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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197413061
Report Date: 10/11/2023
Date Signed: 10/11/2023 02:25:21 PM

Document Has Been Signed on 10/11/2023 02:25 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:DE LEUW FAMILY CHILD CAREFACILITY NUMBER:
197413061
ADMINISTRATOR:DE LEUW, TAMMYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 722-0370
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
10/11/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:07 PM
MET WITH:Tammy De LeuwTIME COMPLETED:
03:00 PM
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On 10/11/2023, Licensing Program Analyst (LPA) Carol Heath conducted an unannounced Required annual inspection at the De Leuw Family Child Care Home. Upon arrival, the LPA met with the licensee, Tammy De Leuw, who guided the LPA on a tour of the facility. Individuals that reside in the home include 4 adults (licensee and adult children). Per Guardian, all adults in this facility obtain a criminal record clearance.
This is a large family childcare facility. The hours of the operation are Monday through Friday, 6:30 a.m. to 5:30 p.m. During the inspection, LPA observed 9 childcare children (3 school-age, 4 preschools and 2 toddlers) with Licensee and her assistant. Per the Licensing Information System, annual facility fees were current. Incidental Medical Services (IMS) were discussed. Per the licensee, she does not have children who need IMS at this time.
The home is set up as follows: This is a two-story home with 4 bedrooms, 3 bathrooms, a kitchen/dining, a family room, a living room, a laundry room and a garage. The following areas are used for daycare:
Daycare is provided in the converted playroom area next to the laundry room. Children use the bathroom in the hallway on the left. Children have access to the converted playroom area, living room, and family room. Off-limit areas include all bedrooms, all of upstairs (with safety gate), bathrooms #2 and #3 (upstairs), laundry room (barricaded with safety gate), and garage (with lock). LPA observed the main care area to be fully barricaded by a safety gate. LPA reminded the licensee the barricade needs to be on the bottom and top staircase; during Daycare hours if there are children under 5 years old in care.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/11/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: DE LEUW FAMILY CHILD CARE
FACILITY NUMBER: 197413061
VISIT DATE: 10/11/2023
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· Playroom Room: In the playroom, there are adequate age-appropriate toys, books, games, and napping mats/hygienic diaper changing equipment. PA observed age-appropriate toys and furniture for the children. There are games and books on the premises of this facility. The carpets and other materials were observed to be in good condition.
· Children's bathroom: Children will use the bathroom down the hall to the left. The bathroom was the tour. The bathroom was clean, sanitized, and in good repair. The toilet was inspected, and the sink/toilet is in operable condition. The toilet and faucets are clean, safe, and operable. The bathroom was observed to be free and clear of hazardous items.
· Kitchen/Dining Room: The kitchen is off limited for the children.
· Backyard (Declaration): The childcare will not be going. The backyard was inspected; the children use the outdoor backyard for outside play. The backyard is safe for children. The backyard is completely fenced (with block cement). There is no body of water. LPA observed two outdoor air conditioners without barricaded with a safety gate.
Other:
· AC/Heating Unit / Swamp Cooler unit was observed. The AC/Heating Unit is located on the right side of the home and is inaccessible to children via barrels blocking access to the AC unit. / The swamp cooler unit is inaccessible to children.
· Bodies of water: Pre the licensee, there were a body of water in the home. There is a spa in the backyard. Spa covers shall be strong enough to completely support the weight of an adult and shall be placed on the pool and locked while the pool is not in use. During the inspection, the spa cover is on, but it is unlocked.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2023
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: DE LEUW FAMILY CHILD CARE
FACILITY NUMBER: 197413061
VISIT DATE: 10/11/2023
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· Electrical outlets: All unused electrical outlets are plugged in and made inaccessible to children.
· Food: The licensee is enrolled in the Food program. The licensee will provide Breakfast, lunch, and snacks.
· Fire extinguisher (2A10BC): LPA observed a required fire extinguisher (2A10BC) reading in Green and located in the playroom, inaccessible to children. It meets standards established by the State Fire Marshall.
· Fireplace: The fireplace was observed in the living room and is screened to make it inaccessible to the children.
· Hanging window blind cords: The cords are inaccessible to children.
· Isolation area (Illness): Per the licensee, if the child shows signs of illness, they will be separated from other children and stay in the living room.
· Medications and cleaning solutions: Detergents/cleaning compounds are in the upper laundry cabinet with safety latch. The children will need to walk through the laundry to use the bathroom and family room. LPA reminded the licensee to put the safety latch for all the laundry cabinets and keep the gate close during the operation hours. Medications are in the off-limits bedroom.
· Napping: Children will nap in designated areas with adult supervision. LPA observed 10 cots in the closet.
· Overnight Care: According to the licensee does not provide overnight care.
· Pets: There are 2 small dogs and 5 dogs. They dogs are kept in outside dog area during daycare hours. They have current vaccinations.
· Phone service: There is a working landline or cell phone.
· Smoke Detectors and Carbon Monoxide: The smoke detectors and carbon monoxide devices tested operable.
· The First Aid kit is in the off-limit playroom area, inaccessible to children. The First Aid Kit was observed to be complete with supplies and a first aid manual.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2023
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: DE LEUW FAMILY CHILD CARE
FACILITY NUMBER: 197413061
VISIT DATE: 10/11/2023
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· Transportation: The licensee does NOT provide transportation for children. The licensee has a valid California driver's license, valid vehicle insurance, and vehicle registration.
· Weapons or Firearms: Per the licensee, there are No Firearms at the facility at this time. LPA does not observe any firearms.
LPA reviewed the following Documentation:
· Child files: LPA observed 5 children's files, and the records were found to be in order with the required forms.
· CPR/First Aid: LPA observed that the licensee has current Pediatric CPR and First Aid Training with an expiration date of 01/2025.
· Fire Drill and Disaster Drill: Per the licensee, fire and disaster drills are conducted every 6 months; the last drill was documented and performed on 02/03/202. OR no current facility earthquake/fire drill documents were observed during this inspection.
· Immunization: The licensee and her assistant have the required immunizations (MMR and DTaP). The licensee and her assistant provided a written statement declining the influenza vaccination.
· Infant Sleeping Plan (LIC 9227) and Sleeping Log: There are 3 infants (13 months) enrolled in the facility. The licensee does not have LIC 9227 and Sleeping log in the files. LPA shared the Safe Sleeping Regulation with the licensee.
· The licensee post all required information.
· Mandated Reporter Training: The licensee has completed and renewed the online mandated reporter training at www.mandatedreporterca.com on 2/2/2023. The licensee’s assistant will need to take the Mandated Reporter training.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2023
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: DE LEUW FAMILY CHILD CARE
FACILITY NUMBER: 197413061
VISIT DATE: 10/11/2023
NARRATIVE
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· Staff Personnel File: LPA observed 1 staff information. The licensee was unable to find all the documentation. LPA suggested the licensee created a file for her assistant (daughter)
The following information was discussed with the licensee:
o Mandatory Forms for the children's and assistant files.
o The licensee is reminded that 100% supervision is required for children at all times.
o Capacity, Roster requirements, and Documentation requirements for disaster drills (fire and earthquake).
o Licensee was made aware that it is their responsibility to know the regulations and anyone who assists in providing care. The licensee was advised that the inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility's phone number; if the phone number is changed, licensing must be notified.
o Licenses were advised of the requirement to report unusual incidents and injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B.
o The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also, call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).
o A baby walker shall not be allowed on the premises of a family childcare home in accordance with Health and Safety code sections 1596.848(b) and (c). State law prohibits baby walkers, bouncy seats, exersaucers, and other items that fall into that category.
o Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2023
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: DE LEUW FAMILY CHILD CARE
FACILITY NUMBER: 197413061
VISIT DATE: 10/11/2023
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o The regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare home and in those areas of the family day care home where children are present (24/7 ban).
o Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates on courses and updates/changes to the regulations.
o Our Quarterly updates come out every 3 months. They are also now in Spanish. Please log in to the CCLD website, or you can email our advocates to have the quarterly updates sent directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov
o Licensee [or facility representative] 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.
o LPA discussed the safe sleep regulations with the licensee [or facility representative] 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 the licensee [facility representative] 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.
o The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 a.m. - 5:00 p.m.
Deficiencies cited: (See LIC 809D). The following Type B deficiencies are being cited in accordance with Title 22 of the California Code of Regulations and Health & Safety codes.
Exit interview conducted and report was reviewed with the licensee, Tammy De Leuw.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/11/2023 02:25 PM - It Cannot Be Edited


