364807305-4-15-2022-12-CC-BIBE-CDHQBE-20220415120127

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364807305
Report Date: 04/15/2022
Date Signed: 04/15/2022 12:01:40 PM

Document Has Been Signed on 04/15/2022 12:01 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:	ROBINSON FAMILY CHILD CARE		FACILITY NUMBER:	364807305
ADMINISTRATOR:	ROBINSON, LEOLA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 247-6612
CITY:	APPLE VALLEY	STATE: CA	ZIP CODE:	92307
CAPACITY:	14	CENSUS: 2	DATE:	04/15/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Robinson,Leola		TIME COMPLETED:	12:25 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) Babatunde Ibitoye met with Leola Robinson (licensee) who granted access into the home. The purpose of the inspection is to conduct a Required 1 Year Annual/ Inspection. Licensee is licensed to provide care and supervision for a Large Family Child Care for the capacity of 14 children. There are currently 8 children enrolled in the family child care. Present during the time of this inspection is licensee, Assistant and 2 Day care children . Currently residing in the home is licensee only. Licensee and LPA toured the home inside and out. The home is set-up as follows: This is a single story house with 3 bedrooms, 2 1/2 bathrooms, kitchen/dining room, living room, family room, laundry room and attached garage. Licensee states the living room, dining room, kitchen, 1 bathroom, family room (day care area) back yard and garage is utilized for the family child care activity area. The off-limit areas of the home is the 3 bedrooms and 2 bathrooms. 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 inaccessible to children. There are children safety latches on the cabinets and drawers. There are age appropriate toys, Napping mats and Cribs are observed on the premises. Per Licensee Children nap in the living room.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde Ibitoye	TELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2022

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ROBINSON FAMILY CHILD CARE	FACILITY NUMBER: 364807305
	VISIT DATE: 04/15/2022

NARRATIVE

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All electrical outlets observed inaccessible to children with covers. Hot water is tested at a safe temperature between 105-120 degrees. Per licensee, there are no weapons or firearms on the premises. There is a jacuzzi enclosed in a room made inaccessible to children with a key/lock on the room door and audile alarms observed.

Incidental Medical Services (IMS) were discussed. Facility is not Currently Providing IMS. 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.

The required fire extinguisher (2A10BC) date of service July 2021, smoke detectors and carbon monoxide devices tested operable. The First Aid Kit was observed complete with supplies and first aid manual. Licensee have current Pediatric CPR and First Aid Training with expiration date 11/16/2023. Licensee have 1 hour of nutrition training. Licensee has 7 hours of Preventive Health and Safety Training. Licensee have proof of being immunized against influenza, pertussis and measles. Licensee does not provides transportation for children. Licensee provides meals and snacks for children.

LPA reviewed 2 children records and 2 staffs during this inspection. Licensee have a current child care facility roster and child care fire drill log, the last fire drill Conducted on 02/26/2022.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde Ibitoye	TELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2022

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ROBINSON FAMILY CHILD CARE	FACILITY NUMBER: 364807305
	VISIT DATE: 04/15/2022

NARRATIVE

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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 is reminded that 100% supervision is required to children at all times.
· 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.
· AB 290 - for each new license issued, at least one director or teacher at a child care center or family child care home shall have at least one hour of childhood nutrition training;
· Senate Bill AB 2231 Civil Penalty Amount Changes. Changes Effective 7/1/2017.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde Ibitoye	TELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2022

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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: ROBINSON FAMILY CHILD CARE	FACILITY NUMBER: 364807305
	VISIT DATE: 04/15/2022

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·Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during inspection). **In addition; A copy of the 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).

·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: www.childcareadvocatesprogram@cdss.ca.gov
Deficiencies cited : No Deficiencies Cited

Exit interview conducted with Licensee Leola Robinson . A notice of site inspection and a copy of this report is discussed and left with licensee.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde Ibitoye	TELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2022

LIC809 (FAS) - (06/04)

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