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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364804106
Report Date: 07/19/2021
Date Signed: 07/19/2021 01:39:12 PM

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:HALL FAMILY CHILD CARE HOMEFACILITY NUMBER:
364804106
ADMINISTRATOR:PAULA HALLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 401-7018
CITY:YUCCA VALLEYSTATE: CAZIP CODE:
92284
CAPACITY:14CENSUS: 10DATE:
07/19/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Paula HallTIME COMPLETED:
01:56 PM
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Licensing Program Analyst (LPA) Aaron Mabika met with licensee Paula Hall. The purpose of the inspection is to conduct an Annual/Random Inspection. Licensee is license to provide care and supervision for a Large Family Child Care for the capacity of 14 children. There are currently 24 children enrolled in the family child care. Present during the time of this inspection is licensee, spouse, 1 assistant 1 grand daughter and 10 children in care. Per licensee residing in the home is licensee and spouse only. Per licensee all adults residing in the home has a Criminal Record Clearance. Licensee and LPA toured the areas of the home utilized for the Family Child Care to ensure the home is incompliance with Community Care Licensing Title 22 Regulations. The days are hours of operation are 6:00 AM to 5:30 PM Monday through Friday.
The home is set-up as follows:
This is a single story house with 3 bedrooms, 3 bathrooms, kitchen/dining room, living room, family room and attached car pot. Per Licensee the family room, living room, one restroom one bedroom and backyard is utilized for the family child care activity area. Per licensee the rest of the house is off-limits
The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, poisons, detergents/cleaning compounds, medicines and hazardous items that can pose a danger to children. LPA observed all items are made inaccessible to children during the time of this inspection. LPA observed age appropriate safe toys and napping equipment on the premises. Per licensee children nap in the family activity room and the one bedroom that is not off-limits. LPA observed electrical outlets had safety covers. There are 10 children present during today’s inspection. LPA tested hot water at a safe temperature between 105-120 degrees. Per licensee, there are no weapons or firearms on the premises. LPA did not observe a swimming pool or bodies of water on the premises. LPA observed in the backyard artificial turf and expansive sand covering the whole play area and leafy green tree providing shade, several slide sets and climbing gyms which were anchored in the ground.

Incidental Medical Services (IMS) were discussed. Per licensee, the facility is not currently providing IMS. LPA informed licensee to refer to IMS information in the Evaluator Manual – Regulation Interpretations and

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2021
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 5
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: HALL FAMILY CHILD CARE HOME
FACILITY NUMBER: 364804106
VISIT DATE: 07/19/2021
NARRATIVE
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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 observed two fire extinguisher (2A10BC) fully charged, smoke detectors and carbon monoxide devices tested operable. The First Aid Kit was observed in the bathroom complete with supplies and first aid manual.
LPA observed licensee and assistant have current Pediatric CPR and First Aid Training with expiration date 05/09/2021 (Aide Serina Guttierez Expiration 02/20/2020, Paula Exprn 01/2023)nutrition training, Preventive Health and Safety Training. Licensee and assistant have proof of being immunized against influenza, pertussis and measles. Per licensee transportation is not being provided for children. Per licensee 2 meals and 2 snacks are being provided to children.
LPA reviewed 4 children’s records. LPA reviewed the child care facility roster and the fire drills, earthquake drills log and documentation for both (completed every (3 month).
The following information was discussed with the licensee:
· Mandatory Forms for the children’s files and provider’s files.
· Requirements for fire drills, earthquake drills and documentation for both.
· Role and responsibilities of being a mandated reporter was discussed.
· Licensee was made aware that it is their responsibility to know and review updates/regulations and forms online at www.ccld.ca.gov as well as anyone who assists in providing care.
· The licensing department must have the facility’s phone number. If the phone number is changed, the licensing department must be notified.
· Licensee is aware that all adults 18 years and older living in the home or visiting for extended periods of time should have criminal background clearances. Failure to comply will result in Civil Penalty assessments.
· On January 1, 2018 or before March 30, 2018, a person who, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the on-line mandated reporter training and shall complete renewal mandated reporter training every two years. Licensee did not have the training The following web reference was provided; @www.mandatedreporterca.com

· Senate Bill AB 2231 Civil Penalty Amount Changes. Changes Effective 7/1/2017.


· Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). **In addition;
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2021
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: HALL FAMILY CHILD CARE HOME
FACILITY NUMBER: 364804106
VISIT DATE: 07/19/2021
NARRATIVE
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A copy of this report must be provided to the authorized representatives of all currently enrolled children and any newly enrolled child for the following 12 months.
· The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC9224) shall be signed and kept in each of the children’s records. The report shall be provided no later than the next business day or the next day the child is in care.
· Failure to meet the posting requirements shall result in an immediate $100.00 civil penalty
· Licensee is made aware that Title 22 Regulation prohibits the smoking of tobacco in a private residence that is licensed as a family child care home, and in those areas of the family day care home where children are present (24/7 ban).
· **§1597.622 Employees or volunteers at family day care home; immunization requirements; records; exemptions (a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
· **Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements
· Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed child care facility are aware of situations that present the greatest danger to children.
· State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category.
· Licensee advised visit www.shotsforschool.org for Immunization information.
· Child Care Advocates: You can now sign up for Quarterly Updates and PINs for one or more programs through our DSS website at www.ccld.ca.gov. Click on “Receive Important Updates” located in the right middle part of the page, immediately above the Quick links. Put your email address and choose which program(s) you would like to subscribe to and click “subscribe”.
· The following deficiencies are being cited in accordance to Title 22 of the California Code of Regulations and/or Health & Safety codes (Mandated Reporter training). Please refer to LIC809D for documentation of deficiencies cited:
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2021
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: HALL FAMILY CHILD CARE HOME
FACILITY NUMBER: 364804106
VISIT DATE: 07/19/2021
NARRATIVE
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Exit interview conducted with Licensee Paula Lee Hall). A copy of this report, notice of site inspection, Appeal Rights (LIC 9058), Confidential Names List (LIC 811) were given and explained during this inspection. Licensee’s signature on this form acknowledges receipt of these rights.
Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty. Copies of this report must be posted for 30 days in visible location the authorized representatives of children.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2021
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: HALL FAMILY CHILD CARE HOME
FACILITY NUMBER: 364804106
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/19/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/19/2021
Section Cited

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102416.2
Reporting Requirements
Any suspected child abuse or neglect, as defined in Penal Code Section 11165.6, of any child in care, in addition to reporting requirements pursuant to Penal Code Section 11166.
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This requirement was not met as evidenvced by the Licensee having an expired Mandated Reporter Training Certification.
This poses a potential risk to the health and safety of children in care.
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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: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:
DATE: 07/19/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/19/2021
LIC809 (FAS) - (06/04)
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