<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364808491
Report Date: 07/23/2021
Date Signed: 07/23/2021 11:26:38 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:BROWN FAMILY CHILD CAREFACILITY NUMBER:
364808491
ADMINISTRATOR:BROWN, ZENNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 693-7500
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92404
CAPACITY:14CENSUS: 0DATE:
07/23/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:59 AM
MET WITH:Zenna BrownTIME COMPLETED:
11:35 AM
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
On 07/23/2021 at about 8:20 AM, Licensing Program Analyst (LPA) Aaron Mabika met with applicant Zenna Brown to conduct a Required Random Annual inspection. Applicant is providing care and supervision for a Large Family Child Care Home with the capacity of 14 children. Days and hours of operation are Monday - Sunday 6:00AM - 5:30AM, for ages 0-10yrs. Currently residing in the home is applicant, 4 biological children (2 adults and 2 minors) and all have background cleared.
The home is neat and clean and set up as follows: This is a single-story home with 4 bedrooms, 2 bathrooms, kitchen, dining room, a living room and an attached garage. The smoke and carbon monoxide detectors were tested and operable. There are fully charged fire extinguisher (2A10BC); and fully stocked first aid kit. The home has central heating, air conditioning, and working phone service. There two fireplaces one in the den and the other in the living room and LPA noticed they were all screened. All unused electrical outlets are plugged and made inaccessible to children. Applicant states there are no weapons in the home. Fire drills are conducted quarterly, per documentation reviewed. LPA provided the Licensee with a summation form for display on the board.
The main areas of day care are the living room, day care room for toddlers in the form of a bonus room and bathroom #1. The off-limit areas of the home are the kitchen, bedrooms #1, #2 , #3 and 4 (inaccessible by safety doorknobs), bathroom #2 (located in master bedroom), laundry room, garage, and the entire backyard. LPA observed 4 exersaucers in the day care room and licensee stated she did not know they were not allowed in the day care. Licensee removed them all for disposal before the departure of the LPA.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2021
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: BROWN FAMILY CHILD CARE
FACILITY NUMBER: 364808491
VISIT DATE: 07/23/2021
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
26
27
28
29
30
31
32
 All sharp utensils are in the off-limits high kitchen cabinet, and the cleaning supplies in a locked hallway cabinet. All medications were observed to be in the off-limits bedroom #3 (master bedroom).
The day care room is located to the right of the front door. The main day care room has child friendly furniture in the form of desks, chairs, library and games. LPA observed a play pen and 10 mats for napping. Per applicant, the children nap on mats in the main day care room and the infant naps in a playpen.
Applicant provide 3 meals and 3 snacks. The children eat in the dining room, there is a table and chairs set up for day care children. Licensee is not providing any transportation at this time.
The backyard is completely fenced, cemented, clean and free from debris, and off limits to day care children. There is no pool on the premises.
Applicant and her assistant have current CPR, First Aid Training with an expiration date of 09/2021. Applicant has completed Preventative Health and Safety Training. Applicant and assistant completed Mandated Reporter dated (2/21/2020). All adults in the home have a fingerprint clearance, and TB exam.
LPA Mabika observed a Parent Board with license and required licensing documents. Four children’s files were reviewed.

LPA discussed the following:


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 (Center or family child care home) are aware of situations that present the greatest danger to children. These situations include:
· Serious health and safety violations resulting in Type A citations;
· Non-compliance conferences; or
· Efforts by the Department to revoke a facility’s license.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2021
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: BROWN FAMILY CHILD CARE
FACILITY NUMBER: 364808491
VISIT DATE: 07/23/2021
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
26
27
28
29
30
31
32
 Any reports (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). Failure to meet the posting requirements shall result in an immediate civil penalty. In addition, all parents of currently enrolled children and any newly enrolled child for the following 12 months shall receive a copy of report and sign the LIC 9224 acknowledging receipt. Civil Penalty assessments will be assessed if all above requirements are not adhered to.
Applicant is advised to visit www.shotsforschool.org for Immunization information.
Applicant is advised of responsibility to report suspected Child Abuse, 1-800-540-4000.
Applicant is advised for quarterly updates to contact the Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

Regulation prohibits smoking of any kind of tobacco in a private residence that is licensed as a Child Care Facility and in those areas of the 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.

LPA discussed "Safe Sleep", staffing ratios, fingerprinting requirements for any new staff and the reporting of any unusual incidents. LPA printed out some safe sleep information.

On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every (2) year following the date on which he or she completed the initial mandated reporter training.

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

DATE: 07/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2021
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: BROWN FAMILY CHILD CARE
FACILITY NUMBER: 364808491
VISIT DATE: 07/23/2021
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
26
27
28
29
30
31
32
5 There is an on-Duty Worker/Officer is available to answer any questions and concerns at
(661) 202-3318. Department hours of operation not including state holidays are Monday - Friday from 8:00am - 5:00pm

A type “B” citation was issued in regard to the possession of forbidden equipment in the form of exersaucers although the licensee disposed of them. An exit interview was conducted, a signed copy of this report was read and left with applicant. A notice of site inspection was discussed and left with Licensee, Zenna Brown
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Aaron MabikaTELEPHONE: (661) 305-7599
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2021
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: BROWN FAMILY CHILD CARE
FACILITY NUMBER: 364808491
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/23/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/23/2021
Section Cited

1
2
3
4
5
6
7
102417 Operation of a Family Child Care Home
(1) Fixtures, furniture and equipment that have been banned or recalled by the United States Consumer Protection Safety Commission shall not be used for children in care or accessible to children in care.
8
9
10
11
12
13
14
This requirement was not met as evidenced by the presence of 4 exersaucers on the premise. Licensee stated she did not know of that regulation.
This poses a potential danger to children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7

1
2
3
4
5
6
7
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: 07/23/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/23/2021
LIC809 (FAS) - (06/04)
Page: 5 of 5