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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153908117
Report Date: 01/31/2024
Date Signed: 01/31/2024 02:23:18 PM

Document Has Been Signed on 01/31/2024 02:23 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:WADE, PATRICIA FAMILY CHILD CAREFACILITY NUMBER:
153908117
ADMINISTRATOR:WADE, PATRICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 305-0997
CITY:ROSAMONDSTATE: CAZIP CODE:
93560
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
01/31/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:11 PM
MET WITH:Patricia Wade, LicenseeTIME COMPLETED:
02:30 PM
NARRATIVE
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On January 31, 2024, Licensing Program Analyst (LPA) Calloway met with Licensee, who granted access. LPA and Licensee toured the home inside and outside for a Required Annual inspection. Residing in the home are the Licensee, and spouse. The home is licensed for twelve to fourteen children. LPA observed two (2) small children in active care with three staff during inspection.
Physical Plant: This is a two story 5-bedroom, 3-bathroom home with kitchen, laundry room, loft, family room, living room, and garage. Childcare is provided: in Living room (upon entry) and family room. Children’s Bathroom: off the childcare area (observed). Unused outlets (covered). Blinds (up high). Age-appropriate toys, furniture, and books (observed). Napping equipment (mats). The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (under kitchen sink with safety latch), medicines (kitchen – safety latch).
Kitchen: hazardous items that can pose a danger to children (sharp knives- kitchen cabinet- safety latch) Fire/earthquake drills complete (current). Roster (current). The required fire extinguisher (2A10BC) (full/green). Smoke detectors and carbon monoxide detectors (operable). Fireplace is screened. Home has central AC and heat. Required postings were present on the wall. No landline phone, but cell phone. Stairs (gated). Fire alarm pull (observed). Surveillance cameras (observed) in day care area. Per licensee, they are active, with the exception of one.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE: DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/31/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: WADE, PATRICIA FAMILY CHILD CARE
FACILITY NUMBER: 153908117
VISIT DATE: 01/31/2024
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Off limit areas: Garage (key lock), Entire upstairs, Bedrooms: #1, #2, #3, #4, #5 (safety knobs), Bathrooms: #2, #3, kitchen, laundry, and loft.
Outside: The backyard is completely fenced. Pets: three large dogs, two cats, (vaccinated). Per Licensee, the pets interact with the day care children. Age-appropriate toys, bikes, and play equipment. There is an above ground pool (empty/broken) and spa (safety lock) on the premises. Pool Fence surrounding the pool (iron) at least five feet high (unlocked) and constructed so that the fence does not obscure the pool from view. In addition to meeting all of the aforementioned requirements for fences, gate swings away from the pool, it is self-closing and has a self-latching device located no more than six inches from the top of the gate. AC unit (covered).
Others: Per Licensee, there are no weapons or firearms on the premises. LPA did not observe any in the home. Required mandated reporter training (not current), CPR/First Aid (Exp: 5/2025), and immunizations (current for Licensee, not spouse). First Aid kit (observed). LPA viewed staff and children’s files and no infants in care. LPA conducted a staff interview with the licensee. Transportation is provided (insurance verified). Incidental Medical Services (IMS) policy and Safe Sleep regulations were discussed.
The following was discussed with the Licensee:
Maintain capacity and transparency per posted parent rights, Roster requirements (keep updated information always), Documentation for disaster drills (fire and earthquake). Mandatory forms, signed, for the children’s files and provider’s files, updated Safe Sleep regulations. The role and responsibilities of being a mandated reporter were reviewed. Licensee reminded that supervision is always required to children in care. If food is brought in, it is properly labeled. Licensee will check food expiration dates periodically.Licensee was advised on how to access forms and regulations for Family Child Care online at www.ccld.ca.gov.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024
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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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: WADE, PATRICIA FAMILY CHILD CARE
FACILITY NUMBER: 153908117
VISIT DATE: 01/31/2024
NARRATIVE
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 Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care and temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day. If closed for the day, (no kids), or absent notify Licensing. 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. Regulations prohibit the smoking of tobacco in a private residence that is licensed as a family childcare home and areas of the 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.

