197412740-8-15-2023-12-CC-JTAO-CUQUBR-20230815152647

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197412740
Report Date: 08/15/2023
Date Signed: 08/15/2023 03:26:54 PM

Document Has Been Signed on 08/15/2023 03:26 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:	SHEPHERD FAMILY CHILD CARE		FACILITY NUMBER:	197412740
ADMINISTRATOR:	SHEPHERD, DARNISHA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 718-2652
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93536
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 16	DATE:	08/15/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:38 PM
MET WITH:	Darnisha Shepherd,Licensee		TIME COMPLETED:	03:45 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 09/15/22, Licensing Program Analyst (LPA) Justeene Tamayo met with Licensee, Darnisha Shepherd, who guided analyst on a tour of the facility for the One Year Required inspection. This is a one story, 4 bedroom, 2.5 bathroom home with kitchen/dining, family room, living room, laundry room and garage. There is a pool/spa or body of water on the premises. Upon arrival LPA observed 3 infants children in care, and 13 preschool children in care, along with two assistants. Family members residing in the home include 2 adults (licensee and licensee's husband) and 1 minor children. Facility operation are Monday-Friday 7AM-5PM. Incidental Medical Services (IMS) policy was discussed. During inspection, licensee was over capacity with 16 children, which poses an immediate risk to children in care. Facility has been cited a Type A Citation. Please see LIC809-D for Deficiency page. This report cites a Type A violation and shall be provided to the parents/guardians of children currently enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 and must be kept in each child's file. Physical Plant: Main care is provided in the living room. Children use the bathroom in hallway on the left. Children have access to the living room and family room. Off limit areas include all bedrooms, bathrooms (#2 and a half), laundry room, and garage. 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 (under kitchen sink with safety latch), medicines (master bedroom with door lock) and hazardous items (sharp knives in upper kitchen pantry unreachable to children in care) that can pose a danger to children. LPA observed the fireplace to be screened. Safe and age appropriate toys, play equipment and materials were observed. The smoke detector and carbon monoxide detector, Fire Extinguisher (3A40BC) are in operable condition. Per Licensee no one smokes in the home.

Mariela Ramon
Justeene Tamayo
	DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: SHEPHERD FAMILY CHILD CARE	FACILITY NUMBER: 197412740
	VISIT DATE: 08/15/2023

NARRATIVE

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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 bedroom #1. LPA observed a firearm and ammunition stored separately in safe (off limits area) following Title 22 regulations. The facility sketch is complete and current, there is working telephone (cell).

Fire/Disaster Drill is complete and maintained current. Last Fire/Disaster drill was completed on 08/04/2023.

Roster complete and maintained current.

Bathroom: Shower/tub are free of hazards (child care bathroom). LPA did not observe any hazardous items in the children's bathroom. Toilet and faucet are clean and operable.

Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. If food is brought from the children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated. The home has a clean and fully stocked refrigerator/freezer. Cleaning supplies are under kitchen sink with safety latch. Breakfast, lunch and snacks are provided. Naps are provided on cots in main care area.

Outdoor: The backyard is safe for children. The backyard is completely fenced (with block cement). LPA observed the in ground swimming pool to be fully barricaded with self latch gate over 5 Ft high, pulling away from the swimming pool. There is an outdoor air conditioner inaccessible to children with barricaded gate. The swimming pool observed follows Title 22 regulations. LPA observed age appropriate toys. Per licensee, there are two dogs on the premises.

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expires on 12/21/2024. Mandated Reporter expires on 09/17/2024. There are no window cords accessible to children.

SUPERVISOR'S NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: SHEPHERD FAMILY CHILD CARE	FACILITY NUMBER: 197412740
	VISIT DATE: 08/15/2023

NARRATIVE

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Documents Provided and or Discussed: Fire Drill Log, Roster, Postings, Safe Sleep PIN 20-24-CCP, Individual Sleeping Plan (LIC9227) and Emergency Disaster Plan. Licensee stated currently does not have child care insurance.

Licensee Shepherd 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 Shepherd 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 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 to licensee 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 Darnisha Shepherd along with her appeal rights and Notice of Site Visit.

SUPERVISOR'S NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/15/2023 03:26 PM - It Cannot Be Edited

Created By: Justeene Tamayo On 08/15/2023 at 03:09 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: SHEPHERD FAMILY CHILD CARE	FACILITY NUMBER: 197412740
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/15/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102416.5(d)(2)

Staffing Ratio and Capacity

(d) For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either: (2) More than twelve and up to fourteen children only if the criteria in Section 1597.465 of the Health and Safety Code are met. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above. Licensee had 16 day care children, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 08/15/2023
	Plan of Correction
1 2 3 4	Licensee shall ensure she is following a large family home child ratios and capacity. Licensee is aware she can have no more than 4 infants with a total of 12 children or 14 total children with no more than 3 infants, 1 child enrolled in kindergarten, and 1 child at least age 6.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Mariela Ramon

LICENSING EVALUATOR NAME:

Justeene Tamayo

LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

LIC809 (FAS) - (06/04)

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