197416564-12-28-2022-12-CC-JTAO-CMJR7B-20221228114605

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197416564
Report Date: 12/28/2022
Date Signed: 12/28/2022 11:46:14 AM

Document Has Been Signed on 12/28/2022 11:46 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:	MILLER FAMILY CHILD CARE		FACILITY NUMBER:	197416564
ADMINISTRATOR:	MILLER, K. & L.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 816-1265
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93536
CAPACITY:	14	CENSUS: 4	DATE:	12/28/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Kathryn Miller, Licensee		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 12/28/22, Licensing Program Analyst (LPA) Justeene Tamayo met with Licensee Kathryn Miller, who guided analyst on a tour of the facility for the One Year Required inspection. This is a two story, 3 bedroom, 3 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 preschool children, and 1 infant in care. Family members residing in the home include 2 adults (licensee and licensee's husband) and no minor children. Facility operation are Monday-Friday 7AM-5:30PM. Incidental Medical Services (IMS) policy was discussed. Physical Plant: Main care is provided in the family room. Children use the bathroom in hallway on the left passed the living room. Children have access to the living room, family room, and dining room area. Off limit areas include all bedrooms, bathrooms #2 and #3 (upstairs), laundry room, and garage. LPA observed the main care area to be fully barricaded by a safety gate, as well as a safety gate barricading the upstairs area. 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 (upstairs bathroom off limits) and hazardous items (sharp knives in kitchen drawer with safety latch) that can pose a danger to children. LPA observed a fireplace in the the living room to be fully screened. Safe and age appropriate toys, play equipment and materials were observed. The smoke detector and carbon monoxide detector, Fire Extinguisher (2A10BC) are in operable condition. Per Licensee no one smokes in the home. Electrical outlets are inaccessible. LPA reminded licensee, no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/ play equipment are allowed. There is a designated area for ill children as necessary in living room. Per Licensee there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (cell).

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Justeene Tamayo	TELEPHONE: 661-202-3796
LICENSING EVALUATOR SIGNATURE:	DATE: 12/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2022

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 3

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: MILLER FAMILY CHILD CARE	FACILITY NUMBER: 197416564
	VISIT DATE: 12/28/2022

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

Fire/Disaster Drill is complete and maintained current. Last Fire/Disaster Drill was completed on 11/16/22.

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 the kitchen sink with a safety latch. Licensee currently has a food program. Breakfast, lunch, snacks and dinner are provided. Naps are provided on cots in the living room.

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 a self latch fences that pulls away from the swimming pool. LPA observed two other areas that are fully barricaded by safety gates. Per licensee, the backyard is currently off limits due to the holiday's and weather. LPA reminded licensee, the barbecue pit and long heaters must be covered or barricaded before the children can access the backyard. LPA observed two dogs fully barricaded by a chain link fence on the right hand side. LPA observed age appropriate toys. Per licensee, there are 5 pets on the premises.

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expires 01/29/2024. Mandated Reporter expires 04/14/2023. There are no window cords accessible to children.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Justeene Tamayo	TELEPHONE: 661-202-3796
LICENSING EVALUATOR SIGNATURE:	DATE: 12/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: MILLER FAMILY CHILD CARE	FACILITY NUMBER: 197416564
	VISIT DATE: 12/28/2022

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

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 has child care insurance.

Licensee Miller 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 Miller 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 Kathryn Miller, along with her appeal rights and notice of site visit.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Justeene Tamayo	TELEPHONE: 661-202-3796
LICENSING EVALUATOR SIGNATURE:	DATE: 12/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2022

LIC809 (FAS) - (06/04)

Page: 3 of 3