197413269-2-7-2023-12-CC-JDMO-CNTTWC-20230207140519

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197413269
Report Date: 02/07/2023
Date Signed: 02/07/2023 02:06:44 PM

Document Has Been Signed on 02/07/2023 02:06 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:	WHEELER FAMILY CHILD CARE		FACILITY NUMBER:	197413269
ADMINISTRATOR:	WHEELER, CYNTHIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	6619464548
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93535
CAPACITY:	14	CENSUS: 2	DATE:	02/07/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Cynthia Wheeler		TIME COMPLETED:	02:10 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 01/27/2023, at 9:20 a.m., Licensing Program Analyst (LPA) Joselito L. Del Mundo conducted an unannounced annual inspection at the Wheeler Family Child Care Home to assess the Facility operation of their program, its current physical plant status and its ability to meet compliance with California Code of Regulations (CCR) Title 22, Health and Safety requirements, and other applicable State and Licensing Statutory requirements. LPA Del Mundo met with Licensee, Cynthia Wheeler and stated the reason for the inspection. The LPA provided a copy of the Entrance checklist form, LIC 126. At 10:00 a.m., Licensee guided the analyst on a tour of the day care areas. Area where care is being provided is the converted garage/day care room. Licensee states the day care hours of operation is from 8:00 am to 5:00 pm, Monday to Friday, and she does not provide transportation to children in care. Currently living in the home is licensee, licensee’s spouse and two adult daughters (32, 35). Physical Plant The facility is a two story house. The home is clean and orderly, with heating and ventilation for safety and comfort, maintains a telephone service, (Licensee was advised that the cell phone shall be charged and available during day care hours) has safe age-appropriate toys, play equipment and materials for children in care to use. At the time of this inspection, there are no fixtures, furniture, and equipment that have been banned or recalled by the United States Consumer Product Safety Commission. Per Licensee, she provides food (breakfast, snacks, lunch and snacks) for children in care. 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: Lady King	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundo	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

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 6

Document Has Been Signed on 02/07/2023 02:06 PM - It Cannot Be Edited

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: WHEELER FAMILY CHILD CARE	FACILITY NUMBER: 197413269
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/17/2023
	Plan of Correction
1 2 3 4	Licensee and assistant will email the Mandated Reporter Training Certificate to LPA.

Type B

Section Cited

CCR

102421(b)

Child's Records

(b) The licensee shall maintain, in each child's record, a copy of the emergency information card as required in Section 102417(g)(7). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/17/2023
	Plan of Correction
1 2 3 4	Licensee will email a copy of the Emergency Information Cards of children to LPA.

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: Lady King	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundo	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC809 (FAS) - (06/04)

Page: 2 of 6

Document Has Been Signed on 02/07/2023 02:06 PM - It Cannot Be Edited

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: WHEELER FAMILY CHILD CARE	FACILITY NUMBER: 197413269
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(7)

Operation of A Family Child Care Home

(7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/17/2023
	Plan of Correction
1 2 3 4	Licensee will email the signed Consent for Emergency Medical Treatment form of children to LPA.

Type B

Section Cited

CCR

102417(m)(3)

Operation of A Family Child Care Home

(3) A file of affidavits signed by each parent with a child enrolled in the home. The affidavit shall state that the parent has been informed that the family child care home does not carry liability insurance or a bond according to standards established by the state. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/17/2023
	Plan of Correction
1 2 3 4	Licensee will email the signed affidavits by parents regarding Liability Insurance of children to LPA.

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: Lady King	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundo	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC809 (FAS) - (06/04)

Page: 3 of 6

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: WHEELER FAMILY CHILD CARE	FACILITY NUMBER: 197413269
	VISIT DATE: 02/07/2023

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

Pg2
The home is free from defects or conditions which might endanger a child. The fireplace is located in the living room and is covered with a glass to prevent access by children. It has operational carbon monoxide-smoke detector and fire extinguisher which meet established standards. Licensee is aware that when children in care are less that five years old, stairs shall be fenced or barricaded. Poisons, detergents, cleaning compounds are stored in the upper cabinets in the kitchen (off-limits) where they are locked and inaccessible to children. Medicines are stored in the first aid kit box in the laundry room (off-limits). Per licensee, there are no firearms in the facility. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, have been instructed in their duties under the disaster plan. Newly enrolled children are informed promptly of their duties as required in the emergency plan. Fire drills and disaster drills are conducted at least once every three months and/or more often, the licensee document the drills, including the date and time of each drill. There are no baby walkers in the facility. Licensee is aware that smoking is prohibited on the premises of a family child care home.

