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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 367700154
Report Date: 04/02/2020
Date Signed: 04/02/2020 11:30:35 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:WILKIE FAMILY CHILD CAREFACILITY NUMBER:
367700154
ADMINISTRATOR:WILKIE, DIANEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 936-4429
CITY:SAN BERNARDINOSTATE: CAZIP CODE:
92407
CAPACITY:14CENSUS: 1DATE:
04/02/2020
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:43 AM
MET WITH:Diane WilkieTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA), Maddox met with with applicant, Diane Wilkie for the purpose of conducting an announced Pre-Licensing inspection. Present today were applicant, spouse, biological child. This is a 2 story with 5 bedrooms, 3 bathrooms. Family members residing in the home include 2 adults 1 child. All adults in the home have fingerprint clearances and exams for T.B., LPA verified applicant has required immunization's. There are no pools, spas or any other bodies of water observed on the premises. Main area of care is conducted in the family room, dining area, 1 bathroom, and backyard. Children will use the bathroom in hallway located near the entrance of the home. Off limit areas include the entire upstairs.

The kitchen and bathroom were toured and inspected for proper storage of chemicals, detergents, cleaning compounds, medications and sharp pointed objects, all items were made inaccessible to children. All unused electrical outlets are plugged and play equipment and toys are available. There are age appropriate toys. applicant is aware that baby walkers, bouncer, or any similar equipment are prohibited in any licensed facility.

The backyard is completely fenced. There are 2 Chocolate Labs on the premises.
applicant has current CPR and First Aid training (exp 2/2022). Per applicant, there are no weapons or firearms of any kind on the premises. The required fire extinguisher (2A 10BC), smoke detector, and carbon monoxide devises were are present and in operable condition.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2020
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: WILKIE FAMILY CHILD CARE
FACILITY NUMBER: 367700154
VISIT DATE: 04/02/2020
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Applicant was informed to keep a maintained a current roster and has documented Emergency Disaster drills no less than twice a year.

· Applicant can access forms on line at www.ccld.ca.gov .
The applicant is reminded of the requirement to report and unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC 624B.

As a REMINDER: when your child(ren) turn 18 years of age, you MUST SUBMIT an updated LIC279, LIC508 and TB Screen and have your child submit for LIVESCAN background clearance. This also applies to any adult PRIOR to them moving into the home or who currently lives in the home. Also, PRIOR to employment of any adult, you must submit the LIC508, TB screening and obtain a background clearance through LIVESCAN.


Issued applicant the following: SIDS information and Shaken Baby Syndrome pamphlet – For more information on SIDS and Safe Sleep Environments, please visit:
California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Rick-of-SIDS-in-Early-Education-and-Child-Care
And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep


SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2020
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: WILKIE FAMILY CHILD CARE
FACILITY NUMBER: 367700154
VISIT DATE: 04/02/2020
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******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

**§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. –

§1596.8662 (b)(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. 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.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2020
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: WILKIE FAMILY CHILD CARE
FACILITY NUMBER: 367700154
VISIT DATE: 04/02/2020
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**Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). Family child care homes shall post during hours of operation. **Failure to meet the posting requirements shall result in an immediate $100.00 civil penalty. In addition; all parents of currently enrolled children and any newly enrolled child for the following 12 months shall receive a copy of report documenting the Type A citation and sign form LIC 9224 acknowledging receipt. Civil Penalty assessments will be assessed if all above requirements are not adhered to. Staff is aware of required forms for children's files and forms that shall be posted after licensure.


The On Duty Worker is available for questions at 661-202-3318 Monday through Friday 8am-5pm. There were no violations of Title 22 Regulations noted. Exit Interview conducted a copy of this report is discussed and left at the facility.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Donna MaddoxTELEPHONE: (661) 568-8971
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2020
LIC809 (FAS) - (06/04)
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