364843215-12-21-2021-12-CC-LTMR-C9WR6H-20211221114446

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364843215
Report Date: 12/21/2021
Date Signed: 12/21/2021 11:44:54 AM

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:	WILEY FAMILY CHILD CARE		FACILITY NUMBER:	364843215
ADMINISTRATOR:	WILEY, MILDRED		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 951-2781
CITY:	VICTORVILLE	STATE: CA	ZIP CODE:	92394
CAPACITY:	14	CENSUS: 0	DATE:	12/21/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:43 AM
MET WITH:	Mildred Wiley		TIME COMPLETED:	12:04 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst's (LPAs) Thompson-Miller and Stepanyan met with Licensee, Mildred Wiley, who guided analyst on a tour of the facility for the One Year Required Inspection. This is a two story 5 bedroom, 3 bathroom home with kitchen/dining, family room, living room, formal dining room, laundry and garage. There is no pool/spa or body of water on the premises. Upon arrival LPAs observed no children in care. Family members residing in the home include 4 adults (licensee, licensee spouse, adult son, adult daughter) and no children. Days/hours of operation are 6AM to 5PM, Monday through Friday. Incidental Medical Services (IMS) policy was discussed. Physical Plant: Main care is provided in the living room (at entrance). Children use the bathroom in hallway on the left. Children have access to Bedroom #1 (infant napping room ). Off limit areas include the entire upstairs (Bedroom #2 , #3 , #4 and #5, bathroom #2 and #3, laundry), kitchen (gated from formal dining room and hallway) and garage (key lock). The home was inspected inside and out for safety, clean and orderly, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (upstairs), medicines (upper kitchen cabinet-off limits) and hazardous items (sharp knives inside kitchen pantry) that can pose a danger to children. Fireplace is screened, off limits room. Safe and age appropriate toys, play equipment and materials. The smoke detector and carbon monoxide detector, Fire Extinguisher (2A10BC) are in operable condition. Stairs have a gate. Per Licensee no one smokes in the home. Electrical outlets are inaccessible, no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/ play equipment were observed on the premises. There is a designated area for ill children as necessary in living room. Per Licensee there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (landline, cell). Fire/earthquake drills complete and maintained current. Roster complete and maintained current. Age appropriate napping (cots, cribs) equipment.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Linda Thompson-Miller	TELEPHONE: (661) 568-8186
LICENSING EVALUATOR SIGNATURE:	DATE: 12/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2021

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: WILEY FAMILY CHILD CARE	FACILITY NUMBER: 364843215
	VISIT DATE: 12/21/2021

NARRATIVE

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Bathroom: Shower/tub are free of hazards (child care bathroom). The following are inaccessible: Sharp items, mouthwash, shampoo, razor, nail polish. Toilet and faucet is clean and operable.
Kitchen: Sharp utensils, open bottles or alcohol are inaccessible. If food is brought from the children’s home, the container shall be labeled with the child’s name and properly stored or refrigerated (Licensee does not allow outside food for the children care). The home has a clean and fully stocked refrigerator/freezer. Cleaning supplies are in laundry area and under kitchen sink with magnet lock (off limit). No chemicals in the kitchen were observed to be accessible. Breakfast, lunch and snacks will be provided.

Outdoor: The backyard is safe for children (lawnmower, gardening tools, poisonous plant, thorn trees, cactus, pets are inaccessible). The backyard is completely fenced (right wooden fence, left wrought iron gate). There is no body of water. The backyard is divided into 3 sections. (first has patio and play area, second and third is gated and is off limits to the children). There is a barbecue grill (covered) and other Little Tikes age appropriate toys. There is a small dog (dog run on the left, vaccinated). There is a swing/slide that is anchored. There is cushioning or resilient material (black industrial mats) around play structures.

Advisory/Other: First Aid kit was observed with supplies (thermometer) readily available. CPR/First Aid expire 10/09/2023. Mandated Reporter expire 12/19/23. Electrical outlets are inaccessible, no baby bouncers saucer chairs, or any recalled and or prohibited toys or sleep/play equipment were observed on the premises. The First Aid kit was observed and is complete. There are no window cords accessible to children in the child care area. Child nap on cots and cribs.
Documents Provided and or Discussed: Fire Drill Log, Roster, Postings, Safe Sleep and Lead Poisoning flyer's, COVID-19 posters and CDPH Mandate (Licensee has mask for the children and the children bring own). Licensee stated currently does not have child care insurance.

Names of all adults living in the home: All adults living/residing in the home are fingerprint cleared and associated.

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 Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Linda Thompson-Miller	TELEPHONE: (661) 568-8186
LICENSING EVALUATOR SIGNATURE:	DATE: 12/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2021

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: WILEY FAMILY CHILD CARE	FACILITY NUMBER: 364843215
	VISIT DATE: 12/21/2021

NARRATIVE

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The following was discussed with the Licensee:
Mandatory licensing forms for the children’s files, facility forms/records, and information to be posted in the family child care home; Requirements to conduct fire and disaster drills once every six months and record it; Role and responsibilities of being a mandated reporter (www.mandatedreporterca.com) were reviewed; Licensee reminded that 100% supervision is required at all times to children in care; Licensee made aware that it is his/her/their responsibility to know the regulations as well as anyone who assists in providing 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 any kind during the operation of the day care. Per Licensee no on smokes in the home. The "Notification of Parent's Rights" poster must be posted in an area of the home accessible to parents. Licensee advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov .
Licensee advised of the requirement to report Unusual Incidents. Licensee informed to utilize the Unusual Incident Report/Injury Report LIC624B when submitting the report to the department (email address on the website: www.unusualincidentreport@dss.ca.gov). A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of family day care home. In addition, a written report shall be submitted to the department within seven days following the occurrence of any events specified above.

Licensee advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days whenever a licensing inspection is conducted. If a Type A deficiency is cited, a copy of the licensing report must also be posted for 30 days. The same report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months & licensee must obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file. Copies of the reports must be provided to each parent when a Type A violation is cited along with Acknowledgment of Receipt of Licensing Reports LIC 9224. If these requirements are not met civil penalties per violation will be assessed.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Linda Thompson-Miller	TELEPHONE: (661) 568-8186
LICENSING EVALUATOR SIGNATURE:	DATE: 12/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2021

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: WILEY FAMILY CHILD CARE	FACILITY NUMBER: 364843215
	VISIT DATE: 12/21/2021

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Prior to making alterations or additions to a family child care home or grounds, the Licensee shall notify the Department of the proposed changed, including, but not limited to, the following: Conversion of a garage (either attached or detached) into a "child care" room; Room additions to the family child care home. Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care. Licensee shall provide the Department with a copy of an inspection report when an inspection is required by the local building inspector as a result of the alteration, addition or construction.

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 name 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 Mildred Wiley 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.

No deficiency. The On Duty Worker is available for questions at (661) 202-3318 Monday through Friday 8am-5pm.
A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Licensee Mildred Wiley. This report was read and provided to Licensee Mildred Wiley on this date

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Linda Thompson-Miller	TELEPHONE: (661) 568-8186
LICENSING EVALUATOR SIGNATURE:	DATE: 12/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2021

LIC809 (FAS) - (06/04)

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