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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197492956
Report Date: 04/27/2023
Date Signed: 04/27/2023 12:47:07 PM


Document Has Been Signed on 04/27/2023 12:47 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:THOMASON FAMILY CHILD CAREFACILITY NUMBER:
197492956
ADMINISTRATOR:HALSTEAD, JENNIFERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 557-4696
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY:14CENSUS: 11DATE:
04/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:28 AM
MET WITH:Jennifer Thomason, Licensee TIME COMPLETED:
01:00 PM
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On 04/27/23 Licensing Program Analyst (LPA) Justeene Tamayo met with Assistant Danielle Moore 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 no pool/spa or body of water on the premises. Upon arrival LPA observed 3 infants, 7 preschool , and 1 school age child in care, along with assistants 1-3. Family members residing in the home include 2 adults (licensee and assistant #1 (fingerprint cleared)) and six minor children. Facility operation are Monday-Friday for less than 24 hours a day. Incidental Medical Services (IMS) policy was discussed. Licensee came to the facility an about an hour later.

Physical Plant: Main care is provided in the living room, family room, and dining room area. Children use the bathroom in hallway on the left. Children have access to the living room, family room, dining room, and backyard. Off limit areas include all bedrooms, bathrooms #2-3 (upstairs)laundry room (garage with key lock), and garage (has a key lock door knob). 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 (in garage with key lock), medicines (in office with key 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 in the home 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 assistant no one smokes in the home. 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 near front entrance. Per assistant, there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (cell).
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Justeene TamayoTELEPHONE: 661-202-3796
LICENSING EVALUATOR SIGNATURE:
DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/27/2023
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: THOMASON FAMILY CHILD CARE
FACILITY NUMBER: 197492956
VISIT DATE: 04/27/2023
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Fire/Disaster Drill is complete and maintained current. Last fire/disaster drill was completed on
03/06/2023.

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. Breakfast, lunch, snacks and dinner are provided. Licensee currently has a food program. Naps are provided on cots in the family room.

Outdoor: The backyard is safe for children. The backyard is completely fenced (with block cement). There is no body of water. There is an outdoor air conditioner inaccessible to children with barricaded gate. LPA observed age appropriate toys. Per assistant, there are two pets on the premises.

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expires 07/17/2024. Mandated Reporter expires 02/08/2025. There are no window cords accessible to children.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Justeene TamayoTELEPHONE: 661-202-3796
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023
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: THOMASON FAMILY CHILD CARE
FACILITY NUMBER: 197492956
VISIT DATE: 04/27/2023
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Documents Provided and or Discussed: Fire Drill Log, Roster, Postings, Safe Sleep PIN 20-24-CCP and Individual Sleeping Plan (LIC9227). Licensee currently has child care insurance.

Licensee 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 assistant 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.

No deficiencies cited at this time.

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, along with her appeal rights and Notice of Site Visit.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Justeene TamayoTELEPHONE: 661-202-3796
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023
LIC809 (FAS) - (06/04)
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