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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153807995
Report Date: 10/04/2021
Date Signed: 11/19/2021 01:50:28 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:LUKENBILL KATHRYN, TENDER HEARTH FAMILY CHILD CAREFACILITY NUMBER:
153807995
ADMINISTRATOR:LUKENBILL, KATHRYNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 256-2807
CITY:ROSAMONDSTATE: CAZIP CODE:
93560
CAPACITY:14CENSUS: 11DATE:
10/04/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:03 AM
MET WITH:Kathryn LukenbillTIME COMPLETED:
11:00 AM
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On 10/4/2021, Licensing Program Analysts (LPAs) Carol Heath and Babatunde Ibitoye conducted an unannounced Required 1 Year inspection at the above facility. Upon arrival, the LPA met with licensee Kathryn Lukenbill who guided the LPAs on a tour of the facility. Present are 11 children (0 infant, 3 Toddler, 2 preschool, 6 School age). Family members residing in the home include 2 adults (licensee, licensee spouse) and three children. Incidental Medical Services (IMS) policy was discussed. Per LIS, facility annual fees are current. All adults living in the home have been background cleared. Per licensee, the hours of operation are Monday through Friday 5:00 a.m. to 5:00 p.m.

The Home is set up as follows:
This is a two story 4-bedroom, 3 bathroom home with kitchen/dining, family room, living room, formal dining room, laundry room and garage. The home was inspected for safety, comfort, cleanliness, telephone service, central air and heat and ventilation.

Ø Main Area: Main Area: Main care is provided in the living room (at entrance) and family room. Children use the bathroom (Bathroom #1) on the left at entrance. Off limit areas include the entire upstairs (Bedroom #2, #3 and #4, bathroom #2 and #3), downstair Bedroom #1 (key lock), laundry (gated) and garage (key lock).

o Living Room: In the living room which is the designated playroom, LPA observed age-appropriate toys and furniture for the children There is a TV which plays educational videos for the children and an adult size couch. The home has central heating and air conditioning. All windows have screens and are free of cracks, bugs, and debris. Hanging window blinds cords are inaccessible to children.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2021
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LUKENBILL KATHRYN, TENDER HEARTH FAMILY CHILD CARE
FACILITY NUMBER: 153807995
VISIT DATE: 10/04/2021
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o Family Room (Toyroom): In the family room a fireplace was observed that was properly screened via mirror glass doors. The fireplace is inaccessible to children. In the family room, there were additional toys observed to be in the room stored on cubbies. . A small table was observed with a total of eight chairs. Several plastic storage bins were observed in which games and toys are stored for the children. A small play kitchen was located by the door with which children can play. There are games and books on the premises of this facility. There are mats on the floor that have educational/learning activities on them. The mats were observed to be in good condition.

o Kitchen The kitchen was inspected to ensure hazardous and dangerous items were inaccessible to children with magnet locks. LPA observed proper storage of all cleaning detergents, medications, and sharp pointed objects. Many of the cabinet were secured with magnet locks. Sharps objects such as knives and scissors are inaccessible to children.

o Bathroom #1: Bathrooms were toured, and inspected sink/toilet are in operable condition. Toilet and faucets are clean, safe, and operable. All poison and medications are made inaccessible to children with child safety latches on the sink cabinet. Children will use this bathroom located on the left at entrance. The bathroom was observed to be free and clear of hazardous items. The bathroom was clean, sanitized, and in good repair.
o Backyard: The backyard was inspected; The backyard is completely fenced. There is 4 small dog (dog run on the right). There is large tree and wooden jungle gym (slide/swing) that is anchored. There is no body of water on the premises.

