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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700313
Report Date: 05/14/2024
Date Signed: 05/14/2024 12:13:35 PM

Document Has Been Signed on 05/14/2024 12:13 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
PALMDALE CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:REYES FAMILY CHILD CAREFACILITY NUMBER:
367700313
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
05/14/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:57 AM
MET WITH:Maria ReyesTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
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On May 14, 2024 Licensing Program Analyst (LPA’S) Braddock and Calloway conducted a Capacity Increase inspection. Upon arrival, LPA’s met with licensee Maria Reyes. The requested capacity is 14. The fire department has granted a fire clearance. Licensee is advised that as a family childcare home operating at full capacity, she must adhere to the following: Operate with a Maximum of 14 children in care with no more than 3 Infants, also must have 2 school age children enrolled. Or Max. 12 Capacity with no more than 4 infants. A Qualified Assistant must be present when more than 8 children are in care.

Upon arrival, LPA’s observed 4 children in care. This is a two story, 3-bedroom, 2.5-bathroom home with kitchen/dining, living room, laundry room and garage. There is a children’s water toy station that is empty on the premises. Family members residing in the home include 1 adult (licensee) and 1 minor child. Hours of operation are Monday through Saturday 23 hours a day. Licensee was advised that a staff member must always be awake while children are in care (for 23-hour operation).
Incidental Medical Services (IMS) policy was discussed.

Physical Plant: Main care is provided in the living room. Children use the bathroom near the front entrance on the left. Children have access to the living room and dining room area.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Sherell Braddock
LICENSING EVALUATOR SIGNATURE: DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/14/2024
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 05/14/2024 12:13 PM - It Cannot Be Edited


Created By: Sherell Braddock On 05/14/2024 at 11:11 AM
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: REYES FAMILY CHILD CARE
FACILITY NUMBER: 367700313

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/21/2024
Section Cited
CCR
102417(g)(3)

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102417 (g)(3) Operation of a Family Child Care Home(g)The home shall be free from ...conditions...endanger a child..shall include...3 Where children less than five years old are in care, stairs shall be fenced or barricaded.This requirement was not met as evidenced by:


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Licensee will provide a written statement that the stairs will remain gated during day care hours and while small children are in care.
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Based on observation, during the inspection, LPAs observed the stairs leading to the off lilmit area to not be barricaded and there were children in care ages 2- 5 years which poses a potential health, safety, or personal rights to the children in the care.
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Type B
05/21/2024
Section Cited
102417(g)(8)

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102417 Operation of a Family Child Care Home (g) he home shall be free from...which might endanger a child.. shall include...(8)Each child care home shall have current roster of children HSC .1596.841. This requirement was not met as evidenced by:


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Licensee will provide proof of the roster to Licensing by POC date and maintain the roster.
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Based on observation, and record review the LIcenseed did not have a current roster for the children in the day care during inspection which poses as a potential health, safety, or personal rights risks to the children in care.
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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:Lady King
LICENSING EVALUATOR NAME:Sherell Braddock
LICENSING EVALUATOR SIGNATURE:
DATE: 05/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/14/2024


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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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: REYES FAMILY CHILD CARE
FACILITY NUMBER: 367700313
VISIT DATE: 05/14/2024
NARRATIVE
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 LPA did not observe the upstairs area to be fully barricaded by a safety gate. Off limit areas include all upstairs: all bedrooms, bathroom #1.5, laundry room(upstairs in off limit area), and garage(key lock). The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (closet with key lock), medicines (off limits bedrooms) and hazardous items (sharp knives in kitchen pantry unreachable to children in care) that can pose a danger to children. LPA did not observe a fireplace in the home.

Safe and age-appropriate toys, play equipment and materials were observed. The smoke detector and carbon monoxide detector, Fire Extinguisher (2A10BC) are in operable condition. Per Licensee there is smoking in the evening when children are not present. Electrical outlets are inaccessible. LPA reminded licensee, no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/ play equipment are allowed. There is a designated area for ill children as necessary near dining room area. Per Licensee there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (cell) and landline.
Safe and age-appropriate toys, play equipment and materials were observed. There is age-appropriate napping (cots) equipment. The window cords (tied high) inaccessible to children.

