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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197492906
Report Date: 02/27/2024
Date Signed: 02/27/2024 01:17:23 PM

Document Has Been Signed on 02/27/2024 01:17 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:MALONE FAMILY CHILD CAREFACILITY NUMBER:
197492906
ADMINISTRATOR:MALONE, JANQUIL & MARVINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 878-1339
CITY:PALMDALESTATE: CAZIP CODE:
93552
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
02/27/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:07 AM
MET WITH:Janquil MaloneTIME COMPLETED:
01:20 PM
NARRATIVE
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On February 27, 2024, Licensing Program Analyst (LPA) Kris Diaz, conducted an unannounced required 3-year inspection. LPA met with Licensee, Janquil Malone who guided LPA on a tour of the home. People who reside in the home are the licensee, her spouse and their adult son who are live scanned and have TB skin tests on file. The large family childcare home operates Monday – Friday 6:00am-6:00pm. At the time of the visit there were 6 children present with 2 staff members. Per licensee, her adult granddaughter, Jalynn Davis works in the childcare facility. LPA did not observe fingerprint clearance for this adult and advised licensee to get her fingerprinted immediately. LPA also advised licensee that the individual should not work in the daycare or with the children until fingerprint clearance is granted.

This is a two-story home with 6 bedrooms, 4 bathrooms, kitchen, dining room, family room, living room, laundry room, office (converted for childcare) and garage. Children have access to the living room (converted for childcare), restroom in the childcare area, and the backyard. LPA advised licensee to sign a statement of declaration making the backyard off-limits until repairs are made to the fence, the sides of the house are made inaccessible, and broken toys and furniture are removed from the play area. Off-limit areas of the home are the entire upstairs, family room, kitchen, dining room, downstairs bedroom (converted into office and infant sleep area), laundry room, and garage. Off-limits areas are made inaccessible with safety gate.

The home was inspected inside for comfort, cleanliness, telephone service, heating and ventilation. The kitchen knives are stored in the kitchen which is inaccessible to children. LPA observed medications in the childcare area accessible to children. LPA observed licensee move the medications to inaccessible area. LPA observed cleaning supplies in closet in childcare area accessible to children. LPA advised licensee to place a lock on door containing cleaning supplies. LPA observed licensee remove scissors from drawer in desk in childcare area. LPA observed licensee remove blanket from infant crib.

Claretta Yates
Kristina Diaz
DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 02/27/2024 01:17 PM - It Cannot Be Edited


Created By: Kristina Diaz On 02/27/2024 at 12:16 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: MALONE FAMILY CHILD CARE
FACILITY NUMBER: 197492906

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/27/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
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
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Based on interview, the licensee did not comply with the section cited above in 3 out of 3 persons which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/28/2024
Plan of Correction
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Licensee has sent reminders to all staff. Per licensee, proof of completion will be submitted to LPA by close of business on due date.
Type A
Section Cited
CCR
102370(d)
Criminal Record Clearance
(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in 1 out of 4 persons which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/27/2024
Plan of Correction
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LPA observed licensee fill out guardian application and send individual for fingerprinting. LPA observed completed fingerprinting. Clearance is in process. LPA reminded licensee that individual cannot work or be present in the home until clearance is granted.
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:Claretta Yates
LICENSING EVALUATOR NAME:Kristina Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 02/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/27/2024


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Document Has Been Signed on 02/27/2024 01:17 PM - It Cannot Be Edited


Created By: Kristina Diaz On 02/27/2024 at 12:16 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: MALONE FAMILY CHILD CARE
FACILITY NUMBER: 197492906

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/27/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, the licensee did not comply with the section cited above in 3 out of 3 persons which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/01/2024
Plan of Correction
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Per licensee, proof of registration will be provided to LPA via email by POC due date above.
Type B
Section Cited
CCR
102425(j)(2)(D)(c)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, the licensee did not comply with the section cited above in 1 out of 1 files which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/28/2024
Plan of Correction
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Per licensee, 15-minute checks will be completed each day and recorded. LPA will observe correction at POC visit tomorrow.
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:Claretta Yates
LICENSING EVALUATOR NAME:Kristina Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 02/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/27/2024