Ø The off-limit Areas: The Licensee states the off-limit areas include the entire upstairs (Bedroom #2, #3 and #4, bathroom #2 and #3), Bedroom #1 (key lock), laundry (gated) and garage (key lock).
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2021
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LUKENBILL KATHRYN, TENDER HEARTH FAMILY CHILD CARE
FACILITY NUMBER: 153807995
VISIT DATE: 10/04/2021
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Ø Others:
§ AC/Heating Unit was observed. AC/Heating Unit has a cover on top of the system to prevent children from accessing the unit.
§ Napping: LPA observed 12 mats and 3 playpen equipment. Children will nap in the designated nap areas with adult supervision.
§ The First Aid kit is located in the kitchen inaccessible to children on top of the refrigerator. The First Aid Kit was observed complete with supplies and a first aid manual.
§ Fire extinguisher (2A10BC): LPA observed there is a required fire extinguisher (2A10BC) fully charged Date: 10/3/2021 and located in the kitchen inaccessible to children.
§ Smoke Detectors and Carbon Monoxide: The smoke detectors and carbon monoxide devices tested operable.
§ Electrical outlets: All unused electrical outlets are plugged in and made inaccessible to children.
§ Bodies of water: There are no bodies of water in the home.
§ Medications and cleaning solutions: The detergents/cleaning compounds in located at laundry room with safety gate, medicines (upstairs off-limits bedroom)
§ Weapons or Firearms: Per Licensee, there are weapons or firearms on the premise inaccessible to children (separate container with locks).
§ Transportation: The licensee will transport daycare children.
§ Incidental Medical Services (IMS): 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 Licensee will be providing medication to children in the future.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2021
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LUKENBILL KATHRYN, TENDER HEARTH FAMILY CHILD CARE
FACILITY NUMBER: 153807995
VISIT DATE: 10/04/2021
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Ø Documentation:

· CPR/First Aid: LPA observed licensee has current Pediatric CPR and First Aid Training with expiration date (06/2023) 1 hour of nutrition training, (8) hours of Preventive Health and Safety Training.
· Immunization: The licensee has the required immunizations. The licensee provided a written statement declining the influenza vaccination.
· Mandated Reporter Training: The licensee has completed the online mandated reporter training at www.mandatedreporterca.com, and will renew 10/3/2021
· Transportation: The licensee does provide transportation for children. The licensee has a valid California driver's license with an expiration date of 02/23/2025. Licensee has valid vehicle insurance with the expiration date of June,2022 and vehicle registration dated 12/2/20.
· Child files: LPA observed 7 children files contained all required licensing documents.
· Staff File: 14 years old daughter is her assistant
· Fire Drill and Disaster Drill: Per the licensee, fire and disaster drills are conducted every 6 months; the last drill was documented and conducted on 04/03/2021.

· Facility Roster: LPA observed Child Care Facility Roster. Per Licensing Information System, facility annual fees were current.


· Licensee has posted as required the Facility License, Emergency Disaster plan, and Parents Rights Poster. The facility roster is not current. there are no current facility earthquake/fire drills documents observed during the time of this inspection.

Ø The following information was discussed with the licensee:


ü Mandatory Forms for the children’s files and provider’s files.
ü Requirements for fire drills, earthquake drills, and documentation for both.
ü The role and responsibilities of being a mandated reporter were discussed.
ü The licensee is reminded that 100% supervision is required for children at all
times.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2021
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LUKENBILL KATHRYN, TENDER HEARTH FAMILY CHILD CARE
FACILITY NUMBER: 153807995
VISIT DATE: 10/04/2021
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ü Capacity requirements, Roster requirements, Posting requirements, Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children’s files and provider’s files, and Safe Sleep Awareness. The role and responsibilities of being a mandated reporter were reviewed. The licensee was reminded that supervision is always required for children in care.

ü Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility’s phone number; if the phone number is changed, licensing must be notified.


ü Licensee was 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

ü The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).

ü Criminal Record Statement: Licensee [or facility representative] 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.

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2021
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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: LUKENBILL KATHRYN, TENDER HEARTH FAMILY CHILD CARE
FACILITY NUMBER: 153807995
VISIT DATE: 10/04/2021
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ü Safe Sleep: LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] 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.

ü Notice of Site Visit: A notice of site visit was given and must remain posted for 30 days.

ü The regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare 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.

ü --Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.


n Our Quarterly updates come out every 3 months they are also now in Spanish please log in to the CCLD website or you can email our advocates to have the quarterly updates send directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

ü The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 AM - 5:00 PM.

ü A copy of the Safe Sleep Proposed Regulations was provided to Licensee.

ü LPA provided consultation during the inspection

No deficiencies are being cited at this time, the facility complies with Title 22


Exit interview conducted and report was reviewed with the licensee Kathryn Lukenbill.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2021
LIC809 (FAS) - (06/04)
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