197407525-6-9-2022-12-CC-JDOY-CF8PLN-20220609112500

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197407525
Report Date: 06/09/2022
Date Signed: 06/09/2022 11:25:11 AM

Document Has Been Signed on 06/09/2022 11:25 AM - 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:	PUGH FAMILY CHILD CARE		FACILITY NUMBER:	197407525
ADMINISTRATOR:	PUGH, DENISE SUE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 724-9086
CITY:	LAKE HUGHES	STATE: CA	ZIP CODE:	93532
CAPACITY:	14	CENSUS: 10	DATE:	06/09/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:05 AM
MET WITH:	Denise Pugh		TIME COMPLETED:	11:40 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Justin Dorsey met with Licensee, Denise Pugh, who guided analyst on a tour of the facility for the One Year Required Inspection. This is a one story 3 bedroom, 2 bathroom home with kitchen, dining room area, living room, and garage. There is no pool on the premises. Upon arrival LPA observed 10 children with the licensee and assistant #1. Physical Plant: Main care is provided in the family room. Children use the bathroom in hallway near the homes bedrooms. Children have access to the living room room, dining room area, one bedroom (play room) children's bathroom and backyard. Off limit area include 2 of the homes bedrooms, 1 bathroom, kitchen, and garage. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (locked under the sink), medicines (in master bedroom) and hazardous items (sharp knives/scissors inaccessible in top kitchen cabinet) that can pose a danger to children. The hove has a wood burning furnace which is barricaded. The home has safe and age appropriate toys, play equipment and materials. The smoke detector and carbon monoxide detector, and Fire Extinguisher (2A10BC) are in operable condition. Per Licensee no one smokes in the home. Electrical outlets are inaccessible, no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/play equipment were observed on the premises. There is a designated area for ill children as necessary in the hallway. Per licensee, there are firearms present at this facility. Fire arms were observed to be locked and ammunition was separate from the firearm. The last fire/earthquake drill was completed 05/26/22. Roster complete and maintained current. Bathroom: Shower/tub are free of hazards (child care bathroom). Toilet and faucet is clean and operable.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

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: PUGH FAMILY CHILD CARE	FACILITY NUMBER: 197407525
	VISIT DATE: 06/09/2022

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Kitchen: Sharp utensils are inaccessible. Per licensee breakfast, AM snack, lunch, PM snack are provided. LPA reminded licensee If food is brought from the children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. Cleaning supplies are locked under the sink. No chemicals in the kitchen were observed to be accessible.

Outdoor: The backyard is safe for children and completely fenced. The backyard has grass, concrete areas and sand boxes for children to play. LPA observed the toys in the backyard to be in safe condition.

Advisory/Other: First Aid kit was readily available. CPR/First Aid expire 08/2023. Mandated Reporter was completed 02/14/22. Children nap on mats in the living room.

Documents discussed: Safe Sleep PIN 20-24-CCP and Infant Sleep Log.

Licensee Pugh 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.

LPA discussed the safe sleep regulations with licensee Pugh 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 Pugh 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.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Denise Pugh.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin Dorsey	TELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

LIC809 (FAS) - (06/04)

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