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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364840815
Report Date: 04/10/2023
Date Signed: 04/10/2023 02:35:50 PM


Document Has Been Signed on 04/10/2023 02:35 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:MITCHELL FAMILY CHILD CAREFACILITY NUMBER:
364840815
ADMINISTRATOR:MITCHELL, RENEEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 240-8657
CITY:APPLE VALLEYSTATE: CAZIP CODE:
92308
CAPACITY:14CENSUS: 0DATE:
04/10/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:MITCHEL RENEETIME COMPLETED:
03:06 PM
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Licensing Program Analyst (LPA) Babatunde Ibitoye met with licensee Renee Mitchell. 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 no children enrolled in the family childcare Since November 2019. Present during the time of this inspection is the licensee and (0) day-care children, Per the licensee, all adults residing in the home have a Criminal Record 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 (5 am to 10 pm).

The home is set up as follows: This is a 1 story home with 3 bedrooms and 3 bathrooms. Per Licensee the following areas of the home are utilized for the Family Child Care: Living Room, Kitchen, dining room, bathroom and Backyard with spa that is locked up. The off-limits of the home is 3 bedrooms, 2 bathroom. There is a fireplace located in the living room which is made inaccessible to children with a metal cage barrier. The home has central heating and air conditioning. In the kitchen, all sharp utensils, poisons are made inaccessible to children with child safety latches on sink cabinet and drawers. LPA toured the bathroom and inspected sink/toilet are in operable condition. All clean supplies, poison and medications are made inaccessible to children with child safety latches on sink cabinet and drawers. All unused electrical outlets are plugged and made inaccessible to children. the equipment and toys are observed to be safe. Per licensee meals and snack will be provided for children.

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde IbitoyeTELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:
DATE: 04/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/10/2023
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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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: MITCHELL FAMILY CHILD CARE
FACILITY NUMBER: 364840815
VISIT DATE: 04/10/2023
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Per licensee, the children will nap on mat in living room. There is a fully charged fire extinguisher (2A10BC); and fully stocked first aid kit with manual. Licensee states there are no weapons or firearms in the home or on the premises and smoke detectors and carbon monoxide detector were tested

Outside:
The backyard play area is clean and free from all trash and debris or dangerous conditions. Backyard is fenced. There is no swimming pool but there is a spa which is secured and locked up on the premises. There is also a chicken coop which is locked up and inaccessible for children.

Documentation:
Licensee does not have current CPR, First Aid Training with the expiration dates of 01-26-2021 see TA LIC 9102 . All adults in the home have a fingerprint clearance and TB Clearance. Licensee have proof of being immunized against influenza, pertussis and measles. Licensee does not have proof of Mandated Reporting Training and was provided information on needed certificates see TA LIC 9102. Per licensee no transportation provided at this time.

The following was discussed with the licensee:
Mandatory Forms for the children’s files and provider’s, Role and responsibilities of being a mandated reporter.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde IbitoyeTELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:

DATE: 04/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023
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: MITCHELL FAMILY CHILD CARE
FACILITY NUMBER: 364840815
VISIT DATE: 04/10/2023
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. 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.

· Requirements for fire drills, earthquake drill discussed and no documentation for drill provided, LPA advised the licensee to conduct a disaster drill every six months.

· 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.

· 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

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde IbitoyeTELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:

DATE: 04/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023
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: MITCHELL FAMILY CHILD CARE
FACILITY NUMBER: 364840815
VISIT DATE: 04/10/2023
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· 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.

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde IbitoyeTELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:

DATE: 04/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023
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: MITCHELL FAMILY CHILD CARE
FACILITY NUMBER: 364840815
VISIT DATE: 04/10/2023
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· State law prohibits baby walkers, bouncy seats, exersaucers, and any other items that fall into that category.

. 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”.

LPA Issued Technical Advisory Note

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 Mitchell Renee.

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde IbitoyeTELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:

DATE: 04/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023
LIC809 (FAS) - (06/04)
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