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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364808491
Report Date: 08/13/2019
Date Signed: 08/13/2019 03:45:55 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME:BROWN FAMILY CHILD CAREFACILITY NUMBER:
364808491
ADMINISTRATOR:BROWN, ZENNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 693-7500
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY:14CENSUS: 2DATE:
08/13/2019
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
01:35 PM
MET WITH:Zemma BrownTIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPAs) Victoria Hunt and Aaron Mabika met with Zenna Brown licensee for the purpose of a case management annual continuation inspection. A previous inspection was conducted on 07/20/19, but due to time constraints LPA was unable to complete a full inspection.

The licensee who guided analysts on a tour of the facility for an annual random inspection. During the time of this inspection licensee had two children in care. Children were observed to be napping in the family room during the time of this inspection. Residing in the home includes: adult (licensee), adult daughter, and two minor children. Per LIS, facility annual fees are current. All adults have been background cleared. Licensee was operating facility within ratio during the time of inspection. Licensee was observed providing adequate supervision during the inspection.

This family child care facility is a single story home with 4 bedrooms, 2 bathrooms. LPA Hunt was able to review children's records; on previous visit. Records were complete.



Licensee is licensed to provide care and supervision for a Small Family Child Care for the capacity of 14 children. There are currently 6 children enrolled in the family child care. Present during the time of this inspection is licensee, Licensee, licensee's assistant (adult daughter, and 2 children in care. 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 in compliance with Community Care Licensing Title 22 Regulations. The days are hours of operation are 23 hours per day Sunday through Saturday,
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 568-8081
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019
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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: BROWN FAMILY CHILD CARE
FACILITY NUMBER: 364808491
VISIT DATE: 08/13/2019
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The home is set-up as follows:
This is a single story house with 4 bedrooms, 2 bathrooms, kitchen/dining room, living room, and attached garage. Per Licensee the living room, dining room, 2 bathroom are used for child care activity. Per licensee off-limit areas of the home is 4 bedrooms, the backyard and garage.

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. LPAs observed all items are made inaccessible to children during the time of this inspection. LPAs observed age appropriate safe toys and napping equipment in the main living room. Per licensee children nap in the living room and mats were observed. LPAs observed all electrical outlets were the child proof type hence inaccessible to children. There are 2 children present during today’s inspection. LPAs tested hot water at a safe temperature between 105-120 degrees. Per licensee, there are no weapons or firearms on the premises. LPAs did not observe a swimming pool or bodies of water on the premises. The front door has a lockable screen and there is 24- hour surveillance around the property. LPAs observed in the backyard lots of shady areas and no play equipment. The front yard consists a lush green lawn and children have occasional access to it. The property has two fire places in each living room and they are all screened off and made inaccessible to children. The garage is under lock and key and is attached to the house.

Incidental Medical Services (IMS) were discussed. Per licensee, the facility is not currently providing IMS. LPAs informed licensee to refer to IMS information in the 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.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 568-8081
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019
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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: BROWN FAMILY CHILD CARE
FACILITY NUMBER: 364808491
VISIT DATE: 08/13/2019
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LPAs observed the required fire extinguisher (2A10BC) fully charged, smoke detectors and carbon monoxide devices tested operable. The First Aid Kit was observed complete with supplies and first aid manual and is kept in a locked cabinet in the hallway.
LPA observe licensee has current Pediatric CPR and First Aid Training with expiration date 09/2019 1 hour of nutrition training, 8 hours of Preventive Health and Safety Training. Licensee/Staff does not have proof of being immunized against influenza, pertussis and measles. Licensee provided a written statement declining the influenza vaccination. Per licensee transportation is not being provided for children. Per licensee meals and snacks are being provided to children.

LPA reviewed the child care facility roster and the fire drills, earthquake drills log and documentation for both.

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.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 568-8081
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019
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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: BROWN FAMILY CHILD CARE
FACILITY NUMBER: 364808491
VISIT DATE: 08/13/2019
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· 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. @www.mandatedreporterca.com
· 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.
· 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; 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
·
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 568-8081
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019
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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: BROWN FAMILY CHILD CARE
FACILITY NUMBER: 364808491
VISIT DATE: 08/13/2019
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 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: www.childcareadvocatesprogram@cdss.ca.gov
The following deficiencies are being cited in accordance to Title 22 of the California Code of Regulations and/or Health & Safety codes. Please refer to LIC809D for documentation of deficiencies cited:

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.

Exit interview conducted with Licensee Zenna Brown) a copy of this report, and notice of site inspection was left with the licensee. This facility was inspected in accordance with Title 22 Regulations. This facility is in compliance and no violations were issued during today's inspection.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 568-8081
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019
LIC809 (FAS) - (06/04)
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