<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197414455
Report Date: 08/12/2022
Date Signed: 08/12/2022 06:10:20 PM

Document Has Been Signed on 08/12/2022 06:10 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:
08/12/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Amanda RodriguezTIME COMPLETED:
04:59 PM
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
During today's complaint subsequent investigation LPA Ortega completed a Case management inspection. Facility was not able to provide facility Roster, daily sign in sheets nor child files.
Operation of a Family Child Care Home(FCCH). Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. Facility Manager was not able to provide children's emergency contact information nor sign in and out sheets. A facility Roster with contact information is required to be at the facility at all times. Child files with immunization were not provided and not on site at FCCH. Before enrollment a child file shall be maintained with child's current immunization record for the health and safety of all children in care. this poses a health and safety risk to children in care.

During this inspection facility do not met Title 22 regulations an is not to be in compliance per Title 22. Facility was cited today, please see LIC 809D for deficiencies. Facility also received technical violations for three staff starting employment without transfer Association to facility. 102370(d)(2) Criminal Record Clearance. Prior to working, or volunteering in a licensed home, all licensees and personnel as specified shall request a transfer of a criminal record clearance as specified in Section 102370(j).
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: 08/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/12/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 08/12/2022 06:10 PM - It Cannot Be Edited


Created By: Isabel Ortega On 08/12/2022 at 04:38 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: 08/12/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
08/15/2022
Section Cited
CCR
102417(g)(8)

1
2
3
4
5
6
7
Operation of a Family Child Care Home. Each family child(FCCH) care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement was not met as evidenced by:
1
2
3
4
5
6
7
FCCH will complete all information required on the facility roster and submit to the Palmdale Regional Office by via-email, or fax(LPA's business card provided) by noon 8/15/22.
8
9
10
11
12
13
14
Based on observation, lic and Manager Amanda stating roster is not at the facility home. Licensee did not comply and was not able to provide a current copy of the facility roster with children's current contact. This poses a potential health and safety risk to children in care.
8
9
10
11
12
13
14
Request Denied
Type B
08/19/2022
Section Cited
CCR102421

1
2
3
4
5
6
7
Child's record: The licensee shall maintain, in each child's record, the signed and dated notice form required in Section 102419(d). (b) The licensee shall maintain, in each child's record, a copy of the emergency information card as required for a Large Family Child Care Home... This requirement was not met as evidence by:
1
2
3
4
5
6
7
According to FCCH licensee will complete all information required child file forms and immunizations and submit to the Palmdale Regional Office by via-email, or fax(LPA's business card provided) by noon 8/19/22.
8
9
10
11
12
13
14
LPA's observation and Manager Amanda stating children files are not at FCCH and was not able to provide any child files for any of the children enrolled. This poses a potential health and safety risk to the children in care.
8
9
10
11
12
13
14
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: 08/12/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/12/2022


LIC809 (FAS) - (06/04)
Page: 2 of 2