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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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MALONE FAMILY CHILD CARE
FACILITY NUMBER: 197492906
VISIT DATE: 02/27/2024
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The First Aid kit is located in a closet in the childcare room accessible to children. LPA advised licensee to place lock on door to make inaccessible. Per licensee, there are no weapons or firearms in the home. LPA did not observe any weapons or firearms. Smoke detectors and carbon monoxide detectors are in operable condition. The Fire Extinguisher is green, fully charged, and meets the standards of the State Fire Marshal. Licensee could not provide proof of completion of Pediatric First Aid/CPR training, mandated reporter training, or any required documentation on staff including immunizations, employee rights, LIC 9108 – Statement Acknowledging Requirement to Report Child Abuse. LPA advised licensee to complete employee files for self and all staff. The licensee has the required immunizations against pertussis (TDAP) and measles (MMR) and a statement of declination of flu on file. Preventative Health and Safety was completed and is on file.

The required posted documents were posted and located in the childcare area accessible to parents/guardians: Notification of Parent's Rights Poster (PUB394) (updated copy provided to licensee), Emergency Disaster Plan (LIC610A), and Earthquake Preparedness Checklist (LIC9148) provided to licensee.

The following was discussed with the licensee:

Mandatory licensing forms for the children’s files, facility forms/records, and information to be posted in the family child care home; Requirements to conduct fire and disaster drills once every six months and record it; Role and responsibilities of being a mandated reporter were reviewed; The licensee was reminded that 100% supervision is required at all times to children in care; Licensee was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care; Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified; Regulation prohibits the smoking of any kind during the operation of the day care.

LPA discussed the safe sleep regulations with licensee and provided PIN 20-24-CCP. LPA discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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.

SUPERVISOR'S NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kristina Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2024
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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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MALONE FAMILY CHILD CARE
FACILITY NUMBER: 197492906
VISIT DATE: 02/27/2024
NARRATIVE
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

The licensee was advised of the requirement to report Unusual Incidents. A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above. The licensee was informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department.

Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, licensees, directors, and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Licensee must meet requirements as a precondition to licensure. New employees shall have 90 days from date of employment to complete training as required. The training may be conducted at the following website www.mandatedreporterca.com.

Prior to making alterations or additions to a family childcare home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: Conversion of a garage (either attached or detached) into a "childcare" room; Room additions to the family childcare home. Any change from an area of the family childcare home previously identified as "off limits" to an area where care and supervision will be provided to children in care. The licensee shall provide the Department with a copy of an inspection report when an inspection is required by the local building inspector as a result of the alteration, addition, or construction.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

SUPERVISOR'S NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kristina Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2024
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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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MALONE FAMILY CHILD CARE
FACILITY NUMBER: 197492906
VISIT DATE: 02/27/2024
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Lead Flyer Requirement Health and Safety Code 1596.7996 mandated that effective January 1, 2019, CCC's and FCCH's are required to provide parents and guardians of children enrolling or reenrolling in care with written information on the risks and effects of lead exposure, blood lead testing requirements and recommendations, and options for locations of affordable blood lead tests as specified. A Lead

Poisoning Facts Flyer was created, in partnership with the California Department of Public Health (CDPH), to satisfy this requirement.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

The licensee was advised it is her responsibility to visit the department's website to access licensing forms, Quarterly Updates and Provider Information Notices (PINs): www.ccld.ca.gov

LPA confirmed that there are no Registered Sex Offenders living in the facility and completed the RSO profile in FAS during the file review.

During the visit, 2 type A deficiencies and 2 type B deficiencies were issued. LPA advised licensee to have all enrolled families view the report and sign the Acknowledgement of Receipt of Licensing Reports (LIC 9224). All families enrolled for the next 12 months must also be shown the report and sign the LIC 9224. Failure to comply with this requirement will result in a civil penalty. LPA suggested help from Technical Support Program and licensee wrote a request for services.

This inspection visit was conducted in person. The report was read, and a copy was provided to the licensee, Janquil Malone. Notice of Site Visit was given and must remain posted for 30 days. Exit interview was conducted.

SUPERVISOR'S NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kristina Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2024
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