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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700174
Report Date: 02/23/2022
Date Signed: 02/23/2022 04:32:19 PM


Document Has Been Signed on 02/23/2022 04:32 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:ALLEN, CRYSTAL FAMILY CHILD CAREFACILITY NUMBER:
197700174
ADMINISTRATOR:CRYSTAL ALLENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 218-1982
CITY:PALMDALESTATE: CAZIP CODE:
93552
CAPACITY:14CENSUS: 6DATE:
02/23/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:43 PM
MET WITH:Crystal AllenTIME COMPLETED:
04:47 PM
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Licensing Program Analyst (LPA) Justin Dorsey met with Licensee, Crystal Allen, who guided analyst on a tour of the facility for the One Year Required Inspection. This is a two story 4 bedroom 3 bathroom home with living room, daycare room, TV room, kitchen, laundry room and attached garage

Physical Plant: The day care room and the TV room on the first floor is the primary location in which care is provided. Children will use the downstairs bathroom located to the right of the laundry room door. The off limits areas include the living room, laundry room, garage, and the entire second floor. The upstairs, kitchen, dining area, and living room are made inaccessible by a fences. The laundry room is made inaccessible by a child proof door knob. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (locked under the sink), medicines (upstairs) and hazardous items (sharp knives are locked in a kitchen drawer) that can pose a danger to children. Fireplace is screened. The home has safe and age appropriate toys, play equipment and materials. The smoke detector and carbon monoxide detector, and Fire Extinguisher (2A10BC) are in operable condition. Stairs have a gate. Per Licensee 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 in living room. Per Licensee there are no weapon/firearms in the home.

Per licensee the last fire/earthquake drill was completed in December 2021 but was not logged. LPA advised licensee that all disaster drills must be logged with the date and time of the drill. Roster complete and maintained current.

Bathroom: Shower/tub are free of hazards (child care bathroom). Toilet and faucet is clean and operable.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:
DATE: 02/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/23/2022
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 2


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: ALLEN, CRYSTAL FAMILY CHILD CARE
FACILITY NUMBER: 197700174
VISIT DATE: 02/23/2022
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Kitchen: Sharp utensils 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. No chemicals in the kitchen were observed to be accessible. Breakfast, AM snack, lunch, PM snack and dinner are provided.

Outdoor: The backyard is safe for children and is completely fenced. The backyard has concrete and sand areas for children to play. LPA observed the homes trampoline to be broken, according to the licensee it was broken by the wind on 02/21/22. Per licensee she has a new one but hasn't put it up. The backyard also has a fenced off-limits area on the left side of the home where a dog is kept.

Advisory/Other: First Aid kit was readily available. CPR/First Aid expires 08/01/22, Mandated Reporter was completed 08/06/21. Child nap on mats in the main care areas.

Documents discussed: Safe Sleep PIN 20-24-CCP.

Licensee Allen 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 Allen 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 Allen 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 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 Crystal Allen.

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022
LIC809 (FAS) - (06/04)
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