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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364844474
Report Date: 10/06/2022
Date Signed: 10/06/2022 01:18:32 PM


Document Has Been Signed on 10/06/2022 01:18 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:GIEBE FAMILY CHILD CAREFACILITY NUMBER:
364844474
ADMINISTRATOR:GIEBE VICTORIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 565-8302
CITY:PHELANSTATE: CAZIP CODE:
92371
CAPACITY:14CENSUS: 9DATE:
10/06/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:49 AM
MET WITH:GIEBE VICTORIA TIME COMPLETED:
01:20 PM
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Licensing Program Analyst (LPA) Babatunde Ibitoye met with licensee GIEBE VICTORIA. The purpose of the inspection is to conduct 1 year Required Annual Inspection. Licensee is licensed to provide care and supervision for a Large Family Child Care for the capacity of 14 children. There are currently (20) children enrolled in the family childcare. Present during the time of this inspection is licensee, Assistant and (9) day-care children, per licensee all adults residing in the home has a Criminal Record Clearance. LPA toured the areas of the home utilized for the Family Child Care to ensure the home is incompliance with Community Care Licensing Title 22 Regulations. The days and hours of operation are Monday -Friday (6am to 6pm).

This is a Two story house with 4 bedrooms, 3 bathrooms, kitchen/dining room, living room, family room, playroom and attached garage. Licensee states the family room/classroom, dining room, 1 bathroom and backyard are utilized for the family child care. The off-limit areas of the home are 4 bedrooms, living room, 2 bathroom, kitchen, Front, outside gated area and garage. There is a fireplace located in the living room which is inaccessible to children with a glass barrier locked.

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 licensee children nap in the family room. LPA observed all electrical outlets made inaccessible to children with safety covers. Per licensee, there are no weapons or firearms on the premises. LPA did not observe a swimming pool or bodies of water on the premises. LPA observe the backyard which is clean and neat.

SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 789-6944
LICENSING EVALUATOR NAME: Babatunde IbitoyeTELEPHONE: 661-568-8179
LICENSING EVALUATOR SIGNATURE:
DATE: 10/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/06/2022
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: GIEBE FAMILY CHILD CARE
FACILITY NUMBER: 364844474
VISIT DATE: 10/06/2022
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LPA observed required fire extinguisher (2A10BC) fully charged, smoke detectors and carbon monoxide devices tested operable. The First Aid Kit was observed complete with supplies and first aid manual. LPA observe licensee has current Pediatric CPR and First Aid Training with expiration date (09-20-2024) 1 hour of nutrition training, (15) hours of Preventive Health and Safety Training. Licensee have proof of being immunized against influenza, pertussis and measles.

Per licensee transportation is being provided for children. LPA observe licensee valid California driver license with the expiration date of 12-22-2022, vehicle insurance with expiration date 03-12-2023 and vehicle registration with the expiration date of 01-27-2023.

LPA reviewed 4 children record and 3 Staff file, LPA reviewed the childcare facility roster and the fire drills, earthquake drills log and documentation for both. Incidental Medical Services (IMS) were discussed. Per licensee, the facility is not currently providing IMS. LPA informed 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 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 04/22/2022, LPA advised licensee to conduct a disaster drill every six months.

· Role and responsibilities of being a mandated reporter was discussed.

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

DATE: 10/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2022
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: GIEBE FAMILY CHILD CARE
FACILITY NUMBER: 364844474
VISIT DATE: 10/06/2022
NARRATIVE
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· 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 on-line mandated reporter training and shall complete renewal mandated reporter training every two years. @www.mandatedreporterca.com

**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 child care 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.

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

DATE: 10/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2022
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: GIEBE FAMILY CHILD CARE
FACILITY NUMBER: 364844474
VISIT DATE: 10/06/2022
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· 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 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.

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

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

DATE: 10/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2022
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: GIEBE FAMILY CHILD CARE
FACILITY NUMBER: 364844474
VISIT DATE: 10/06/2022
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· 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”.

A notice of site visit was given and must remain posted for 30 days.

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

Deficiencies Cited :No deficiencies cited.

Exit interview conducted and report was reviewed with the licensee GIEBE VICTORIA.

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

DATE: 10/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2022
LIC809 (FAS) - (06/04)
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