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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157700064
Report Date: 12/23/2021
Date Signed: 12/23/2021 02:42:49 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:ATKINS FAMILY CHILD CAREFACILITY NUMBER:
157700064
ADMINISTRATOR:DARLETTA ATKINSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(442) 247-7077
CITY:CALIFORNIA CITYSTATE: CAZIP CODE:
93505
CAPACITY:14CENSUS: 0DATE:
12/23/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Applicant Darletta AtkinsTIME COMPLETED:
02:55 PM
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On December 23, 2021 at 9:20AM, Licensing Program Analyst (LPA) Brigitte Tsutaoka met with Applicant, Darletta Atkins, who guided LPA on a tour of the facility for a Pre-licensing inspection for a Large Family Child Care Home with a capacity of 14. This is a single story 4 bedroom, 2 bathroom home with kitchen/dining, living room, and attached garage. There is no pool/spa or body of water on the premises. Family members residing in the home include 1 adult (applicant) and one child. Hours of operation are Monday Through Friday, 5:30AM until 7:00PM. Incidental Medical Services (IMS) policy was discussed.

Main care is provided in living room and bedroom (at entrance). Children use the bathroom at end of hallway next to sick room/office. Off limits areas include Bedroom #1 through #3, bathroom #2, kitchen, and garage. Applicant agreed to obtain safety gate to make kitchen inaccessible. The home was inspected inside and out for safety, comfort, cleanliness, telephone service (land line), heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (top kitchen cabinet), medicines (Bedroom #1) and hazardous items (sharp knives in upper kitchen cabinet) that can pose a danger to children. Applicant reminded to conduct fire/earthquake drills every 6 months and document. A Roster was provided to Applicant to complete and maintain.

The backyard is completely fenced. There is one dog that stays in Bedroom #2 or dog run and one cat that stays in Bedroom #1. Applicant stated they will be adding faux grass and additional outdoor toys, but renovations have not begun yet. Facility has one grill next to side yard/dog run. Applicant agreed to move grill in inaccessible/off-limits area dog run before licensure.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte TsutaokaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2021
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 4
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: ATKINS FAMILY CHILD CARE
FACILITY NUMBER: 157700064
VISIT DATE: 12/23/2021
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Per Applicant, there are no weapons or firearms on the premises. LPA did not observe any in the home at this time. There are age appropriate toys. Age appropriate napping equipment (mats). The required fire extinguisher (3A40BC; 2A10BC minimum), smoke detector and Carbon Monoxide Detector are in operable condition. Fireplace needs secure gate to make inaccessible. Home has central AC and heat. CPR/First Aid expire 07/20/2023. Preventive Health and Safety training with Lead Poisoning Prevention and Nutrition completed 12/10/2021. Fire clearance completed/approved 11/17/2021. The First Aid kit was observed and is complete. Applicant agreed to purchase no-touch thermometer before licensure.

The following was discussed with the Applicant:
Mandatory Forms for the children’s files and provider’s files. Requirements for fire drills, earthquake drills and documentation for both. Role and responsibilities of being a mandated reporter were reviewed. Applicant reminded that 100% supervision is required at all times to children in care. Applicant was advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov . Applicant was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care. Applicant was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified. Regulation prohibits the smoking of tobacco in a private residence that is licensed as a family child care 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.

--Applicant is advised visit www.shotsforschool.org for Immunization information.
--Applicant was informed of responsibility to report suspected Child Abuse, 1-800-827-8724/760-243-6640
--Family Child Care Providers (Disaster Planning information): https://ccld.family-child-care-providers/disaster-planning-and-fire-safety/
--Child Care Videos: https://ccld.childcarevideos.org
--Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte TsutaokaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2021
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: ATKINS FAMILY CHILD CARE
FACILITY NUMBER: 157700064
VISIT DATE: 12/23/2021
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--Applicant advised to visit the CCL website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.
--Provider Information Notice (PIN) Summary - PIN 18-02-CCP; Family Child Care Providers (Disaster Planning information):https://cccld.childcarevideos.org/family-child-care-providers/disaster-planning-and-fire-safety/

Applicant 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 LIC624. Pamphlet Information regarding SIDS, Seat Belt Safety, and Notification of Parent's Rights poster (Palmdale Regional Child Care Office) were provided. The "Notification of Parent's Rights" poster must be posted in an area of the home accessible to parents. The information regarding new legislation with regards to exemptions and Parent’s Rights was also discussed.

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

Requirements for fingerprint clearances and associations were discussed with the Applicant. The applicant was informed that all adults living in or having access to the home are required to have fingerprint clearances with Department of Justice, FBI and Child Abuse Index prior to having contact with children. If the aforementioned is not adhered to, a Civil Penalty of up to $500, per non-cleared adult will be assessed immediately.

Applicant informed to review Quarterly updates/regulations for 2021/2022.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte TsutaokaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2021
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: ATKINS FAMILY CHILD CARE
FACILITY NUMBER: 157700064
VISIT DATE: 12/23/2021
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Applicant was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent when a serious deficiency, Type A, is cited (LIC9224).

During inspection, COVID-19 technical assistance was provided. The Child Care Program COVID-19 Self-Assessment is completed and placed in the facility file.

The On Duty Worker is available for questions at 661-202-3318 Monday through Friday 8:00AM-5:00PM. LPA provided consultation during the inspection.

Before licensure the following must be completed:
1. Install gate on fireplace to make inaccessible.
2. Install safety gate at kitchen entrance to make off-limits.
3. Move grill to off-limits area.
4. Install safety locks on cabinets in day care room.
5. Install child safety door knob cover on off-limits bedrooms.
6. Proof of purchase of no-touch thermometer.
7. Cushion pole base in backyard.

Once corrections have been verified, the application for a large Family Child Care Home will be submitted for approval with a maximum capacity of 12 or 14 with parent notification. Applicant advised that all corrections are due within 30 days or the application may be withdrawn.

An exit interview was conducted, a copy of this Report, and Appeal Rights were provided to the Applicant Darletta Atkins.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte TsutaokaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4