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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700053
Report Date: 05/07/2024
Date Signed: 05/07/2024 02:29:58 PM


Document Has Been Signed on 05/07/2024 02:29 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:O'NEAL FAMILY CHILD CAREFACILITY NUMBER:
197700053
ADMINISTRATOR:O'NEAL, PATRINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 547-1184
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY:14CENSUS: 4DATE:
05/07/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:04 AM
MET WITH:Licensee Patrina O'NealTIME COMPLETED:
02:50 PM
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On 5/7/2024 at 11:04am, Licensing Program Analyst (LPA) Andrea Pittman conducted an unannounced annual inspection. The LPA disclosed the purpose of the inspection and was permitted entry by the Facility Representative. The Licensee guided the LPA on a tour of the home. Upon entry to the facility, the LPA observe 4 children in care and two staff providing care and supervision (fingerprint cleared and associated to the home.)

The operational childcare hours are Monday through Friday from 9:00am to 6:00pm.

This is a two-story family home. There is a living room, classroom, office (located in the downstairs bedroom), kitchen, five bedrooms, three bathrooms, and attached garage but not accessible from inside the home via a safety knob. Licensee does provide napping, there are fourteen mats and one crib. The off-limits areas are the four upstairs bedrooms, two bathrooms, and garage. Licensee provides breakfast, lunch, and two snacks. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. Hanging window blind cords: There are no blinds on the windows, only curtains in child care on-limits area. Pets: there are no pets on premises. Phone service: There is a working landline and cell phone, charged and kept on Licensee at all times. Transportation: The Licensee does provide transportation for children and is aware that all drivers must be licensed and the vehicles must be insured and registered. Isolation occurs in the office for children in care showing signs of illness. The calming area is located in the book nook in the classroom. There is a fireplace that is barricaded with a book shelf and inaccessible to children in care. The stairs are barricaded with a gate to prevent the off-limits area from being accessed by children in care.

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SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
LICENSING EVALUATOR SIGNATURE:
DATE: 05/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/07/2024
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: O'NEAL FAMILY CHILD CARE
FACILITY NUMBER: 197700053
VISIT DATE: 05/07/2024
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Licensee was made aware that Licensee fees are past due and the Licensee paid the fees during the visit.

Knives are kept in the kitchen in the pantry secured with a safety knob, inaccessible to children in care. Medication is kept in the kitchen in the off-limits upstairs hallway, inaccessible to children in care. Cleaning supplies and chemicals are kept under the sink and inaccessible to children in care.

There are age-appropriate toys and equipment on the premises. The outdoor area was inspected for sharp objects, broken toys/furniture & equipment, and other debris. At 11:44am, LPA observed two tricycles with damaged handle bars, the Licensee immediately placed them in an off-limits area making them inaccessible to children in care, Licensee was provided technical assistance on ensuring that toys and furniture are not damaged for the children in care. Per the Licensee, there are no weapons, firearms, and ammunition in the facility. The LPA did not observe any weapons. Per the Licensee, there is no smoking on the premises.

The First Aid kit included a temperature thermometer, tweezer, scissors, gauzes, adhesive tape, first aid manual, and cleansing pads/solution was observed to be complete and inaccessible to children kept high in the closet secured with a safety knob. The required fire extinguisher (2A10BC) is reading in green, last tested on 11/10/2023. Smoke and carbon monoxide detectors were found to be in operating condition, tested as operable at 11:42am and 11:41am, respectively. Fire and Disaster drills are conducted at least every six-month, last drills were recorded on 2/2/2024 at 4:00pm.

Licensee had all the required posted documents: Facility License (LIC 203, Notice of Parent's Rights Poster (PUB 394), Emergency Disaster Plan (LIC 610A), PUB 269 Child Passenger Safety Law, Facility Sketch LIC 999A, and Earthquake Preparedness Checklist (LIC 9148).

Licensee has insurance coverage for the facility.

The Licensee provided proof of immunization against pertussis (TDAP), measles (MMR), TB, and statement declining the Influenza for self.



