367700290-7-22-2022-12-CC-BIBE-CGKRY9-20220722132558

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 367700290
Report Date: 07/22/2022
Date Signed: 07/22/2022 01:26:11 PM

Document Has Been Signed on 07/22/2022 01:26 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:	MALDONADO FAMILY CHILD CARE		FACILITY NUMBER:	367700290
ADMINISTRATOR:	KASEY MALDONADO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 338-9836
CITY:	APPLE VALLEY	STATE: CA	ZIP CODE:	92308
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	07/22/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:37 AM
MET WITH:	Kasey Maldonado		TIME COMPLETED:	01:50 PM

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Licensing Program Analyst (LPA) Babatunde Ibitoye met with Applicant Kasey Maldonado. The purpose of the inspection is to conduct a change of location pre-licensing Inspection for a Large family childcare home. Per Applicant all adults residing in the home has a Criminal Record Clearance. The days are hours of operation will be Monday -Friday (6am to 5:30 PM).

This is a Two story house with 5 bedrooms, 3 bathrooms, kitchen/dining room, living room, and attached garage. Applicant states the living room, bedroom #1,Daycare room formal dining room, outside Patio by day-care room , kitchen, bathroom #1 is utilized for the family childcare. The off-limit areas of the home are the entire upstairs bedrooms #2, #3,#4,#5, bathroom #2,#3, backyard, and garage. There is a fireplace located in the dinning room, which is inaccessible to children with a glass barrier locked and a gate.

The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, poisons, detergents/cleaning compounds, medicines and hazardous items that can pose a danger to children, LPA observed all items are made inaccessible to children during the time of this inspection. LPA observed age appropriate safe toys and napping equipment on the premises. Per Applicant children will nap in the Day-care room and bedroom # 1 LPA observed all electrical outlets made inaccessible to children with safety covers. Per Applicant, there are firearms on the premises with a lock. LPA did not observe a swimming pool or bodies of water on the premises.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2022

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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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: MALDONADO FAMILY CHILD CARE	FACILITY NUMBER: 367700290
	VISIT DATE: 07/22/2022

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LPA observed required fire extinguisher (2A10BC) fully charged, smoke detectors and carbon monoxide devices tested operable. The First Aid Kit was observed complete with supplies and first aid manual. LPA observe Applicant has current Pediatric CPR and First Aid Training with expiration date (03-31-2023) 1 hour of nutrition training, (8) hours of Preventive Health and Safety Training. Applicant does have proof of being immunized against influenza, pertussis and measles.

. Incidental Medical Services (IMS) were discussed. Per licensee, the facility is not currently providing IMS. LPA informed Applicant to refer to IMS information in the 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 following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www/ada.gov/childqanda.htm.

The following information was discussed with the Applicant:

· Mandatory Forms for the children’s files and provider’s files.

· Requirements for fire drills, earthquake drills and documentation for both, LPA advised Applicant to conduct a disaster drill every six months.

Role and responsibilities of being a mandated reporter was discussed.

· Applicant was made aware that it is their responsibility to know and review updates/regulations and forms online at www.ccld.ca.gov as well as anyone who assists in providing care.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2022

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: MALDONADO FAMILY CHILD CARE	FACILITY NUMBER: 367700290
	VISIT DATE: 07/22/2022

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The licensing department must have the facility’s phone number. If the phone number is changed, the licensing department must be notified.

· Applicant is aware that all adults 18 years and older living in the home or visiting for extended periods of time should have criminal background clearances. Failure to comply will result in Civil Penalty assessments.

· On January 1, 2018 or before March 30, 2018, a person who, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the on-line mandated reporter training and shall complete renewal mandated reporter training every two years. @www.mandatedreporterca.com

· AB 290 - for each new license issued, at least one director or teacher at a childcare center or family child- care home shall have at least one hour of childhood nutrition training.

· Senate Bill AB 2231 Civil Penalty Amount Changes. Changes Effective 7/1/2017.

· Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit. **In addition; A copy of this report must be provided to the authorized representatives of all currently enrolled children and any newly enrolled child for the following 12 months.

· The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC9224) shall be signed and kept in each of the children’s records. The report shall be provided no later than the next business day or the next day the child is in care.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2022

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: MALDONADO FAMILY CHILD CARE	FACILITY NUMBER: 367700290
	VISIT DATE: 07/22/2022

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· Failure to meet the posting requirements shall result in an immediate $100.00 civil penalty

· Applicant is made aware that Title 22 Regulation prohibits the smoking of tobacco in a private residence that is licensed as a family child- care home, and in those areas of the family day care home where children are present.

**§1597.622 Employees or volunteers at family day care home; immunization requirements; records; exemptions (a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

· **Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements

· Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed child care facility are aware of situations that present the greatest danger to children.

· State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category.

· Safe Sleep in Child Care: Resources can be found on our website at http://www.cdss.ga.gov/inforesources/Child-Care-Licensing/Public-Information-and-Resources/Safe-Sleep

· Lead Poisoning: For more information, go to the California Childhood Lead Poisoning Prevention Branch’s website at www.cdph.ca.gov/programs/clppb,or call them at (510) 620-5600.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2022

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: MALDONADO FAMILY CHILD CARE	FACILITY NUMBER: 367700290
	VISIT DATE: 07/22/2022

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· Applicant is advised to visit www.shotsforschool.org for Immunization information.

· 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”.

At this time the facility is in Compliance with Title 22 regulations and LPA Ibitoye will submit the proper documentation and information to request the facility to be issued a Family Child Care License.

Exit interview was conducted a copy of this report was printed and given to the applicant Kasey Maldonado.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Babatunde Ibitoye
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2022

LIC809 (FAS) - (06/04)

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