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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364842697
Report Date: 06/13/2019
Date Signed: 06/13/2019 04:08:42 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME:WALKER-JACKSON FAMILY CHILD CARE HOMEFACILITY NUMBER:
364842697
ADMINISTRATOR:WALKER-JACKSON, YASHIKAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 987-7605
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY:14CENSUS: 6DATE:
06/13/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Dawn WalkerTIME COMPLETED:
04:20 PM
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Licensing Program Analyst (LPA) Neal met with licensee's mother, Dawn Walker for the purpose of a Random inspection. This is a two story 5 bedroom, 4 bathroom home with kitchen, living room/dining room, family room, laundry room and garage. The garage is used for storage only and no child care activities are conducted there. There were 6 child care children present during this inspection and 2 assistants (background cleared). Licensee was not home during this inspection, however LPA spoke to her over the phone and was guided on a tour of the home by licensee's mother.

Main care is provided in the family room. Children use the bathroom near the entrance to the home down the hall to the left. The home was inspected inside for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds (upper shelf in pantry), medicines, and hazardous items that can pose a danger to children. Sharp knives are stored in a high kitchen cabinet above the microwave/oven. Fireplace is screened.

LPA observed age appropriate toys and equipment on the premises. Home has central AC and heat. Staff 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.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle NealTELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2019
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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME: WALKER-JACKSON FAMILY CHILD CARE HOME
FACILITY NUMBER: 364842697
VISIT DATE: 06/13/2019
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Staff 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.

No deficiencies were cited during this inspection.

LPA Neal will return to the family child care home to continue inspection on a later date.
Exit interview was conducted and a copy of report was read and provided to the assistant on this date.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Jazelle NealTELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2019
LIC809 (FAS) - (06/04)
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