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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157700024
Report Date: 09/01/2023
Date Signed: 09/01/2023 10:10:50 AM

Document Has Been Signed on 09/01/2023 10:10 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 CAREFACILITY NUMBER:
157700024
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
09/01/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Maria ContrerasTIME COMPLETED:
10:15 AM
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On 09/01/2023 Licensing Program Analysts (LPA) Beneroso conducted an announced Case management Licensee Initiated inspection as Licensee is requesting to increase her capacity from 8 children to 14 children. The LPA disclosed the purpose of the inspection and was granted entry by Licensee who guided the LPA on a tour of the facility. Upon entry to the facility the LPA observed six children in care.

Licensee was initially licensed on 08/12/2019 as a Small Family Child Care Home. The Fire Department has inspected the home and granted a fire clearance for 14 children effective 06/07/2023. Family Child Care Home operates Monday through Saturday 4am to 4pm. The facility provides breakfast, morning snack, lunch, afternoon snack.

The facility is one story dwelling with 4 bedrooms, 2 bathrooms, kitchen, living room, family room, dining area and backyard. All the bedrooms and bathroom #2 are off-limits. The backyard is used for outdoor playtime. No hazardous objects were observed in the backyard used by children. The outdoor areas are completely fenced in, and no bodies of water were observed. There is a garage in the premises that remains locked and with a safety door knob.

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
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The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation were inspected, 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. LPA did not observe a fireplace or any bodies of water at the above facility. LPA observed mats provided for nap time. Children nap in the day care area.

The First Aid kit was observed to be complete, including a thermometer. The required fire extinguisher (2A10BC) reading in green, smoke and carbon monoxide detectors were found to be in operable condition. Fire and disaster drills are conducted every six-month last drill was conducted in April 11, 2023. The facility annual fees are current. The parent board was reviewed and had all the required forms posted and accessible to parents.

Incidental Medical Services (IMS) policy was discussed

The licensee provided proof of immunization against pertussis (TDAP), measles (MMR), and influenza. Licensee’s Mandated Reporter certification is curren, it expires on 05/12/2024 and CPR/First Aid is current expires 03/30/2025.



The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot-line at 1-800-540-4000.
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
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The following were discussed: No smoking, infant walkers, Johnny jumpers, exersaucers and any other item that falls into that category are 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 and penalty

Licensee was reminded with a capacity increase she must have a qualified assistant present whenever she has more than 8 children in care. Licensee was provided with a capacity and ratio handout pertaining to large Family Child Care Homes and the various age groups that can be under care at one given time.

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.



The Licensee was reminded 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 applicant was informed to utilize the Unusual Incident Report/Injury Report form LIC624B when submitting the report to the department.
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
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Safe Sleep regulations (under 24 months) were discussed with Licensee and referred to the CCL web site for additional information and PINS. Provided licensee with an infant sleep plan form LIC 9227.
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

Facility meets the requirements for a capacity 14 license effective 09/01/2023. No citations were issued during this inspection. Exit interview conducted and report was reviewed with licensee, Contreras. A copy of this report was provided electronically along with her appeal rights and Notice of Site Visit. A notice of site visit must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

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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