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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197412230
Report Date: 02/17/2022
Date Signed: 02/17/2022 04:05:45 PM


Document Has Been Signed on 02/17/2022 04:05 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:MAYER FAMILY CHILD CAREFACILITY NUMBER:
197412230
ADMINISTRATOR:MAYER, MICHELLEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 285-5077
CITY:PALMDALESTATE: CAZIP CODE:
93552
CAPACITY:14CENSUS: 5DATE:
02/17/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:24 PM
MET WITH:Michelle MayerTIME COMPLETED:
04:20 PM
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Licensing Program Analyst (LPA) Justin Dorsey met with Licensee, Michelle Mayer, 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 area, family room (main care area), living room, laundry room and garage. There is no pool on the premises. During the visit there were 5 children present.

Physical Plant: Main care is provided in the converted family room. Children use the bathroom in the hallway near the bedrooms. Children have access to the family room and the side back yard area. Off limit areas include the homes bedrooms, living room, garage and back portion of the homes backyard. 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 (master bathroom) and hazardous items (sharp knives above the refrigerator) that can pose a danger to children. Fireplace is screened. The home has safe and age appropriate toys, play equipment and materials. The smoke detector and carbon monoxide detector are in operable condition. LPA Dorsey observed the home to have 1A10BC fire extinguisher, LPA advised the licensee to get a 2A10BC fire extinguisher. Per Licensee no one smokes in the home. No baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/ play equipment were observed on the premises. Per licensee all ill children are immediately taken home. Per Licensee there are no weapon/firearms in the home.

The last fire/earthquake drill was completed 02/11/21, LPA advised licensee to conduct a fire drill and log the time and date. LPA reminded the licensee that fire drills must be conducted every 6 months. 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 YatesTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:
DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/17/2022
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: MAYER FAMILY CHILD CARE
FACILITY NUMBER: 197412230
VISIT DATE: 02/17/2022
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Kitchen: Sharp utensils are inaccessible. Cleaning supplies are locked under the sink. No chemicals in the kitchen were observed to be accessible. Breakfast, lunch, PM snack and dinner are provided. Per licensee outside food is not allowed to be brought to the facility.

Outdoor: The home has an on-limits and off-limits areas to the backyard. The on-limits area of the backyard is safe for children. The backyard is completely fenced. The on-limits backyard has grass 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 expires 06/16/23. The licensees Mandated Reporter was completed 06/08/21. Child nap on mats in the main care area.

Documents discussed: Safe Sleep PIN 20-24-CCP and Large Family Child Care ratios.

Licensee Mayer 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 Mayer 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 Mayer 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 Michelle Mayer.

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022
LIC809 (FAS) - (06/04)
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