197417815-7-5-2023-12-CC-JTAO-CTFSZS-20230705141938

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197417815
Report Date: 07/05/2023
Date Signed: 07/05/2023 02:19:45 PM

Document Has Been Signed on 07/05/2023 02:19 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:	BUTLER FAMILY CHILD CARE		FACILITY NUMBER:	197417815
ADMINISTRATOR:	BUTLER, BRANDI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 992-0165
CITY:	QUARTZ HILL	STATE: CA	ZIP CODE:	93536
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	07/05/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Brandi Butler, Licensee		TIME COMPLETED:	02:40 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	On 07/05/23, Licensing Program Analyst (LPA) Justeene Tamayo met with Licensee, Sandra Cuellar, who guided analyst on a tour of the facility for the One Year Required inspection. This is a two story, 4 bedroom, 3 bathroom home with kitchen/dining, family room, living room, laundry room and garage. There is no pool/spa or body of water on the premises. Upon arrival LPA observed 0 day care children in care. Licensee currently does not have any infants in care but does understand the requirements. Family members residing in the home include 3 adults (licensee and licensees husband, and licensee's son) and 5 minor children. Facility operation are Monday-Friday 6AM-6 PM. Incidental Medical Services (IMS) policy was discussed. Physical Plant: Main care is provided in the living room and family room area. Children use the bathroom in hallway on the right. Children have access to the living room, family room, dining room and backyard. Off limit areas include all bedrooms, kitchen, bathrooms #2 and #3, laundry room (key lock), and garage (has a key lock door knob). 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 (under kitchen cabinet with master lock), medicines (upper kitchen cabinet with master lock) and hazardous items (sharp knives in upper kitchen cabinet with master lock) that can pose a danger to children. Per licensee, she will be having her carpet cleaned on 07/10/23. LPA observed a fireplace in the living room screened. Safe and age appropriate toys, play equipment and materials were observed. The smoke detector and carbon monoxide detector, Fire Extinguisher (3A40BC) are in operable condition. 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 the living room. Per Licensee there are no weapon/firearms in the home. The facility sketch is complete and current, there is working telephone (cell).

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 06/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023

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: BUTLER FAMILY CHILD CARE	FACILITY NUMBER: 197417815
	VISIT DATE: 07/05/2023

NARRATIVE

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Fire/earthquake drills are maintained current. Last fire/disaster drill was completed on 04/01/2023.

Roster complete and maintained current.

Bathroom: Shower/tub are free of hazards (child care bathroom). LPA did not observe any hazardous items in the children's bathroom. Toilet and faucet are 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. The home has a clean and fully stocked refrigerator/freezer. Breakfast, lunch, snacks and dinner are provided. Per licensee, she only has school age children enrolled, no naps are provided.

Outdoor: The backyard is safe for children. The backyard is completely fenced (with block cement). There is no body of water. LPA observed an outdoor air conditioner covered and inaccessible to children in care. LPA observed age appropriate toys.

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expire 04/24/2025. Licensee could not find her mandated reporter training. Licensee will retake her mandated reporter training and submit proof of completion to LPA Tamayo no later than 07/10/2023.There are no window cords accessible to children.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 07/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/05/2023

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: BUTLER FAMILY CHILD CARE	FACILITY NUMBER: 197417815
	VISIT DATE: 07/05/2023

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Documents Provided and or Discussed: Fire Drill Log, Mandated Reporter Training,Safe Sleep PIN 20-24-CCP, Safe Sleep Log, and Individual Sleeping Plan (LIC9227). No day care children were present at the time of inspection, however one file was reviewed.

Licensee Butler 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 Butler 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.

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

No deficiencies have been cited at this time.

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

Exit interview conducted and report was reviewed with the licensee Brandi Butler, along with her appeal rights and Notice of Site Visit.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 07/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/05/2023

LIC809 (FAS) - (06/04)

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