Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364830982
Report Date: 01/26/2018
Date Signed 01/26/2018 01:04:27 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME:SANCHEZ FAMILY CHILD CAREFACILITY NUMBER:
364830982
ADMINISTRATOR:SANCHEZ, ALMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 269-6559
CITY:ADELANTOSTATE: CAZIP CODE:
92301
CAPACITY:14CENSUS: 4DATE:
01/26/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:38 AM
MET WITH:Alma SanchezTIME COMPLETED:
01:18 PM
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Licensing Program Analyst (LPA) Thompson-Miller met with Licensee, Alma Sanchez, who guided analyst on a tour of the facility for an Annual Random inspection. This is a two story 3 bedroom, 3 bathroom home with kitchen/dining, family room, living room, laundry area, permitted play room and garage. There are decorative water fountains on the premises. Family members residing in the home include 2 adults (licensee, licensee spouse) and no children. Incidental Medical Services (IMS) policy was discussed.

Main care is provided in the playroom next to the kitchen. Children use the bathroom next to the kitchen. Children have access to living room. Off limit areas include the entire upstairs (Bedroom #1, #2 and #3, bathroom #2 and #3) and garage. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (garage), medicines and hazardous items (sharp knives in upper cabinet of kitchen) that can pose a danger to children. Fire/earthquake drills complete and maintained current. Roster complete and maintained current. Stairs have a gate.

The backyard is completely fenced. There is a large jungle gym, water fountains with no water and age appropriate toys. No pets. Gated area on the right off limits.
SUPERVISOR'S NAME: Burnett MageeTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Linda Thompson-MillerTELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2018
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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: SANCHEZ FAMILY CHILD CARE
FACILITY NUMBER: 364830982
VISIT DATE: 01/26/2018
NARRATIVE
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Licensee is advised visit www.shotsforschool.org for Immunization information.
Licensee was informed of responsibility to report suspected Child Abuse, 1-800-540-4000.
Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov
Licensee advised to visit the CCL website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.

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.

Licensee was cited Type B deficiency(ies), according to California Code of Regulations Title 22 See 809D report for deficiencies.



An exit interview was conducted and a copy of this report was read and provided to the Licensee on this date.
SUPERVISOR'S NAME: Burnett MageeTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Linda Thompson-MillerTELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2018
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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: SANCHEZ FAMILY CHILD CARE
FACILITY NUMBER: 364830982
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/26/2018
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/26/2018
Section Cited
CCR
102416(c)
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102416(c) Personnel Requirements. The Licensee and other personnel as specified shall complete training on preventive health practices including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.
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Licensee shall maintain current CPR/First Aid at all times. Licensee shall provide proof of CPR/First Aid to CCL by due date.
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Licensee could not provide proof of current CPR/First Aid.
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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: Burnett MageeTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Linda Thompson-MillerTELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2018
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2018
LIC809 (FAS) - (06/04)
Page: 5 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: SANCHEZ FAMILY CHILD CARE
FACILITY NUMBER: 364830982
VISIT DATE: 01/26/2018
NARRATIVE
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Per Licensee, there are no weapons or firearms on the premise. The LPA did not observe any in the home. There are age appropriate toys. Age appropriate napping (mats, playpen) equipment. The required fire extinguisher (2A10BC) and smoke detector are in operable condition. The home has a Carbon Monoxide detector. Fireplace is screened (family/living room). Home has central AC and heat. CPR/First Aid expired 10/2017. The First Aid kit was observed and is complete.

The following was discussed with the Licensee:
Mandatory Forms for the children’s files and provider’s files, Requirements for fire drills, earthquake drills and documentation for both. Role and responsibilities of being a mandated reporter were reviewed. Licensee reminded that 100% supervision is required at all times to children in care. Licensee advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov . Licensee made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care. Licensee advised that inaccessibility of hazards must be constantly reassessed depending on the children in 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 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 (24/7 ban). State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category.
SUPERVISOR'S NAME: Burnett MageeTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Linda Thompson-MillerTELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2018
LIC809 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: SANCHEZ FAMILY CHILD CARE
FACILITY NUMBER: 364830982
VISIT DATE: 01/26/2018
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Requirements for fingerprint clearances and associations were discussed with the licensee.

Licensee advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B. Pamphlet Information regarding SIDS, Seat Belt Safety, Shaken Baby, Notification of Parent's Rights poster (Palmdale Regional Child Care Office) was provided. The "Notification of Parent's Rights" poster must be posted in an area of the home accessible to parents. The information regarding new legislation with regards to exemptions and Parent’s Rights was also discussed.

Licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent when a serious deficiency, Type A, is cited (LIC9224).

Licensee informed to review Quarterly updates/regulations for 2015-2017 on the department website: AB 1207 - all child care employees must complete mandated reporter training beginning January 1, 2018; Summer 2015 - Incidental Medical Services information.
SUPERVISOR'S NAME: Burnett MageeTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Linda Thompson-MillerTELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2018
LIC809 (FAS) - (06/04)
Page: 3 of 5