197419585-11-6-2023-12-CC-JDMO-CXC3T9-20231106173133

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197419585
Report Date: 11/06/2023
Date Signed: 11/06/2023 05:31:50 PM

Document Has Been Signed on 11/06/2023 05:31 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	JONES FAMILY CHILD CARE		FACILITY NUMBER:	197419585
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS:	DATE:	11/06/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:55 AM
MET WITH:	Kharla Jones		TIME COMPLETED:	05:30 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 11/06/2023 at 12:55 P.M., Licensing Program Analyst (LPA) Joselito L. Del Mundo, conducted an Annual and Capacity Increase inspection with licensee/applicant, Kharla Jones. The purpose of this inspection was to assess the home for an annual and capacity increase and ensure the facility meets basic licensing requirements set forth by Title 22, Health and Safety and statutory requirement. The licensee is requesting to provide care for a Large family childcare home (FCCH) for the capacity of 14 children. Fire clearance was granted on 07/07/2023. During the inspection, four children were present (ages 1 to 10 years old). The licensee was providing supervision at the time of the inspection. Per licensee, currently residing in the home is the licensee and two minor children (twins,10 years old). The home is described as follows: This is a two-story home with 4 bedrooms and 3 bathrooms, living room, family room, dining area, kitchen, and attached garage. Per licensee, living room and bathroom #1 are utilized for child care activities. The off-limits of the home are 4 bedrooms (master bedroom, licensee’s children’s room, guest room, and playroom), bathroom #2 and #3, kitchen, family room, backyard, and attached garage. There is a fireplace located in the family room (off limits) which is made inaccessible to children via glass barrier and a mesh screen. The home has central heating and air conditioning. Indoor: (On limits) Living room (Day care area): This area was furnished with a couch, carpet, drawers, and a table for four. Bathroom 1: Located in front of the laundry room and adjacent to the attached garage. The bathroom was equipped with a toilet and sink. The bathroom was clean and orderly. During the inspection, LPA did not observed razors and/or sharp objects, shampoos, mouthwash, medications, perfumes, air freshener, nail polish and nail remover that will pose a health and safety risk to children in care.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: JONES FAMILY CHILD CARE	FACILITY NUMBER: 197419585
	VISIT DATE: 11/06/2023

NARRATIVE

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Napping equipment: LPA observed four sleeping cots. Per licensee, parents provide a flat mattress and sheets for the infant when sleeping.
Electrical outlets: All electrical outlets are covered with a safety plastic cover and made inaccessible to children.
Weapons or Firearms: Per Licensee, there are no firearms in the home.
Cleaning compounds and detergents: Per licensee, cleaning products are stored in the upper cabinets of the attached garage (off-limits).
Knives and other sharp objects: All sharp utensils, knives, were inaccessible to the children in care. Per licensee, they are stored in the upper cabinets of the attached garage.
The smoke detector and a carbon monoxide detector: located in the hallway between the living room and family room and are in operable condition. The home has a pull-down fire alarm located near the entrance door.
Fire extinguisher (2A10BC) There was a fully charged fire extinguisher (4-A:60-B:C) which meets fire marshal standards.

Off Limit areas:

LPA observed a child safety gate installed on the stairs to prevent access by children.
Bedroom #1: (Master Bedroom) (Off-limits): located upstairs. Per licensee, the bedroom was furnished with a king size bed, television, dressers, and personal belongings. The bedroom has a bathroom (#2) with a bathtub, toilet, and two sinks.
Bedroom #2 (Children’s room) Off limits): located upstairs. Per licensee, the bedroom was furnished with two separate beds, television, personal computer, and computer desk.
Bedroom #3 (Guest room) (Off limits): located upstairs. Per licensee, the bedroom was furnished with a bed and a television.
Bedroom #4 (Playroom) Off limits): located upstairs. Per licensee, the bedroom was furnished with video games, television, bookcase, and chairs.
Kitchen: The refrigerator, dishwasher, stove, microwave, etc., are clean. The kitchen was clean, orderly, and free of hazardous items. Per licensee, children bring their own meals and snacks.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: JONES FAMILY CHILD CARE	FACILITY NUMBER: 197419585
	VISIT DATE: 11/06/2023

NARRATIVE

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Dining Area: Furnished with table and chairs. Per Licensee, this area is not utilized during mealtime.
Outside (side yard): The facility has no body of water on the premises and the backyard is currently off limits to children. The outdoor space is covered with turf. LPA observed a climber, exercise equipment, highchairs, and other toys. Per licensee, the outdoor area is currently under renovation.
Garage (Off limits): Located off the laundry room and bathroom #1. Per licensee, the garage held household items such as storage cabinets for clothing, shelves for food, and a freezer.
Currently, the licensee has 4 children enrolled in the facility. Licensee stated that when a child shows signs of illness, he/she is separated from other children in an area near the entrance door of the facility.

LPA reviewed the Licensee file. All required forms were within the files at the time of this inspection. Per LPAs review, the Licensee has a current mandated reporter training completed on 04/01/2023 and CPR/First Aid that was completed on 04/01/2023.

Licensee has proof of immunization against measles, influenza, and pertussis. Licensee has TB skin test on file.

Licensee has received criminal record clearance.

The following was discussed with the licensee:
Licensee reminded that 100% supervision is required at all times to children in care. Licensee was made aware that it is he/her responsibility to know the regulations as well as anyone who assists in providing care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: JONES FAMILY CHILD CARE	FACILITY NUMBER: 197419585
	VISIT DATE: 11/06/2023

NARRATIVE

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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.

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

LPA and Licensee discussed the large family home capacity regulations. LPA also discussed the personal requirements for the new staff person.

There were no deficiencies cited today. As a result of this inspection, the home does meet Title 22 Regulations for a large family child care license. The applicant is ready for licensure pending the manager's approval.

Exit interview conducted, a copy of this report, Notice of Site Visit, and Appeal Rights were provided with the licensee, Kharla Jones.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2023

LIC809 (FAS) - (06/04)

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