364817663-5-10-2023-12-CC-BIBE-CRPQWU-20230510123230

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364817663
Report Date: 05/10/2023
Date Signed: 05/10/2023 12:32:55 PM

Document Has Been Signed on 05/10/2023 12:32 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:	HAEFELE FAMILY CHILD CARE		FACILITY NUMBER:	364817663
ADMINISTRATOR:	HAEFELE, MELISSA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 265-2453
CITY:	BARSTOW	STATE: CA	ZIP CODE:	92311
CAPACITY:	14	CENSUS: 2	DATE:	05/10/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	MELISSA HAEFELE		TIME COMPLETED:	12:50 PM

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Licensing Program Analyst (LPA) Babatunde Ibitoye met with licensee Melissa Haefele The purpose of the inspection is to conduct a 1-year Required Annual Inspection. Licensee is licensed to provide care and supervision for a Large Family Child Care for a capacity of 14 children. There are currently (10) children enrolled in the family childcare. Present during the time of this inspection is the licensee and (2) day-care children, Per the licensee, husband and 2 adult son residing in the home have a Criminal Record Clearance and TB clearance . 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 and hours of operation are Monday -Friday (6 am to 6 pm).

This is a single-story house with 3 bedrooms, 2 bathrooms, a kitchen/dining room, living room, family room, room addition ( enclosed patio), and attached garage. The living room; family room; room addition (enclosed patio) and 1 bathroom are designated for child care. Off-limit areas Include: 3 bedroom,Master Bathroom,Garage, Front yard and Backyard. There is a fireplace located in the living room which is inaccessible screened and home has radiant heat and swamp cooler for ventilation.

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 are made inaccessible to children during the time of this inspection. LPA observed age-appropriate safe toys and napping equipment on the premises. Per the licensee, children nap in the room Addition . LPA observed all electrical outlets made inaccessible to children with safety covers. Per the licensee, there are no weapons or firearms on the premises. LPA did not observe a swimming pool or bodies of water on the premises.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde Ibitoye	TELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

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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Document Has Been Signed on 05/10/2023 12:32 PM - It Cannot Be Edited

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: HAEFELE FAMILY CHILD CARE	FACILITY NUMBER: 364817663
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/10/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102416.1(a)(6)

Personnel Records

(a) Personnel records shall be maintained on each employee and shall contain the following information: (6) Documentation of completion of training on preventative health practices as required by Section 102416(c). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/24/2023
	Plan of Correction
1 2 3 4	Licensee will submit proof by due date

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde Ibitoye	TELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

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

FACILITY NAME: HAEFELE FAMILY CHILD CARE	FACILITY NUMBER: 364817663
	VISIT DATE: 05/10/2023

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LPA observed required fire extinguisher (2A10BC) was fully charged, and smoke detectors and carbon monoxide devices were tested operable. The First Aid Kit was observed complete with supplies and a first aid manual. Licensee will submit proof of current Pediatric CPR and First Aid Training LPA Observed Licensee have proof of 1 hour of nutrition training, (8) hours of Preventive Health and Safety Training. Licensee has proof of being immunized against pertussis, and measles. exemption for Influenza

Per the licensee, transportation is being provided for children at this time.

LPA reviewed 5 children’s records , LPA reviewed the childcare facility roster and the fire drills, earthquake drills log, and documentation for both. Incidental Medical Services (IMS) were discussed. Per the licensee, the facility is not currently providing IMS. LPA informed the 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www/ada.gov/childqanda.htm.

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. The last fire/earthquake drill was completed on 01/18/2023, LPA advised the licensee to conduct a disaster drill every six months.

· Role and responsibilities of being a mandated reporter were 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 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.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde Ibitoye	TELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

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

FACILITY NAME: HAEFELE FAMILY CHILD CARE	FACILITY NUMBER: 364817663
	VISIT DATE: 05/10/2023

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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 online 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 childcare center or family child-care home shall have at least one hour of childhood nutrition training.

· **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 childcare facility are aware of situations that present the greatest danger to children.

· Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit. **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.

**§1597.622 Employees or volunteers at a 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.

· State law prohibits baby walkers, bouncy seats, exersaucers, and any other items that fall into that category.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde Ibitoye	TELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

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

FACILITY NAME: HAEFELE FAMILY CHILD CARE	FACILITY NUMBER: 364817663
	VISIT DATE: 05/10/2023

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. Safe Sleep: LPA discussed the safe sleep regulations with the 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.

· Lead Poisoning: For more information, go to the California Childhood Lead Poisoning Prevention Branch’s website at www.cdph.ca.gov/programs/clppb,or call them at (510) 620-5600.

· Licensee advised visit www.shotsforschool.org for Immunization information.

· Child Care Advocates: You can now sign up for Quarterly Updates and PINs for one or more programs through our DSS website at www.ccld.ca.gov. Click on “Receive Important Updates” located in the right middle part of the page, immediately above the Quick links. Put your email address and choose which program(s) you would like to subscribe to and click “subscribe”.

Deficiencies Cited: one deficiency is being cited in accordance with Title 22 of the California Code of Regulations and/or Health & Safety codes. See LIC 809D.

Notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted and the report was reviewed with the licensee Melissa Haefele.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde Ibitoye	TELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

LIC809 (FAS) - (06/04)

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