334843668-1-14-2022-09-CC-ECOL-CANTP8-20220114135354

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334843668
Report Date: 01/14/2022
Date Signed: 01/14/2022 01:54:05 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	MIXON FAMILY CHILD CARE		FACILITY NUMBER:	334843668
ADMINISTRATOR:	MIXON, MICAELA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(909) 534-4594
CITY:	BEAUMONT	STATE: CA	ZIP CODE:	92223
CAPACITY:	14	CENSUS: 7	DATE:	01/14/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:05 AM
MET WITH:	Licensee - Micaela Mixon		TIME COMPLETED:	02:10 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Corral conducted a required Annual Inspection on today’s date. Upon entrance to the Facility, there were 7 children present in care with Licensee and Assistant Kathleen Carter providing care and supervision. A review of the Facility Personnel Report Summary on 01/12/2022 indicates all facility staff who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Licensee was reminded that all adults 18 and over, 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 Family Child Care Home. A civil penalty of $100 minimum per day and up to $500 maximum per day per person will be assessed if this regulation is violated. The hours of Operation are Monday – Friday, 4:30 AM – 6:30 PM. A tour of the inside and outside of the facility was conducted with Licensee Micaela Mixon. The playroom was observed to have age appropriate play equipment. Off limits areas are made inaccessible by means of child safety door knobs and children gates. The childcare area consists of the living room which was turned into the playroom that is located off the main entrance to the the left. The children have access to the 1st floor except the bedroom that is located behind the kitchen. The children's restroom is located passing the kitchen to the right. The play equipment was found to be in good condition, free of sharp, loose, or pointed edges. Items which could pose a danger to children such as detergents, cleaning compounds, and medications were stored out of the reach of children. Licensee stated Poisons/Hazardous items are not kept on the premises. The children's bathroom, toilet and hand washing sink were observed to be clean, sanitary and in good repair. The facility has conducted an emergency drill within the past six months and keeps documentation of drills. The facility has one working smoke detector, carbon monoxide detector and fire extinguisher. LPA Corral verified there is working phone service. Facility meets all posting requirements. Licensee understands the Family Child Care Home shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children. Continue to Page 2.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Eileen Corral	TELEPHONE: 951-233-7183
LICENSING EVALUATOR SIGNATURE:	DATE: 01/14/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2022

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 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: MIXON FAMILY CHILD CARE	FACILITY NUMBER: 334843668
	VISIT DATE: 01/14/2022

NARRATIVE

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The outdoor activity areas were also inspected for compliance. The outdoor activity was observed to have age appropriate equipment and to be in good condition. Outdoor area was enclosed by appropriate fences and the surface of the outdoor activity space were free of hazards. Licensee was reminded visual supervision is required during outdoor play. There are no bodies of water present on-site, Licensee was informed all wading pools or similar product must be emptied immediately after use and stored in an upright position.

During today’s inspection, LPA Corral also conducted Record Review of Staff and Children Files. Each Staff’s files contain the required documentation. Licensee and Assistant Kathleen Carter completed their Pediatric CPR/First Aid which expire on 12/2023. Licensee and Assistant Kathleen completed their Mandated Child Abuse Reporter training on 01/05/2022. Six Children files were reviewed, 1 file was missing the required identification and emergency information. Licensee was reminded not to exceed the conditions, limitations and capacity specified on the license. Licensee was also informed to ensure each child is accorded a safe, healthful and comfortable accommodations, furnishings and equipment to meet the child's needs.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

LPA discussed the Safe Sleep Regulations and 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.

The CCLD website www.ccld.ca.gov was provided to access regulations, updates, and licensing forms. Licensee was advised to register to childcareadvocatesprogram@dss.ca.gov to receive quarterly updates.
Continue to Page 3.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Eileen Corral	TELEPHONE: 951-233-7183
LICENSING EVALUATOR SIGNATURE:	DATE: 01/14/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2022

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: MIXON FAMILY CHILD CARE	FACILITY NUMBER: 334843668
	VISIT DATE: 01/14/2022

NARRATIVE

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Licensee was advised of their responsibility to review the Provider Information Notices (PIN) found on the CCLD website. A copy of the California Department of Social Services Lead Information Brochure was explained and provided to the licensee.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/nspection-process

Licensee was reminded a request to transfer, associate/disassociate individuals can be submitted to Associations_Disassociations862@dss.ca.gov. Licensee was also informed of their Reporting Requirements, Unusual Incident Reporting inbox was provided UnusualIncidentReportsDO09@dss.ca.gov. Lastly, Licensee was informed the Duty Officer is available to answer questions Monday – Friday from 8:00am to 5:00pm at (951)782-4200.

Based on Today’s inspection, Facility will be issued a Technical Violation for Children's Records.

Exit interview was conducted and Evaluation Report was reviewed with Licensee Micaela Mixon. A Notice of Site Visit was provided, Licensee was reminded it must remain posted for 30 days.

End of Report.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Eileen Corral	TELEPHONE: 951-233-7183
LICENSING EVALUATOR SIGNATURE:	DATE: 01/14/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2022

LIC809 (FAS) - (06/04)

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