Type A deficiency: Type A deficiency shall be posted for 30 consecutive days along with the Notice of Site Visit Letter (printed out after every visit) and posted during hours of operation, as there is an immediate risk to the health, safety, or personal rights of children in care. Licensee shall provide a copy any Type A deficiency 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 the Type A report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224) must be placed in the child's file for verification of the Type A deficiency. Failure to do so will result in a civil penalty being assessed. Licensee is advised to visit: www.shotsforschool.org for Immunization information.


--Licensee was informed of their responsibility to report suspected Child Abuse (LIC 9108), 1-800-827-8724/760-243-6640
--Family Child Care Providers (Disaster Planning information): https://cccld.childcarevideos.org/family-child-care-providers/disaster-planning-and-fire-safety/
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024
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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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: WADE, PATRICIA FAMILY CHILD CARE
FACILITY NUMBER: 153908117
VISIT DATE: 01/31/2024
NARRATIVE
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--Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov
--Child Care Videos: https://ccld.childcarevideos.org
--Licensee advised to visit the CCLD website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulationsIncidental 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 prior to providing the IMS. 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.
Lead Poisoning: For more information, go to the California Childhood Lead Poisoning Prevention Branch’s website at www.cdph.ca.gov/programs/clppb,or call them at (510) 620-5600. Reminder: The On Duty Worker is available for questions at: (661) 202-3318 (Monday-Friday 8am-5pm) and for reporting Unusual Incident Reports (within 24 hours). Written Unusual Incident Reports are sent (using (LIC 624B form) to the following email address: unusualincidentreport@dss.ca.gov within seven (7) days after reporting the incident via telephone.

Per Title 22 Regulation, Division 12, Chapter 1, there are deficiencies cited during this inspection. See 809D pages attached to this report.

An exit interview was conducted, a copy of this report was read, and a Notice of Site Visit, Appeal Rights were provided to S1, Licensee. A Notice of Site Visit must remain posted for thirty (30) consecutive days. Failure to maintain the posting will result in $100 civil penalty.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024
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Document Has Been Signed on 01/31/2024 02:23 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 01/31/2024 at 02:08 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: WADE, PATRICIA FAMILY CHILD CARE
FACILITY NUMBER: 153908117

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/31/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on observation, interview, Record review], the licensee did not comply with the section cited above in two staff S1 and S3 did not have updated mandated reporter training which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/08/2024
Plan of Correction
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2
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Licensee will provide proof of training by POC date
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(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 between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in Staff 2 (spouse) did not have MMR, and Tdap immunizations which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/15/2024
Plan of Correction
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Licensee will provide proof of immunizations by POC date.
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:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 01/31/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/31/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/31/2024 02:23 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 01/31/2024 at 02:08 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: WADE, PATRICIA FAMILY CHILD CARE
FACILITY NUMBER: 153908117

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/31/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102418(g)
Immunizations
(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review the licensee did not comply with the section cited above in C4 did not have immunization records in their file which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/15/2024
Plan of Correction
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Licensee will provide proof of child's immunization by POC date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 01/31/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/31/2024


LIC809 (FAS) - (06/04)
Page: 6 of 7
Document Has Been Signed on 01/31/2024 02:23 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 01/31/2024 at 02:08 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: WADE, PATRICIA FAMILY CHILD CARE
FACILITY NUMBER: 153908117

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/31/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102419(d)(1)
Admission Procedures and Authorized Representatives Rights
(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). (1) The licensee shall request the child's parent or authorized representative to sign and date the bottom portion of the notice form LIC 995A (8/06), which acknowledges that the parent or
authorized representative has received and read the LIC 995A. The bottom portion of this form
must be kept in the child’s file as proof that the parent or authorized representative has been
notified of his or her rights and received a copy of the Caregiver background Check Process, LIC
995E (6/05), and the Family Child Care Consumer Awareness Information, LIC 9212 (10/05).

This requirement is not met as evidenced by:
Deficient Practice Statement
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3
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Based on observation, interview, record review, the licensee did not comply with the section cited above in three children C1, C2, C3 did not have LIC 995A form in files which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/15/2024
Plan of Correction
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2
3
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Licensee will provide proof to Licensing by POC date.

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:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 01/31/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/31/2024


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