Bathroom: downstairs bathroom free of hazards. The following are inaccessible: Sharp items, mouthwash, shampoo, razor, nail polish. Toilet and faucet are clean and operable.
Kitchen: The home has a clean and fully stocked clean refrigerator/freezer. Breakfast, lunch, snacks and dinner are provided. Licensee is a participant in a food program. Food brought from the children’s home shall be labeled and dated.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Sherell Braddock
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: REYES FAMILY CHILD CARE
FACILITY NUMBER: 367700313
VISIT DATE: 05/14/2024
NARRATIVE
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Outdoor: Children play in the back yard. The play area is clear and clean of debris, play area is fenced and gated all around, play yard has sand and cement for play time. LPA also observed two small, shaded tables and benches in the backyard. LPA observed age-appropriate Little Tykes play equipment, toys, and bikes for children. LPA observed a barbecue grill and recommended covering.
Advisory/Other: First Aid kit was observed with supplies (thermometer) readily available. Licensee has CPR/First Aid 07/30/2022 exp 07/2024. Mandated Reporter Training will expire on 08/11/2024. Review of records to be maintained: LPA reviewed with licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. All children files were reviewed on the annual inspection on 2/7/2024.
Documents Provided and or Discussed: Fire Drill Log (2/22/2024), Roster, Postings, Safe Sleep PIN 20-24-CCP, Individual Sleeping Plan (LIC9227), Large and Small Child Care Ratio Packet, and Lead Poisoning flyers.

Incidental Medical Services (IMS) policy was discussed. For IMS information see 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
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN),
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Sherell Braddock
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: REYES FAMILY CHILD CARE
FACILITY NUMBER: 367700313
VISIT DATE: 05/14/2024
NARRATIVE
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Program Quarterly Update Newsletters and other important information communication platform.
To receive important licensed - related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.
The following was discussed with the Licensee:
Mandatory licensing forms for the children’s files, facility forms/records, and information to be posted in the family child care home; Requirements to conduct fire and disaster drills once every six months and record it; Role and responsibilities of being a mandated reporter (www.mandatedreporterca.com) were reviewed, to be completed every two years; Licensee reminded that 100% supervision is required at all times to children in care; Licensee made aware that it is his/her/their responsibility to know the regulations as well as anyone who assists in providing care; Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified; Regulation prohibits the smoking of any kind during the operation of the day care. Licensee currently does not have Child Care Insurance. Per Licensee no on smokes in the home. The "Notification of Parent's Rights" poster must be posted in an area of the home accessible to parents. Licensee advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov.

Licensee advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department (email address on the website: [email protected]. 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.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Sherell Braddock
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: REYES FAMILY CHILD CARE
FACILITY NUMBER: 367700313
VISIT DATE: 05/14/2024
NARRATIVE
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In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above.

Licensee advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days whenever a licensing inspection is conducted. If a Type A deficiency is cited, a copy of the licensing report must also be posted for 30 days. The same report must be provided to part obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file. Copies of the reports must be provided to each parent when a Type A violation is cited along with Acknowledgment of Receipt of Licensing Reports LIC 9224. If these requirements are not met civil penalties per violation will be assessed.
Prior to making alterations or additions to a family child care home or grounds, the Licensee shall notify the Department of the proposed changed, including, but not limited to, the following: Conversion of a garage (either attached or detached) into a "child care" room; Room additions to the family child care home. Any change from an area of the family childcare home previously identified as "off limits" to an area where care and supervision will be provided to children in care. Licensee shall provide the Department with a copy of an inspection report when an inspection is required by the local building inspector as a result of the alteration, addition or construction.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Sherell Braddock
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: REYES FAMILY CHILD CARE
FACILITY NUMBER: 367700313
VISIT DATE: 05/14/2024
NARRATIVE
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Any duly authorized officer, employee, or agent of the Department shall, upon presentation of proper identification, shall inspect the facility. The Licensee shall permit the Department to inspect the family childcare home, and to privately interview children or staff, to determine compliance with or to prevent violations of family child care laws or regulations, also enter and inspect any place providing personal care, supervision and services at any time, with or without advance notice, to secure compliance with, or to prevent a violation.

LPA discussed the safe sleep regulations with licensee's and also instructed Licensee to visit the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
If you have questions regarding this PIN, please contact CPMB at 888-422-5669 or [email protected] for assistance.
The Department will convey all new information through PINs. Please sign up to be notified here and visit the Department’s website for the latest PINs.

There are deficiencies cited during this inspection. See 809D pages. The On Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm.
Before the capacity increase is granted
The following needs to be completed: Cushioning mats needs to be placed underneath the taller slide. The broken wood on the gate needs to be repaired. The electrical wiring needs to be made inaccessible in the light posts.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Sherell Braddock
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
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 CC RO, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: REYES FAMILY CHILD CARE
FACILITY NUMBER: 367700313
VISIT DATE: 05/14/2024
NARRATIVE
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The propane inside the fire grill needs to be made inaccessible.

Exit interview conducted and report was reviewed with Licensee. This report was read and provided to Licensee on May 14, 2024. Notice of Site Visit: A notice of site visit was given and must remain posted for 30 days. Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Sherell Braddock
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
LIC809 (FAS) - (06/04)
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