364808491-8-19-2024-12-CC-KZIS-D8APY5-20240819114322

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364808491
Report Date: 08/19/2024
Date Signed: 08/19/2024 11:43:28 AM

Document Has Been Signed on 08/19/2024 11:43 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	BROWN FAMILY CHILD CARE		FACILITY NUMBER:	364808491
ADMINISTRATOR:	BROWN, ZENNA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(909) 693-7500
CITY:	SAN BERNARDINO	STATE: CA	ZIP CODE:	92404
CAPACITY:	14	CENSUS: 3	DATE:	08/19/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Licensee Zenna Brown		TIME COMPLETED:	12:00 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	On August 19, 2024, at 09:10 a.m., Licensing Program Analyst (LPA) Zirbes met with Licensee Zenna Brown who guided analyst on a tour of the home for the Annual/Random inspection. Upon arrival, LPA observed three preschool age children in care, with the Licensee and Adult 1 (A1) providing supervision. Based on LPA observation, the child care was meeting the staffing/ratio requirements at the time of this inspection. According to the Licensee currently living in the home are the Licensee, two adult children and one minor child. All adults are associated and have eligible clearances. Current days and hours of operation are Monday through Sunday 23 hours a day. Physical Plant: This is single story home with four bedrooms, two bathrooms, kitchen, dining room, living room, child care room (bonus room) front and backyard and a detached garage. Per Licensee, the living room, kitchen, dining room, hallway bathroom, bonus room and front yard are utilized for the family child care activities. Per licensee off-limit areas of the home are all four bedrooms, master bathroom, detached garage and the backyard. The off limits areas were inaccessible via locked doors. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds, medicines and hazardous items that can pose a danger to children. During the inspection, LPA observed cleaning products were stored in a key locked cabinet in the kitchen. If medications are required for the child care children, they are contained in a key locked container. Household medications are stored in the off limit locked bedrooms. Knives and sharp items were stored a high inaccessible kitchen cabinet. LPA observed a smoke detector and carbon monoxide detector in the home. The home had two fire places located in the living room, and child care room. The fireplaces were inaccessible via fireplace screens. LPA did not observe baby bouncers/saucer chairs, or any recalled and or prohibited toys on the premises. Per Licensee, there are zero firearms or weapons stored in the family child care. Report continued on page two

SUPERVISOR'S NAME: Lady King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal Zirbes	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2024

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: BROWN FAMILY CHILD CARE	FACILITY NUMBER: 364808491
	VISIT DATE: 08/19/2024

NARRATIVE

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Report continued from page one

According to the documentation a fire extinguisher was purchased in April 2024.

Bathroom: (located in the hallway): Toilet, sink, shower were clean and sanitary.

Outdoor: The outdoor activity space is located in the front yard which is fully enclosed with a fence. The outdoor activity space was free of hazards at the time of this inspection. Per Licensee there are zero bodies of water on the property. LPA did not observe bodies of water on the property.

Per Licensee, there are three dogs on the property. The dogs do not interact with the child care children.

Record Review: LPA reviewed five child files, the Licensees file and the assistants file. Per LPA review, all required documentation was within the files at the time of this inspection.

During the exit interview, the Licensee Zenna Brown, confirmed that there are no Registered Sex
Offenders living in the facility and LPA completed the RSO profile in FAS.

Review of records to be maintained: LPA reviewed with licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.
The following was discussed with the licensee:
Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/
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. Report continued on page three

SUPERVISOR'S NAME: Lady King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal Zirbes	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2024

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: BROWN FAMILY CHILD CARE	FACILITY NUMBER: 364808491
	VISIT DATE: 08/19/2024

NARRATIVE

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Report continued from page two

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

As a result of this inspection, zero citations were issued.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Zenna Brown. Appeal Rights were provided.

SUPERVISOR'S NAME: Lady King	TELEPHONE: (310) 568-1824
LICENSING EVALUATOR NAME: Kendal Zirbes	TELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2024

LIC809 (FAS) - (06/04)

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