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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414455
Report Date: 05/31/2022
Date Signed: 09/25/2023 01:34:30 PM

Document Has Been Signed on 09/25/2023 01:34 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:RAMIREZ FAMILY CHILD CAREFACILITY NUMBER:
197414455
ADMINISTRATOR:KAREENA L. RAMIREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 891-5325
CITY:MISSION HILLSSTATE: CAZIP CODE:
91345
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 14DATE:
05/31/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:29 AM
MET WITH:Kareena Ramirez, LicenseeTIME COMPLETED:
05:15 PM
NARRATIVE
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This report is being amended for the purpose to dismiss a citation issued on 5/31/2022.

On 05/31/22 at 9:30 am Licensing Program Analyst (LPA) Liana Stepanyan conducted an unannounced comp annual random inspection to ensure the health & safety standards as required by regulations governing family childcare homes.

On 05/31/22 at 9:30 am Licensing Program Analyst (LPA) Liana Stepanyan conducted an unannounced comprehensive annual random site visit to ensure the health & safety standards as required by regulations governing family child care homes. Facility has 2 entrance to the facility.



LPA toured the entire home, including off-limit area. LPA observed 14 children in care with 2 assistants and licensee. Licensee has all appropriate forms posted. First Aid/CPR certificate is valid thru 03/15/2023, however mandated reporting certificate is expired for licensee and her assistant. LPA confirmed with licensee that all adults residing/working in the home have criminal record/TB clearances. Children’s records were reviewed and found infant files were missing individual sleeping plan. Licensee has practiced fire/emergency drills with daycare children on 12/06/2021. Licensee did not have a completed current roster.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE: DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2022
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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Document Has Been Signed on 05/31/2022 05:07 PM - It Cannot Be Edited


Created By: Liana Stepanyan On 05/31/2022 at 03:45 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 197414455

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/31/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Deficiency Dismissed
Type A
Section Cited
CCR
102391(b)
Inspection Authority of the Department
(b) The licensee shall permit the Department to inspect the family child care home, and to privately interview children or staff, to determine compliance with or to prevent violations of family child care
laws or regulations. The Department shall exercise this authority as specified in Health and Safety Code
Section 1596.8535(a).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above. LPA Stepanyan arrived at the facility at 9:30am. LPA rang the door bell. An adult spoke on the speaker. LPA annouced the reason for the visit. Adult told LPA one moment. LPA waited approxmately 20 minutes. LPA observed children in care with 2 assistance inside the house. LPA rang the door numerous time however, no one answered. LPA also observed an adult closing all the blinds of the windows. Department contacted licensee via phone however, no answered. At 10:40am licensee allowed LPA inside the facility. Licensee stated she was not home and family member was affaid to allow LPA inside. This poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 05/31/2022
Plan of Correction
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Licensee allowed LPA inside the facility an hour later. Licensee understand the regulation. She will train her staff to allow access to the facility immediately when licensing arrives.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Mariela Ramon
LICENSING EVALUATOR NAME:Liana Stepanyan
LICENSING EVALUATOR SIGNATURE:
DATE: 05/31/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/31/2022


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/31/2022 05:07 PM - It Cannot Be Edited


Created By: Liana Stepanyan On 05/31/2022 at 03:45 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 197414455

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/31/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interviews and record review, the licensee did not comply with the section cited above. Licensee does not have mandated reporting certificate nor does the assistant Amanda Rodriguez which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/14/2022
Plan of Correction
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Licensee and her assistants will complete mandated reporter training and email LPA by POC.
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above. Licensee is missing a page of the current roster which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/14/2022
Plan of Correction
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Licensee will provide an updated facility roster and email LPA by POC due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Mariela Ramon
LICENSING EVALUATOR NAME:Liana Stepanyan
LICENSING EVALUATOR SIGNATURE:
DATE: 05/31/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/31/2022


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/31/2022 05:07 PM - It Cannot Be Edited


Created By: Liana Stepanyan On 05/31/2022 at 03:45 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 197414455

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/31/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview and record review, the licensee did not comply with the section cited above. LPA did not observe LIC 9227 infant sleep plan in the children's file. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/14/2022
Plan of Correction
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Licensee will ensure all her infants file contain LIC 9227 Infant Sleeping plan will be filled out by their authorized representative.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Mariela Ramon
LICENSING EVALUATOR NAME:Liana Stepanyan
LICENSING EVALUATOR SIGNATURE:
DATE: 05/31/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/31/2022


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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 197414455
VISIT DATE: 05/31/2022
NARRATIVE
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This 1 story, 3-bed, 2-bath home was toured, the following areas are used for daycare: living/dining/family room, hallway bathroom/bedroom, and backyard. Off limit areas include: master bedroom/bathroom, 2nd bedroom, kitchen/laundry room, and garage. Drawers and lower cabinets in kitchen/bathroom are either latched or do not contain any hazardous items. There is an operational smoke alarm and fire extinguisher maintained in the home. The home has electrical outlet covers throughout and maintains a First Aid Kit in the kitchen. There is no fireplace in the home. There are adequate age appropriate toys, books, games, and napping mats/hygienic diaper changing equipment. There are no firearms present on the premises as stated by licensee. Furthermore, there are no bodies of water. The outdoor play area is a fenced backyard, which is free of hazards and has sufficient toys. There is no pet in the home. Per licensee, operating hours are 24 hours, 7 days a week.

LPA reviewed the following: required departmental documents, regulation highlights, community resources, capacity limitations, supervision, clearances, emergency drills, heat-related illness, child passenger law, unusual incidents, mandated reporting, SIDS, and Shaken Baby Syndrome. Licensee is reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats shall never be permitted during daycare operation.
For licensing regulations/updates/forms, go to webpage http://www.ccld.ca.gov

There were items found in non-compliance per CCR, Title 22, Division 12, Chapter 3; see deficiencies cited on LIC809D. Discussed appeal rights with licensee.

Licensee was issued a Type A and Type B citation today along with a Civil Penalty assessment in the amount of $500.00 for violating CCR 102391(b) Inspection Authority of the Department. See LIC809D for deficiencies.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Liana Stepanyan
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2022
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: RAMIREZ FAMILY CHILD CARE
FACILITY NUMBER: 197414455
VISIT DATE: 05/31/2022
NARRATIVE
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Discussed appeal rights with licensee. Be aware that Notice of Site Visit must be posted for 30 days. Furthermore, upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

Exit interview was conducted with the Licensee and appeal rights explained and provided along with notice of site visit.
SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Liana Stepanyan
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2022
LIC809 (FAS) - (06/04)
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