdss.ca.gov/inforesources/forms-brochures/forms-alphabetic-list/i-l

Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care.

Licensee Contreras was reminded that all adults 18 and over living or working in the home, 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.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2023

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: CONTRERAS FAMILY CHILD CARE	FACILITY NUMBER: 157700024
	VISIT DATE: 09/01/2023

NARRATIVE

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LPA discussed the safe sleep regulations with licensee Ruballo 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.

No deficiencies have been cited at this time. A notice of site visit was given to licensee and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Contreras, along with her appeal rights and Notice of Site Visit.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Barbara Beneroso
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2023

LIC809 (FAS) - (06/04)

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