Licensee was able to provide a valid CPR/First Aid training expiring in 2025. Child Care Provider Mandated Reporter Training Certificate has been completed and expiring in 2025. Staff Personnel files were complete with the: LIC 9052-Notice of Employee Rights, LIC 9108-Statement Acknowledging Requirement to Report
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2024
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: O'NEAL FAMILY CHILD CARE
FACILITY NUMBER: 197700053
VISIT DATE: 05/07/2024
NARRATIVE
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Child Abuse, Mandated Reporter Training, Immunizations: MMR, Tdap, TB, & Flu shots/statements declining the Flu shot, background clearances, and Pediatric First Aid & CPR.

Children’s records: files were found to be incomplete and did include the following required documents although not in every file: LIC 700-Identification and Emergency Consent, LIC 627-Consent for Medical Treatment, LIC 995A-Notification of Parent’s Rights, LIC 995E-Caregiver Background Check Process, and LIC 9150- Parent Notification of Additional Children in Care, LIC 9212-Family Child Care Consumer Awareness Information, School enrollment forms, and PM 286-California School Immunization Record. The Licensee is missing the school enrollment forms for the school age children and the PM-286- California School Immunization Record for some of the children not attending school. This is a Type B Violation, see the LIC 809D for the details.

Licensee's facility child roster is current and maintained up to date.

The following were discussed: No smoking, infant walkers, Johnny jumpers, exersaucers and any other item that falls into that category which are not permitted in the facility. The LPA also discussed earthquake safety and necessity of drills, required forms for children’s files, facility files, posting requirements, and penalties.

Facility Representative 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 reminded 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 Form LIC624B when submitting the report to the department.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2024
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: O'NEAL FAMILY CHILD CARE
FACILITY NUMBER: 197700053
VISIT DATE: 05/07/2024
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LPA discussed the safe sleep regulations with the Facility Representative and 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 the Facility Representative 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.

Beginning on January 1, 2018, Assembly Bill 1207 (2015) requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants 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.

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/.

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

During the exit interview, the Licensee confirmed that there are no Registered Sex Offenders living in the facility and the RSO profile has been completed in FAS.

Child Care Advocates:
To sign up for our Quarterly Updates, please email the Child Care Advocates at
chilcareadvocatesprogram@dss.ca.gov & call at (916) 654-1541.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2024
LIC809 (FAS) - (06/04)
Page: 11 of 13
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: O'NEAL FAMILY CHILD CARE
FACILITY NUMBER: 197700053
VISIT DATE: 05/07/2024
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The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot-line at 1-800-540-4000.

Per Title 22 Regulations, this facility is not in compliance, two Type B Deficiencies have been cited. Please, see the LIC 809D for the citations.

An exit interview was conducted, a copy of this Report, a Notice of Site visit, and Appeal rights were provided and discussed with the Facility Representative.

All licensing reports are recommended to be kept for 3 years. The Notice of Site visit is to be posted and visible to parents for 30 days.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2024
LIC809 (FAS) - (06/04)
Page: 12 of 13
Document Has Been Signed on 05/07/2024 02:29 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: O'NEAL FAMILY CHILD CARE
FACILITY NUMBER: 197700053

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/07/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102418(g)(1)
Immunizations
(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. (1) This requirement includes updating each child's PM 286 (6/95) when the child is due to receive required immunizations after enrollment in the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above by not having the PM-286 completed for the non-school age children which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/21/2024
Plan of Correction
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Licensee plans to e-mail the proof of the PM-286 for the children that are not school age no later than 5/21/2024
Type B
Section Cited
CCR
102421(c)
Child's Records
(c) In any case in which the licensee cares for an additional child pursuant to Section 102416.5(b) for a Small Family Child Care Home or Section 102416.5(d) for a Large Family Child Care Home, the licensee shall maintain, in the child’s record, a copy of documentation verifying the child’s enrollment and attendance at kindergarten, including transitional kindergarten, or elementary school as required in Section 102416.5(g).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above by not having the school enrollment forms for the school age children which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/21/2024
Plan of Correction
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Licensee plans to e-mail the proof of the school age forms for the children enrolled in school no later than 5/21/2024.
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: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Andrea PittmanTELEPHONE: 661-202-3375
LICENSING EVALUATOR SIGNATURE:
DATE: 05/07/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/07/2024
LIC809 (FAS) - (06/04)
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