197407366-4-6-2023-12-CC-AVIA-CQMSLA-20230406135801

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197407366
Report Date: 04/06/2023
Date Signed: 04/06/2023 01:58:48 PM

Document Has Been Signed on 04/06/2023 01:58 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:	WHITE FAMILY CHILD CARE		FACILITY NUMBER:	197407366
ADMINISTRATOR:	LATOYIA WHITE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 838-3693
CITY:	MISSION HILLS	STATE: CA	ZIP CODE:	91345
CAPACITY:	14	CENSUS:	DATE:	04/06/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:42 PM
MET WITH:	Latoyia White, Licensee		TIME COMPLETED:	02:20 PM

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On April 6, 2023, Licensing Program Analysts (LPA) Annelise Villa, met with licensee, Latoyia White who guided analyst on a tour of the facility for the One Year Required inspection. Upon arrival LPA observed 9 children in care and 2 adults caring for them. Family members residing in the home include Licensee. Facility hours of operation are Monday - Saturday, for 24 hours. Incidental Medical Services (IMS) policy was discussed.

Physical Plant: This is a one story family home. The home consists of a kitchen, living room, family room, three bedrooms, 2.5 bathrooms, and front yard. The primary care for children will be conducted in the living and family rooms. Bathroom #1 located on the right side of the living room. The home was inspected inside and out for safety, comfort, cleanliness, orderliness, telephone service (cell phone), heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds which are kept in bathroom #2 which is locked and off limits to children in care, and medicines are kept in a kitchen cabinet, sharp knives are kept in the kitchen drawer. The kitchen is off limits and made inaccessible to children with a safety gate. Children nap on cots in the daycare area.

Safe and age appropriate toys, play equipment and materials were observed. The smoke detector, carbon monoxide detector and Fire Extinguisher (2A10BC) are all in operable condition. Electrical outlets are inaccessible. No recalled and or prohibited toys or sleep/ play equipment were observed on the premises. There is a designated area for ill children as necessary. Per Licensee, there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (cell).

Bathroom: LPAs observed toilet and faucet are clean and operable. There are no shampoos or cleaning products in bathroom #1.

Continued on LIC 809-C

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Annelise Villa	TELEPHONE: 661-202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: WHITE FAMILY CHILD CARE	FACILITY NUMBER: 197407366
	VISIT DATE: 04/06/2023

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Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. The home has a clean and fully stocked refrigerator/freezer. Breakfast, lunch, dinner, and snacks are provided, depending on the times the children are in care. Licensee stated she currently is not a participant in a food program.

Outdoor: The front yard is used for outdoor play. The front yard is completely fenced in with a tall wooden fence. There are age appropriate play equipment that is in good repair.

Pools/Spas/Bodies of Water: There is a swimming pool and a spa in the backyard. The bodies of water are completely enclosed by a 5 ft mesh fence. The fence runs all the way down to the concrete on which it sits, leaving no room between the bottom of the fence and the concrete. The pool gate was tested and observed to be self-closing and self-latching. The gate has an installed mechanism containing a key to lock the gate and it is located within 6 inches from the top of the gate. The lever to open the gate is located at the top of the gate. The pool gate opens away from the body of water. All items rendering the fence climbable are moved away from the fence. The mesh fencing is sturdy and capable of withstanding the impact of children's toys including bicycles. There are no other bodies of water on the premises.

Advisory/Other: First Aid kit was observed in a hall closet with supplies readily available. CPR/First Aid expires 3/2024. Mandated Reporter expires on 5/2022. LPA reminded licensee mandated reporter training and CPR/First Aid certification must be renewed every 2 years.

The facility annual fees are current. Licensee had all the required posted documents: Facility License (LIC 203), Notice of Parent's Rights Poster (PUB 394), Emergency Disaster Plan (LIC 610A), and Earthquake Preparedness Checklist (LIC 9148). Children files were found to be complete. Fire/Disaster drills are maintained current. Fire disaster was completed on 4/6/2023.

Documents Provided and or Discussed: Fire Drill Log, Postings, Children's records, Safe Sleep PIN 20-24-CCP and Individual Sleeping Plan (LIC9227). Licensee currently does have child care insurance.

Licensee 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.

Continued on LIC 809-C

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Annelise Villa	TELEPHONE: 661-202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: WHITE FAMILY CHILD CARE	FACILITY NUMBER: 197407366
	VISIT DATE: 04/06/2023

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LPA discussed the safe sleep regulations with licensee 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. LPAs also informed licensee 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. Currently no Incidental Medical Services are provided to children in care. LPA reviewed equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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/childquanda.htm

Director advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department (email address on the website: www.unusualincidentreport@dss.ca.gov). A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of the day care center. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. An On Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

As a result of this inspection, licensee is found to be in compliance with Title 22 and CCR regulations. No citations were given today.

An exit interview was conducted, a copy of this report was reviewed and provided to licensee along with the appeal rights.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Annelise Villa	TELEPHONE: 661-202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

LIC809 (FAS) - (06/04)

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