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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414455
Report Date: 08/08/2022
Date Signed: 08/08/2022 07:46:35 PM

Document Has Been Signed on 08/08/2022 07:46 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: 10DATE:
08/08/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
04:20 PM
MET WITH:Amanda RodriguezTIME COMPLETED:
05:45 PM
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During today's complaint investigation LPA Ortega completed a Case management inspection. Staff was not able to provide proof of CPR/First Aid. Staff disclosed CPR/First Aid has expired for more than two staff. Facility is aware children may not be left alone with any staff member that has their CPR/First Aid expired until certification is renewed and send to the Palmdale Regional Office

Licensee is aware any authorized employee of the Department may enter and inspect any place providing personal care and services at any time with or without advance notice. Licensee is aware other personnel shall complete training on preventive health practices including CPR and first aid per regulation 102416 (c). Manager's and Staff's CPR/First Aid certificate have expired.

During this inspection facility was observed not to be in compliance with Title 22. Please see LIC 809D for deficiencies.

Exit interview conducted and copy of this report with notice of site visit and appeal rights was provided. Facility must post the Notice of site visit for 30 days visible to parents.
SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2022
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 08/08/2022 07:46 PM - It Cannot Be Edited


Created By: Isabel Ortega On 08/08/2022 at 05:43 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: 08/08/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/16/2022
Section Cited
HSC
1596.866

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Additional health and safety training; condition of licensure. Training in pediatric first aid and pediatric CPR by persons described in subdivisions (a) and (b) shall be current at all times. Requirement is not met as evidenced by: licensee does not have proof of current pediatric CPR/first
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The staff will renew pediatric CPR and first aid class and submit a copy of current CPR and first aid card to the Palmdale Regional Office by Fax, email or via mail by 8/16/2022.
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aid training. More than two staff Amanda, Jazmin ect. were not able to provide proof of current Previous CPR/First Aid which is a potential risk to the heath and safety of children.
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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:Carissa Bell
LICENSING EVALUATOR NAME:Isabel Ortega
LICENSING EVALUATOR SIGNATURE:
DATE: 08/08/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/08/2022


LIC809 (FAS) - (06/04)
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