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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197418025
Report Date: 11/17/2022
Date Signed: 11/17/2022 06:33:32 PM


Document Has Been Signed on 11/17/2022 06:33 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:HANNA FAMILY CHILD CAREFACILITY NUMBER:
197418025
ADMINISTRATOR:HANNA, MARIANNEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 622-2515
CITY:CANYON COUNTRYSTATE: CAZIP CODE:
91387
CAPACITY:14CENSUS: 9DATE:
11/17/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
05:31 PM
MET WITH:Marianne HannaTIME COMPLETED:
06:35 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 11/17/2022 Licensing Program Analyst(LPA) Isabel Ortega conducted an unannounced inspection. The purpose of the inspection was to collect the Family Child Care Roster. Upon arrival LPA observed 9 children and 2 staff providing care and supervision.

LPA reviewed the facility history and facility profile, LPA Ortega met with Licensee Marianna Hanna. During inspection today licensee failed to obtain a California clearance or a criminal record exemption as required by the Department for adult #3 and was issued a Type A deficiency.

Health & Safety Code. 1568.0822 (2) (A) If the department issues a notification of deficiency to a facility for a repeat violation of a violation specified in paragraph (1), the department shall assess an immediate civil penalty of two hundred fifty dollars ($250) per repeat violation and one hundred dollars ($100) for each day the repeat violation continues
after citation. The notification of deficiency shall state the manner in which the deficiency constitutes a repeat violation and shall be submitted to a supervisor for review and approval. The licensee was cited for a repeated violation of allowing an uncleared adult reside on the premises.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:
DATE: 11/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/17/2022
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


Document Has Been Signed on 11/17/2022 06:33 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: HANNA FAMILY CHILD CARE
FACILITY NUMBER: 197418025

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/17/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/17/2022
Section Cited

1
2
3
4
5
6
7
102370 Criminal Record Clearance (d)(1) All individuals...shall prior to working, residing, or volunteering in a licensed facility...Obtain a California clearance or a criminal record exemption as required by the Department...This requirement is not met as evidenced by:
8
9
10
11
12
13
14
Based on observation and record review uncleared Adult #3 is not fingerprint cleared and associated to the facility. Staff #3 was observed providing care and supervision, which poses an immediate Health, Safety or Personal Rights risk to children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7

1
2
3
4
5
6
7
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 KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:
DATE: 11/17/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/17/2022
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: HANNA FAMILY CHILD CARE
FACILITY NUMBER: 197418025
VISIT DATE: 11/17/2022
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
LPA Ortega observed uncleared adult #3 in the home providing care and supervision.

Facility cited Type A deficiency, according to California Code of Regulations Title 22. LIC809D issued for deficiency. Immediate $100 civil penalty was assessed for today 11/17/2022. According to licensee Adult #3 was only here today due to other staff not available.



Licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. A Type A deficiency was cited, a copy of the licensing report must also be posted for 30 days. The same report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months & licensee must obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file. Copies of the reports must be provided to each parent a Type A violation is cited along with Acknowledgment of Receipt of Licensing Reports LIC 9224. If these requirements are not met civil penalties per violation will be assessed.

Due to Printer difficulties LPA Ortega via emailed LIC 809, Notice of Site Visit, Appeal Rights, LIC421BG to licensee.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Isabel OrtegaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3