367700067-11-9-2020-12-CC-JNEL-BV7U74-20201109141920

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 367700067
Report Date: 11/09/2020
Date Signed: 11/09/2020 02:19:33 PM

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:	WILLIAMS FAMILY CHILD CARE		FACILITY NUMBER:	367700067
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 2	DATE:	11/09/2020
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	01:16 PM
MET WITH:	Maxine Williams		TIME COMPLETED:	02:07 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 (LPA) Neal met with Licensee, Maxine Williams via unannounced Tele-inspection for the purpose of conducting a change of capacity inspection from a small to a large family child care home. Home consists of 6 bedrooms, 4 bathrooms, kitchen, living room, family room, dining area and backyard. Parents enter child care through the front door. Family members residing in the home include 3 adults (Applicant's and one applicant's mother) and 4 children. There were 2 children present during this inspection. Home was inspected inside and outside for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that are inaccessible to children. Fireplace is located in the off-limits family room and is screened. Child care activities are conducted in the living room and dining room areas. Children use the bathroom down the left hallway (observed clean and free from hazards). Garage and laundry room have child locks for inaccessibility. Garage is used for storage only and no child care activities are conducted there. Off limits areas include all bedrooms (child safety knobs observed) and other 2 bathrooms. Exception made for the bedroom at the end of the hallway on the right side of home. Bedroom at the end of the hallway is used only for ill children. Cleaning compounds and detergents are kept inaccessible to children in laundry room. Knives are kept in a butcher block in a high, child locked kitchen cabinet. Child safety knob observed on pantry door. Medications are made inaccessible by child lock in a high kitchen cabinet. Parent board was observed.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2020

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: WILLIAMS FAMILY CHILD CARE	FACILITY NUMBER: 367700067
	VISIT DATE: 11/09/2020

NARRATIVE

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There are mats and a pack and play available for napping children. There is a large fish tank in the dining room area. Cabinets underneath have magnet locks and there is a combination lock for inaccessibility. There is no pool or spa on the premises. Children play in the backyard. There is a padlocked gate that separates child care play area from the rest of the backyard. LPA observed grass and concrete for active play. There is 1 large dog. The dog run is located in the off limits portion of the backyard. There is also a garage (key locked) used for storage at the far end of the off-limits portion of the backyard . No childcare activities are conducted there.
Ffirearms are stored in a separate locked area from where ammo is stored. Both are made inaccessible in locked safes and stored in an off limits area of the home. The required fire extinguisher, carbon monoxide detector and smoke detector are in operable condition. The facility has central AC and heat. Licensees have current pediatric CPR/First Aid certification. Licensees were reminded that Mandated Reporter training must be completed every 2 years.

Licensees are aware if one provider or assistant is alone with any children, then it reverts to a small family child care. Licensee also understands the ratio and capacity requirements of the small and large family child care license. Licensee understands that any cleared adult caring for the children alone, in addition to background check clearance, must also have current Pediatric 1st Aid and CPR certificates, Mandated Reporter certificate for child care and proof of the required immunizations.

Fire Clearance was granted for a Large Family Child Care Home.

Facility was evaluated in accordance to licensing laws and regulations to ensure the health and safety of children. No deficiencies were cited on this date.

Capacity increase is approved and effective today 11/9/2020. This inspection was conducted via Tele-Inspection due to the COVID 19 crisis, report has been emailed for “Read Receipt” from the licensees. Exit interview was conducted with licensee.

SUPERVISOR'S NAME: Mariela Ramon	TELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Jazelle Neal	TELEPHONE: (661) 568-8945
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2020

LIC809 (FAS) - (06/04)

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