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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 147700032
Report Date: 10/20/2020
Date Signed: 10/20/2020 03:38:20 PM

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:KLIKS FAMILY CHILD CAREFACILITY NUMBER:
147700032
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
10/20/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Raschelle Kliks, LicenseeTIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) Nadia Flores conducted a Tele-Visit with licensee Raschelle Kliks, who guided analyst on a tour of the facility for a case management, capacity increase inspection for a large family child care. This visit was held virtually due to COVID-19 Emergency Response. Currently this facility is not operating under a waiver.

This is a 1 story home with 3 bedrooms and 2 bathrooms. The following areas of the home will be utilized for the Family Child Care: Front yard, Living room, bedroom #2, and bathroom #1. The off-limits of the home are the Master bedroom, bathroom #2, bedroom #1, kitchen and backyard. Currently dining room us being used for distance learning. The home does not have a central heating nor air conditioning. There are two swamp coolers. The kitchen sharp utensils are put away. Poisons and medications are put away in the master bedroom which is an off-limit area. Bathroom was toured and inspected sink/toilet are in operable condition. All unused electrical outlets are completely plugged and made inaccessible to children. Smoke detectors and carbon monoxide detector tested operable. There is a fully charged fire extinguisher (2A10BC). Fully stocked first aid kit with manual.

This home was inspected for safety, comfort, cleanliness, telephone service. Also for inaccessibility to poisons, detergents, cleaning compounds, medicines, and other hazardous items that can pose a danger to children. Per licensee, there are no weapons or firearms on premises; LPA did not observe any firearms during this inspection.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Nadia FloresTELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
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: KLIKS FAMILY CHILD CARE
FACILITY NUMBER: 147700032
VISIT DATE: 10/20/2020
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Main care is conducted in the living room, which is designated as a playroom LPA observed age appropriate toy and furniture that the children have access to. The changing table was observed, it was clean, sanitary and in good condition. The table was observed to have a vinyl pad that is at least 3 inches thick.

Books, games and toys are on premises of this facility and in good condition and free of cracks or repairs. Cots and play pins were observed. Educational postings posted on the walls throughout the playroom.

Children utilize a bathroom located near the dining and kitchen area. The bathroom was inspected and the bathroom was observed to have a operational sink and toilet. The bathroom sink was observed to have a child proof latch on the door in good condition at the time of the inspection.

There is a first aid kit on premises. LPA observed that applicant has a fire extinguisher 2A10BC which meets fire marshal standards. Smoke detector was tested and is in operational condition. Licensee has at least one working carbon monoxide detector located in the kitchen. The front yard was inspected, the front yard is fenced all the way around to prevent children from going onto the street.

Licensee is not be providing medication to children. 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

SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Nadia FloresTELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2020
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: KLIKS FAMILY CHILD CARE
FACILITY NUMBER: 147700032
VISIT DATE: 10/20/2020
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Licensee and staff have the required immunizations for pertussis, measles, and influenza. Licensee and staff have also completed the 1207 Mandated Reporter Training.
There shall be no smoking, no infant walkers, johnny jumpers, exersaucers and any other item that falls into that category. Also discussed were earthquake, fire & disaster drills shall be documented at least once every six months.

LPA discussed licensing capacity requirements. Licensee understands the ratio and capacity requirements. Licensee understands that any cleared adult left alone caring for children must have a background clearance check and current Pediatric 1st Aid and CPR certificates. Licensee advised that children residing in the home under the age of 10 count towards capacity/ratio.
If licensee is operating a large family child day care and no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home. Therefore, the large family childcare reverts to small capacity requirements of (8) children.

Posting requirements were discussed such as the posting of the Parent’s Rights poster in a visible location for the children’s authorized representatives. Children records requirements, mandated child abuse and injury/ death reporting, background check clearance transfer requirements, SIDS, Infants Safe Sleep on Back, and Never Shake A Baby were all discussed. Licensee agrees children shall be positioned for sleep on their back.

No deficiencies were cited today, this facility was found to be operating in substantial compliance of Title 22 Regulations. A copy of this report was discussed and read to licensee. It will be mailed with a read receipt.

Fire Clearance was granted by fire inspector for a Large Family Child Care Home on 10/13/20. Capacity increase to 14 children has been approved and is effective 10/20/20.

SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Nadia FloresTELEPHONE: (661) 568-8103
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2020
LIC809 (FAS) - (06/04)
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