Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364842131
Report Date: 05/07/2018
Date Signed 05/07/2018 04:57:41 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:BADILLO FAMILY CHILD CAREFACILITY NUMBER:
364842131
ADMINISTRATOR:BADILLO, NELLIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 902-6974
CITY:TWENTYNINE PALMSSTATE: CAZIP CODE:
92277
CAPACITY:14CENSUS: 6DATE:
05/07/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
03:11 PM
MET WITH:Nellie BadilloTIME COMPLETED:
05:12 PM
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Licensing Program Analysts (LPAs) Thompson-Miller and Mason met with Licensee, Nellie Badillo, who guided analyst's on a tour of the facility for an Annual Random inspection. This is a single story 3 bedroom, 2 bathroom home with kitchen/dining, family/den room, living room, patio and garage. There is no pool/spa or body of water on the premises. Family members residing in the home include 2 adults (licensee, licensee spouse) and no children. Assistant present during the inspection. Incidental Medical Services (IMS) policy was discussed.

Main care is provided in the living room, family/den room and Bedroom #1. Children use the bathroom in hallway on the right. Off limit areas include Bedroom #2, #3, bathroom #2, garage (key lock) and laundry (in 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 (garage) and hazardous items (sharp knives in upper kitchen cabinet) that can pose a danger to children. Fire/earthquake drills complete and maintained current. Roster complete and maintained current.

The backyard is completely fenced. There is a swing/slide that is anchored. No pets. There is a trampoline (waiver in file). There is a fire pit that is covered.
SUPERVISOR'S NAME: Burnett MageeTELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Linda Thompson-MillerTELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2018
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: BADILLO FAMILY CHILD CARE
FACILITY NUMBER: 364842131
VISIT DATE: 05/07/2018
NARRATIVE
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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, Items not permitted by Licensed Family Child Care Home, 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 2015-2018 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: 05/07/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2018
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: BADILLO FAMILY CHILD CARE
FACILITY NUMBER: 364842131
VISIT DATE: 05/07/2018
NARRATIVE
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Per Licensee, there are weapons or firearms on the premise. LPAs observed weapon and ammunition secured separately (inaccessible-off limits). 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. Home has central .AC and heat. CPR/First Aid expire 02/09/2020. 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: 05/07/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2018
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: BADILLO FAMILY CHILD CARE
FACILITY NUMBER: 364842131
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/07/2018
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/07/2018
Section Cited
HSC
1597.622(a)(1)
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H&S 1597.622(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
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Licensee shall ensure all staff and volunteers have appropriate records for immunization. Immunization shall be completed and submitted to CCL by due date.
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between August 1 and December 1 of each year. LPA observed licensee/staff without proof of required immunization.
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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: 05/07/2018
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2018
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: BADILLO FAMILY CHILD CARE
FACILITY NUMBER: 364842131
VISIT DATE: 05/07/2018
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, 1-800-827-8724/760-243-6640
--Family Child Care Providers (Disaster Planning information): https://ccld.family-child-care-providers/disaster-planning-and-fire-safety/
--Child Care Videos: https://ccld.childcarevideos.org
--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

The On Duty Worker is available for questions at 661-789-6944 Monday through Friday 8am-5pm. LPA's provided consultation and community care licensing child care video during the inspection.

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


Exit interview conducted and a copy of report was read and provided to 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: 05/07/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2018
LIC809 (FAS) - (06/04)
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