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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153807995
Report Date: 09/19/2022
Date Signed: 09/19/2022 02:29:59 PM


Document Has Been Signed on 09/19/2022 02:29 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: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: 5DATE:
09/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:49 AM
MET WITH:Kathryn ukenbillTIME COMPLETED:
11:45 AM
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On 9/19/2022, Licensing Program Analyst (LPA) Carol Heath conducted an unannounced Required 1 Year inspection at the Lukenbill Family Child Care. Upon arrival, the LPA met with the licensee, Kathryn Lukenbill who guided the LPA on a tour of the facility. Family members residing in the home include 2 adults (licensee, licensee spouse) and three children. 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. During this inspection, there were 5 daycare children ( 3 infant, 2 Toddlers) and 1 assistant present. Incidental Medical Services (IMS) were discussed.

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. There is no pool, spa, or other bodies of water on the premises. The home was inspected for safety, comfort, cleanliness, telephone service, central air, and heat and ventilation. The home has central heating and air conditioning. All windows have screens and are free of cracks, bugs, and debris.
Ø Main Area: Main care is provided in the living room (at the entrance) and family room. Children use the bathroom (Bathroom #1) on the left at the entrance.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:
DATE: 09/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/19/2022
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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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: 09/19/2022
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· Living room/Family room: In the living room which is the designated playroom, LPA observed age-appropriate toys and furniture for the children. LPA observed: There is a TV that 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. 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 in 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.
· Children's Bathroom (#1): Children use the bathroom (Bathroom #1) on the left at the entrance. The Bathroom was toured and inspected sink/toilet is 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 and drawers. The bathroom was observed to be free and clear of hazardous items. The bathroom was clean, sanitized, and in good repair.
· Kitchen/Dining Room: The kitchen was inspected to ensure hazardous and dangerous items were inaccessible to children (Safety latches). In the kitchen, all sharp utensils, poisons, and medications are made inaccessible to children with child safety latches on cabinet doors and drawers. Sharp knives are kept in a butcher block in the gated kitchen.
· Backyard: The backyard was inspected; The backyard is gated all around. Children play in the backyard. Backyard: The backyard was inspected; The backyard is completely fenced. There is 4 small dog (the dogs run on the right). There is a large tree and wooden jungle gym (slide/swing) that is anchored. There is no body of water on the premises.
Off-limit: Off-limit areas include 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).

Ø Others:


· AC/Heating Unit was observed. AC/Heating Unit is located on the right side of the home and is inaccessible to children via barrels blocking access to the unit.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2022
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: 09/19/2022
NARRATIVE
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· Bodies of water: Per the licensee, there are no bodies of water in the home. There is a decorative water fountain that has no water.
· Electrical outlets: All unused electrical outlets are plugged in and made inaccessible to children.
· Fire extinguisher (2A10BC): LPA observed there is a required fire extinguisher (2A10BC) fully charged Date: 8/3/2022 and located in the kitchen inaccessible to children. It meets standards established by the State Fire Marshall.
· Fireplace: The fireplace was observed in the off-limits living room and is screened to make it inaccessible to the children.
· Hanging window blind cords: The cords are inaccessible to 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. The Licensee will not be providing IMS to the children at this time.
· Isolation area (Illness): Per licensee, if the child shows signs of illness, he/she will be separated from other children and stay in Family Room.
· Medications and cleaning solutions: Detergents/cleaning compounds are in the off-limit garage. Medications are in the upper kitchen cabinets
· Napping: Children will nap in the designated nap areas with adult supervision. LPA observed 12 mats and 3 playpen equipment.
· Overnight Care: Pre-licensee, she does not provide overnight care.
· Pets: 3 small dogs. They have current vaccinations.
· Phone service: There is a working landline or cell phone
· Smoke Detectors and Carbon Monoxide: The smoke detectors and carbon monoxide devices tested operable.
· Stairs (For two-story home): There is a safety gate barricaded to make the stairs inaccessible to the children.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2022
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: 09/19/2022
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· The First Aid kit: The First Aid kit is located in the off-limit area inaccessible to children on top of the refrigerator. The First Aid Kit was observed complete with supplies and a first aid manual.
· Transportation: The licensee does provide transportation for children. The licensee has a valid California driver's license with an expiration date of 10/2025. The licensee has valid vehicle insurance and vehicle registration.
· Weapons or Firearms: Per Licensee, there are weapons or firearms on the premise inaccessible to children (separate container with locks). LPA observed the ammunition stored and locked separately from firearms and the firing pins shall be stored and locked separately from firearms.
Ø Documentation:
· Child files: LPA observed 10 children's files contained all required licensing documents.
· 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.
· Criminal Record: Pre Guardian, all adults who live in this facility obtain a criminal record clearance.
· Facility fees: Per Licensing Information System, facility annual fees were current.
· Facility Roster: LPA observed the facility roster is complete and maintained current.
· 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 09/6/2022.
· Immunization: The licensee and her assistant have the required immunizations (MMR and DTaP). The licensee and her assistant provided a written statement declining the influenza vaccination.
· Infant Sleeping Plan (LIC 9227) and Sleeping Log: LPA observed 2 infants have LIC 9227 and the Sleeping log is also in each infant’s file.
· Licensee (does not) has posted as required the Facility License, Emergency Disaster plan, Earthquake Preparedness, and Parents Rights Poster
· Mandated Reporter Training: The licensee has completed and renewed the online mandated reporter training at www.mandatedreporterca.com on 10/3/2023
· Staff Personnel File: LPA observed 1 staff information. LPA observed LIC 508, 9052, IZ, TB test, LIC 9108, Mandated Reporter Training, and CPR/First Aid certificates. The file contained all required licensing documents.
· Staffing Ratio and Capacity: This is a large family childcare facility. LPA observed 5 children 3 infant, 2 Toddlers during the inspection.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2022
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: 09/19/2022
NARRATIVE
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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.
ü Capacity requirements, Roster requirements, Posting requirements, and 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. The licensee was advised that the 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 The 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 Hot-line 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 the 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.
ü Safe Sleep: LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage 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.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2022
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: 09/19/2022
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ü Notice of Site Visit: A notice of site visit was given and must remain posted for 30 days.
ü Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
ü Type A citation: LPA (name of analyst) informed licensee [or facility representative] (include name) that this report dated (insert visit date) document(s) (number of Type A citation) Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.
Also, LPA (name of analyst) informed the licensee [or facility representative] to provide a copy of this licensing report dated (insert visit date) that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
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 sent 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 the 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: 09/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2022
LIC809 (FAS) - (06/04)
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