<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197411710
Report Date: 04/06/2023
Date Signed: 04/06/2023 11:41:09 AM


Document Has Been Signed on 04/06/2023 11:41 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:BROOKS FAMILY CHILD CAREFACILITY NUMBER:
197411710
ADMINISTRATOR:BROOKS, REGINA L.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 733-4340
CITY:PALMDALESTATE: CAZIP CODE:
93551
CAPACITY:14CENSUS: 11DATE:
04/06/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:34 AM
MET WITH:Licensee Brooks Regina TIME COMPLETED:
12:00 PM
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
On 04/06/2023 Licensing Program Analyst (LPA) Andrew Alemoh, met with licensee, Regina Brooks who guided analyst on a tour of the facility for the One Year Required inspection. This is a one story 5 bedroom, 3 bathroom home with kitchen, dining room area, family room, and garage. There is no pool on the premises. Upon arrival LPA observed 11 children in care(1 infant) and 2 adults caring for them (licensee and assistant #1). Family members residing in the home include 2 adults (licensee, licensee's husband). Facility hours of operation are Monday - Friday 6AM- 6 PM. Incidental Medical Services (IMS) policy was discussed.

Physical Plant: Main care is provided in the playroom and living room area. Naps are provided on cots/cribs in the infant room and the living room. The children use the bathroom located in the hallway(first door on the right). The off-limits areas are two bedrooms, and two restrooms. Laundry room and garage are also off limits and are kept locked during business hours. The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds which are kept in the garage. (There are no medicines) Vitamins are kept in the kitchen cabinet high enough making it inaccessible to children, and hazardous items (sharp knives are kept in the closed door kitchen pantry high enough that they are inaccessible to children.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew AlemohTELEPHONE: 661-202-3365
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)
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: BROOKS FAMILY CHILD CARE
FACILITY NUMBER: 197411710
VISIT DATE: 04/06/2023
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
26
27
28
29
30
31
32
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 in the living room. Per Licensee, no one smokes in the home, and there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (cell).

Fire/Disaster drills are maintained current. Last fire disaster drill was completed on 10/03/2022. Their is a fireplace in the living room that is screened. Child rosters, sleep chart where observed.

Bathroom: (There is no shower/tub) Toilet and faucet are clean and operable. Underneath the bathroom sink are extra diapers. LPA did not observe any cleaning solutions, and or prohibited items in the children bathroom.

Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. The home has a clean and fully stocked refrigerator/freezer. Kitchen cabinets have safety latches. There is a food pantry where the sharp knives are stored Cleaning supplies are in the garage which is locked during business hours. Breakfast, lunch, snacks and dinner are provided. Licensee stated she currently does have a food program.

Outdoor: The front yard is off limits. The backyard is completely fenced in with a brick wall. The two AC units are barricaded and covered. LPA inspected the play structure to be sturdy, safe and age appropriate for children. The BBQ pit is fully covered. LPA observed 2 storage sheds in the back to be locked. Inside the sheds there are garden tools, as well as extra storage. On the left side of the backyard is a black iron fence that barricades the left side of the yard.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew AlemohTELEPHONE: 661-202-3365
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)
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: BROOKS FAMILY CHILD CARE
FACILITY NUMBER: 197411710
VISIT DATE: 04/06/2023
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
26
27
28
29
30
31
32
Per licensee the left side is off-limits to day care children. There are two dogs in the premises, that come in contact with day care children. LPA observed age appropriate toys, well secured and safe for children. There is a gated and separate area where licensee keeps a barbecue pit inaccessible to children.

Advisory/Other: First Aid kit was observed with supplies readily available in the kitchen cabinet. CPR/First Aid expires 06/23. Mandated Reporter expires on 06/23. LPA reminded licensee; mandated reporter training must be completed every 2 years.

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

Licensee Regina 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 Regina 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.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew AlemohTELEPHONE: 661-202-3365
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)
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: BROOKS FAMILY CHILD CARE
FACILITY NUMBER: 197411710
VISIT DATE: 04/06/2023
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
26
27
28
29
30
31
32
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 RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrew AlemohTELEPHONE: 661-202-3365
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)
Page: 4 of 4