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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700269
Report Date: 12/08/2022
Date Signed: 12/08/2022 01:15:38 PM

Document Has Been Signed on 12/08/2022 01:15 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:CERON FAMILY CHILD CAREFACILITY NUMBER:
367700269
ADMINISTRATOR:JULIA CERONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 339-5858
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
12/08/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:03 AM
MET WITH:JULIA CERONTIME COMPLETED:
01:30 PM
NARRATIVE
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On 12/8/2022, LPA Carol Heath and Kuliema Calloway made an unannounced initial 10-day visit, for the complaint received on 12/6/2022. The purpose of the inspection was to inform the Licensee that an investigation is being conducted regarding the above allegations. Licensee granted access to the facility.
Description of situation: LPAs observed twelve (12) children in care: three (3) infant children, two were in play pens, eight (8) toddler aged children, one (1) school aged child on a Zoom meeting in a separate room with the door closed and no supervision. Licensee was alone with all the children and no assistant during today’s inspection. The assistant was sick and told not to come in today by the Licensee. One of the infant children was observed in a bouncy seat. The gates to the off limit areas were not affixed.
Based on observation and interviewed today, the preponderance of evidence has been met, Therefore the above allegation is Substantiated for over capacity and bouncy seat.
Deficiency cited. Type “A” California Code of Regulation, Title 22, Division 12 Chapter 1 Article 06.
Exit interview conducted and a copy of this report, notice of site inspection and appeal rights were discussed and give it to Licensee Julia Ceron.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 12/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/08/2022
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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Document Has Been Signed on 12/08/2022 01:15 PM - It Cannot Be Edited


Created By: Carol Heath On 12/08/2022 at 12:35 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: CERON FAMILY CHILD CARE
FACILITY NUMBER: 367700269

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/08/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/08/2022
Section Cited
CCR
102417(g)(10)

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102417 Operation of a Family Child Care Home: A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Section 1596.846(b) and (c). This requirement is not meet as evidenced by:
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The licensee will give the bouncy chair back to the family today.
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Based on observation and interview, the licensee allow a buncy chair in the facility Which poses an immediate Health, Safety, or Personal Rights risk to persons in care.
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Type A
12/08/2022
Section Cited
CCR102416.5

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102416.5 Staffing Ratio and Capacity: The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time. This requirement is not meet as evidenced by:
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The licensee called 2 parents to pick up the children Her assistant came back to help her. The licensee will review the capacity requirement 102416.5 Staffing Ratio and Capacity.
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Based on observation and interview, the licensee has 12 children 3 infants, 8 toddlers and 1 school age in the facility, Which poses an immediate Health, Safety, or Personal Rights risk to persons 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:Claretta Yates
LICENSING EVALUATOR NAME:Carol Heath
LICENSING EVALUATOR SIGNATURE:
DATE: 12/08/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/08/2022


LIC809 (FAS) - (06/04)
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