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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364815803
Report Date: 12/07/2023
Date Signed: 12/07/2023 01:55:03 PM


Document Has Been Signed on 12/07/2023 01:55 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:BROWN FAMILY CHILD CAREFACILITY NUMBER:
364815803
ADMINISTRATOR:BROWN, MAYRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 245-6023
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY:14CENSUS: 11DATE:
12/07/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Mayra BrownTIME COMPLETED:
02:00 PM
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On 12/07/2023, at 10:50 A.M., Licensing Program Analyst (LPA) Joselito L. Del Mundo conducted an unannounced annual inspection at Hancock-Ege Family Child Care Home to assess its ability to meet compliance with California Code of Regulations (CCR) Title 22, Health, and Safety requirements. LPA Del Mundo met with Licensee, Mayra Brown and stated the reason for the inspection. The LPA provided copies of the LIC 126 Entrance Checklist Form, LIC 311D Forms/Records to Keep in the Family Child Care Home, and all records/forms that need to be maintain in the facility. Licensee guided the analyst on a tour of the day care areas. The day care take place in the following area of the home: living room (main day care), front room, dining area, bedroom # 1 (infant room), bathroom #1, and outdoor play area.

Licensee states the day care hours of operation is Monday to Friday, from 7:00 A.M. to 6:00 P.M. Currently living in the home is the licensee and licensee’s spouse. Licensee is currently not providing transportation to children in care. During this visit, LPA observed eleven children present in the facility and two assistants.

Physical Plant: 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. LPA observed all cleaning products and detergents are stored in the laundry room (off limits) where they are inaccessible to children. Knives and other sharp items are stored in the kitchen pantry (off limits) and secured with a lock to make them inaccessible to children. Household medications are also stored in the kitchen pantry (off limits) where children do not have any access. Licensee also told LPA that zero medications are currently being provided for the current children in care. Licensee stated that she is a member of a food program and is providing two meals and two snacks to children.

The facility is a two-story house. All room upstairs are off limits, and a wooden gate is installed to barricade the entrance upstairs. There is a fireplace in the facility and is covered with a metal screen and a glass door.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundoTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:
DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/07/2023
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: 364815803
VISIT DATE: 12/07/2023
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The home has central heating and air conditioning units.

Based on records review, licensee conducted the fire/earthquake drills on November 10, 2023, at 9:00 A.M. and 9:30 A.M., and is conducted once every six months. The facility has a fully charge fire extinguishers with a 3-A:40-B:C classification (reading in green, checked at 11:56 A.M.) and the last service date was 08/27/2021.



LPA observed safe and age-appropriate toys, dolls, building blocks, puzzles, numbers, letters, tables, chairs, cubbies, books, and other learning materials in the living room (main day care area). LPA observed ten sleeping cots and are in the front room (sleeping area) of the facility. Per licensee, she provides fourteen sleeping cots for children to use. The facility is using bedroom #1 (infant sleeping room). LPA observed 2 cribs, diaper changing table, sink, cubbies for diapers, hand sanitizer, wet wipes, globes, facemasks, diaper changing sheet, and plastic bags inside bedroom #1.

Licensee has first aid kit box mounted on a wall beside the entrance door of the facility. The smoke detector and carbon monoxide detector are in operable conditions (checked at 11:52 A.M.). LPA observed electrical outlets are covered with a safety plastic plug to prevent access by children in care. Licensee stated that she owns no firearms, and no one smoke in the facility.

Licensee is advised that baby bouncers, saucer chairs, or any recalled and or banned toys or sleep/ play equipment are prohibited on the premises. Licensee is advised to check for fixture, furniture and equipment that have been banned or recalled by the United States Consumer Product Safety Commission.

Bathroom: Toilet, sink and faucet were clean and operable. During the inspection, LPA observed a step stool inside the bathroom. LPA did not observed razors and/or sharp objects, shampoos, mouthwash, medications, perfumes, air freshener, nail polish and nail remover that will pose a health and safety risk to children in care.



Currently, the licensee has 18 children enrolled in the facility. Licensee stated that when a child shows signs of illness, he/she is separated from other children in the living room of the facility.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundoTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
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: 364815803
VISIT DATE: 12/07/2023
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Outdoor: The facility has no body of water on the premises. The outdoor play area has a covered porch and age-appropriate toys and play equipment. LPA observed toy houses, basketball, slides, seesaw, small tricycles, and kitchen set toy. The outdoor play area is covered with grass, concrete, and mulch. Per licensee, she supervised children while playing outside.

At the time of inspection, Licensee is aware of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing on the day of the incident and/or 24 hours of incident by telephone, fax and/or in writing to the Department. Licensee is familiar with the Unusual Incident Report form, LIC624B. The report on unusual incident/injuries can also be mailed to unusualIncidentreport@dss.ca.gov

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. LPA reviewed five children’s files, licensee, and assistants’ files. Based on records review, children’s files are complete; licensee and assistants have current mandated reporter trainings completed on 07/19/2023 and 06/02/2022; CPR/First Aid trainings were completed on 01/21/2023. Licensee and assistants have proof of immunization against measles, pertussis, and influenza except for assistant #1 who is missing measles shot record. Licensee is advised to send a copy of assistant #1 measle immunization records. Licensee and assistants have TB skin test on file.

Licensee and other adults working and living at the facility have received criminal record clearance.

The following was discussed with the licensee:

The licensee was reminded that 100% supervision is always required for children in care. Licensee was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care. Licensing must always have the facility’s phone number; if the phone number is changed, licensing must be notified.



The regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare 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.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundoTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: BROWN FAMILY CHILD CARE
FACILITY NUMBER: 364815803
VISIT DATE: 12/07/2023
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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-and-resources/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.

Incidental Medical Services (IMS) policy was discussed. 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

Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates on courses and updates/changes to the regulations. Our Quarterly updates come out every 3 months and are also in Spanish. Please log in to the CCLD website, or you can email our advocates to have the quarterly updates sent directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov



The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 AM - 5:00 PM.

The facility is in compliance per Title 22 regulations. During today's inspection, LPA Del Mundo did not observed deficiencies that may hinder the health and safety of the children in care. No deficiencies were cited

SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundoTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: BROWN FAMILY CHILD CARE
FACILITY NUMBER: 364815803
VISIT DATE: 12/07/2023
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during this inspection. An exit Interview and discussion of observations were conducted with the licensee.

Notice of Site Visit: A Notice of Site Visit (LIC 9213 was given and must remain posted for 30 days.
Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

A copy of this Report was reviewed, and Appeal Rights were also provided to Licensee, Mayra Brown.
SUPERVISOR'S NAME: Lady KingTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Joselito DelMundoTELEPHONE: (661) 202-3491
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
LIC809 (FAS) - (06/04)
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