Currently, there are no infants in their program but have two cribs/play yards. Licensee is aware that there must be one crib or play yard for each infant who is unable to climb out of the crib or play yard. The crib(s) or play yards use by the facility must meet the United States Consumer Product Safety Commission safety standards. Placement of crib(s or play yards shall not hinder entrance or exit to and from the space where infants sleep. Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged. The mattresses shall be made specifically for the size crib or play yard in which they are placed.

The facility has no bodies of water on the premises. The outdoor play area (backyard) is properly fenced and supervised by the licensee. The LPA explained to Licensee how to obtain information from the Community Care Licensing (CCL) website (www.cdss.ca.gov).

SUPERVISOR'S NAME: Lady King	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundo	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC809 (FAS) - (06/04)

Page: 4 of 6

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: WHEELER FAMILY CHILD CARE	FACILITY NUMBER: 197413269
	VISIT DATE: 02/07/2023

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

Pg3
Care and Supervision
Per Licensee, she is present in the home during child care time and ensure all children in care are supervised at all times. When circumstances requires her to be temporarily absent from the home, she arranges for a substitute adult to care for and supervise the children during her absence. Per Licensee, her temporary absences does not exceed 20 percent of the hours that the facility is providing care per day. Licensee states that when a child shows signs of illness he/she is separated isolated other children in the living room.

Facility Administration
The licensee and assistant do have a current mandated reporter training certificate. The Licensee and assistant has current Pediatric CPR and First Aid training certificate. Licensee and assistants has proof of immunizations against influenza, pertussis, and measles. Licensee and assistant have any TB skin test on file. Licensee and assistants were advised to take the training on preventive health practices. At the time of inspection, Licensee is aware of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing on the day of the incident and/or within 24 hours of incident by telephone, fax and/or in writing to the Department. Licensee is familiar with the Unusual Incident Report form, LIC624B. The report on unusual incident/injuries can also be mailed to unusualIncidentreport@dss.ca.gov

Licensee is aware that personnel records should be maintained on Licensee and each assistant (if any) and contain the following information: Licensee and staff full name; A signed and dated copy of the Notice of Employee Rights [LIC 9052]; Driver's license number if the employee is to transport children; Date of employment; Date of birth; Current home address and phone number; Documentation of completion of training on preventative health practices as required by Section 102416(c). All personnel records are maintained at the facility. Any changes to the facility from an area of the family child care home should be reported to the Department.

SUPERVISOR'S NAME: Lady King	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundo	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC809 (FAS) - (06/04)

Page: 5 of 6

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: WHEELER FAMILY CHILD CARE	FACILITY NUMBER: 197413269
	VISIT DATE: 02/07/2023

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

Pg4
Records
Licensee and other adults living in the home, working at and associated to the facility have received criminal record clearance. At the time of inspection, there are no emergency information card maintained for two children present in the day care.

Per Licensee, each child receiving services at the Facility are treated with dignity and respect. They are provided with safe, healthful, and comfortable accommodations, furnishings, and equipment. There is no corporal or unusual punishment of any kind, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. 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/childqanda.htm

The Facility is not in compliance per Title 22 regulationsDuring today's inspection the LPA observed deficiencies that may hinder the health and safety of the children in care. Deficiencies were cited during inspection. An exit Interview was conducted and a discussion of observations and this report was conducted. View points were discussed.

A copy of this Report, Review of Staff Records form (LIC 859) and Notice of Site Visit (LIC 9213), Appeal Rights were provided to Licensee, Cynthia Wheeler.

SUPERVISOR'S NAME: Lady King	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundo	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC809 (FAS) - (06/04)

Page: 6 of 6