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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700297
Report Date: 05/18/2021
Date Signed: 05/18/2021 11:13:26 AM

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:BYRNE FAMILY CHILD CAREFACILITY NUMBER:
197700297
ADMINISTRATOR:BYRNE, APRILFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 886-1120
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY:14CENSUS: 10DATE:
05/18/2021
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Licensee April ByrneTIME COMPLETED:
11:17 AM
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On May 18, 2021, Licensing Program Analyst (LPA) Brigitte Tsutaoka conducted a follow up visit to clear the Plan of Correction (POC) and verify Staff 2 is not present at facility. LPA disclosed purpose of inspection and was granted entry by Licensee who guided LPA on a tour of the facility. Upon entry, LPA counted 8 children in care.

At 10:30 AM, LPA observed Licensee alone with the 8 children. Staff 2 is not present. According to Licensee, Staff 2 went to conduct fingerprint clearance today, May 18, 2021. LPA advised Licensee Staff 2 cannot be present at facility until fingerprint clearance has gone through.

At 10:45AM, Staff 1 arrived with 2 children for a total of 10 children, still in ratio.

During inspection, Licensee completed the declaration as part of the POC.

On Monday, May 17, 2021, the Licensee was cited, and a plan of correction was due Tuesday, May 18, 2021 which has been corrected.

The facility was in compliance per Title 22 regulations, and civil penalties will not be cited today, May 18, 2021. An exit interview was conducted, a copy of this report and a notice of site visit was provided to the Licensee April Byrne. Appeal rights were provided and discussed with licensee.
SUPERVISOR'S NAME: Carissa BellTELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte TsutaokaTELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2021
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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