Created By: Carol Heath On 10/11/2023 at 02:06 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: DE LEUW FAMILY CHILD CARE
FACILITY NUMBER: 197413061

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/11/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(5)(A)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (5) All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence. (A)Fences shall be at least five feet high and shall be constructed so that the fence does not obscure the pool from view. The bottom and sides of the fence shall comply with Division 1, Appendix Chapter 4 of the 1994 Uniform Building Code. In addition to meeting all of the aforementioned requirements for fences, gates shall swing away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate. Pool covers shall be strong enough to completely support the weight of an adult and shall be placed on the pool and locked while the pool is not in use.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and intervie), the licensee did not comply with the section cited above. The licensee has a hot spa in the backyard. The spa cover is on but it was unlock, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/13/2023
Plan of Correction
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The licensee agree tol find the spa cover key and lock the cover.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claretta Yates
LICENSING EVALUATOR NAME:Carol Heath
LICENSING EVALUATOR SIGNATURE:
DATE: 10/11/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/11/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/11/2023 02:25 PM - It Cannot Be Edited


Created By: Carol Heath On 10/11/2023 at 02:06 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: DE LEUW FAMILY CHILD CARE
FACILITY NUMBER: 197413061

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/11/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day 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.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above. The assistant does not complete the training. which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/16/2023
Plan of Correction
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The licensee agree to have her assistant complete the Mandated Reporter Training and email the certification to LPA
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review)], the licensee did not comply with the section cited above. The licensee did not fill out LIC 9227 with 3 infants, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/13/2023
Plan of Correction
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The licensee agree to flll out the LIC 9227 in the future.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claretta Yates
LICENSING EVALUATOR NAME:Carol Heath
LICENSING EVALUATOR SIGNATURE:
DATE: 10/11/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/11/2023


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