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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364830475
Report Date: 07/18/2023
Date Signed: 07/20/2023 09:49:19 AM


Document Has Been Signed on 07/20/2023 09:49 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:ABDALRAHIM FAMILY CHILD CAREFACILITY NUMBER:
364830475
ADMINISTRATOR:ABDALRAHIM LABRINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 885-9582
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY:14CENSUS: 0DATE:
07/18/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Labrina AbdalRahimTIME COMPLETED:
03:15 PM
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On July 18, 2023, Licensing Program Analyst (LPA) Kris Diaz conducted an unannounced Annual/Random inspection. LPA met with licensee, Labrina Abdalrahim who guided LPA on a tour of the home. People who reside in the home is the licensee, who has fingerprint clearance. The licensee has the required immunizations against pertussis (TDAP), measles (MMR) and have provided a signed statement declining the flu vaccine. At the time of the visit LPA observed zero child care children. Per licensee, five children are currently enrolled in the facility. Per the licensee, the large family childcare home operates 24 hours. LPA reminded licensee that someone has to be awake and supervising the children when the children are awake. Incidental Medical Services (IMS) were discussed. Per the licensee, she does not have children who need IMS currently.

This is a 3-bedroom, 2 bathroom apartment home with kitchen and living room. There is a gated pool on the complex premises. Main care is provided in the childcare room down the hall to the left (next to the master bedroom) and the living room. Children use the bathroom located near the child care room entrance on the right. The master bedroom is made off limits by lock. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds (above refrigerator), medicines (master bedroom), and hazardous items that can pose a danger to children. Sharp knives are kept on top of refrigerator inaccessible to children. The facility roster is complete and maintained current. Fire/earthquake drills are also current. LPA observed play equipment and other age-appropriate toys. The licensee has no pets.

LPA observed a large outdoor play structure with sand underneath within walking distance on the apartment complex grounds. Licensee states she does not take the children to the playground on premises. The pool is on the other side of the play structure and is gated. The license states she does not take the children into the pool area.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kristina DiazTELEPHONE: (661) 202-3372
LICENSING EVALUATOR SIGNATURE:
DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/18/2023
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: ABDALRAHIM FAMILY CHILD CARE
FACILITY NUMBER: 364830475
VISIT DATE: 07/18/2023
NARRATIVE
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Per licensee, there are no weapons or firearms of any kind in the facility at this time. The LPA did not observe any weapons. Children nap in the living room area. Mats are provided for napping. The required fire extinguisher (2A10BC) does not meet the standards of the state fire marshall. LPA advised licensee that it should be replaced or serviced. The smoke detector and carbon monoxide detector is in operable condition. Home has central AC and heat. Licensee's Pediatric CPR/First Aid expires 12.2024. The licensee has a First Aid kit which is kept in the children's bathroom cabinet (child locked). LPA observed the parent board and required documents are posted. The licensee was reminded that Mandated Reporter Training for child care must be completed by licensees and any adults assisting in the child care every 2 years. Licensee has completed a mandated reporter training that does not meet the standards of the state. LPA informed licensee that the required training can be found at mandatedreporterca.com

The following 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 were reviewed. Licensee reminded that 100% supervision is required at all times to children in care. The licensee was advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov . Licensee was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care. The licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified. 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 child 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.

Requirements for fingerprint clearances and associations were discussed with the licensee. Licensee can be cited a civil penalty of $100 per day, up to $500.00 for the 1st offense and up to $3000.00 for the 2nd offense within a 12 month period, PER PERSON.

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


SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kristina DiazTELEPHONE: (661) 202-3372
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023
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: ABDALRAHIM FAMILY CHILD CARE
FACILITY NUMBER: 364830475
VISIT DATE: 07/18/2023
NARRATIVE
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Licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B. Handout of Safe Sleep Concepts (PIN 20-24-CCP) was given to the licensee.

Licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent and a copy of the Acknowledgment of receipt of licensing report (LIC9224) must be kept in each child's file. In addition, any child enrolled within the following 12 months must also receive a copy of the Type A Citation.

1 Type B deficiency was cited during this inspection. See 809D for details. Appeal Rights were given.

Exit interview was conducted, report was read with and provided to Licensee on this date.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kristina DiazTELEPHONE: (661) 202-3372
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023
LIC809 (FAS) - (06/04)
Page: 10 of 10
Document Has Been Signed on 07/20/2023 09:49 AM - 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551


FACILITY NAME: ABDALRAHIM FAMILY CHILD CARE
FACILITY NUMBER: 364830475

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/18/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(1)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/04/2023
Plan of Correction
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Licensee has contacted applicable party to schedule appointment for service of fire extinguisher. Licensee will provide proof of correction by or before the date above.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Kristina DiazTELEPHONE: (661) 202-3372
LICENSING EVALUATOR SIGNATURE:
DATE: 07/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/18/2023
LIC809 (FAS) - (06/04)
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