197492922-3-7-2023-12-CC-JTAO-CPPT2D-20230307132034

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197492922
Report Date: 03/07/2023
Date Signed: 03/07/2023 01:20:48 PM

Document Has Been Signed on 03/07/2023 01:20 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:	EDGAR FAMILY CHILD CARE		FACILITY NUMBER:	197492922
ADMINISTRATOR:	EDGAR, NICOLE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 606-4937
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93536
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 8	DATE:	03/07/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:04 PM
MET WITH:	Nicole Edgar, Licensee		TIME COMPLETED:	02:00 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 03/07/23 Licensing Program Analyst (LPA) Justeene Tamayo met with Licensee, Nicole Edgar, who guided analyst on a tour of the facility for the One Year Required inspection. This is a one story, 4 bedroom, 2 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 4 infants and 4 preschool children in care, along with two staff. Family members residing in the home include 3 adults (licensee, licensee's daughter, and licensee's mother) and no children. Facility operation are Monday-Friday 7AM-6 PM. Incidental Medical Services (IMS) policy was discussed. Physical Plant: Main care is provided in the living room, family room and bedrooms #1-2 Children use the bathroom in hallway on the right. Children have access to the living room, family room, and bedrooms #1-2. Off limit areas include bedrooms 3-4, bathroom #2, laundry room, 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 sink with safety latch), medicines (upper kitchen cabinet inaccessible to children ) and hazardous items (sharp knives in upper kitchen pantry unreachable to children in care) that can pose a danger to children. LPA observed a fireplace in the home to be screened. Safe and age appropriate toys, play equipment and materials were observed. The smoke detector and carbon monoxide detector, Fire Extinguisher (2A10BC) 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 teaching 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: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

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: EDGAR FAMILY CHILD CARE	FACILITY NUMBER: 197492922
	VISIT DATE: 03/07/2023

NARRATIVE

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Fire/Disaster Drill is complete and maintained current. Last fire/disaster drill was completed on 02/15/23.

During file review, staff #1 and staff #2 were missing proof of immunization's in file. This can pose a potential risk to children in care. Facility has been cited a type B citation. Please see LIC809-D.

During children's file review, some day care children did not have proof of immunizations in their file. This can pose a potential risk to children in care. Facility has been cited a type B citation. Please see LIC809-D.

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. Cleaning supplies are under the kitchen sink with safety latch. Breakfast,lunch, and snacks are provided. Licensee currently has a food program. Naps are provided in the family room and bedrooms #1-2.

Outdoor: Per licensee, at this time the backyard is currently off limits due to renovation of turf. LPA observed the backyard to be completely fenced (with block cement). There is no body of water. LPA observed age appropriate toys. Per licensee, there is one pet on the premises. LPA observed a playground area on the side of the home with a chain link fence. LPA reminded licensee no barbecue pits or any other hazardous items should be accessible to children in care.

Advisory/Other: First Aid kit was observed with supplies readily available. CPR/First Aid expire 08/19/2024. Licensee will need to take her mandated reporter training at www.mandatedreproterca.com and send proof of completion to LPA Tamayo no later than 03/10/23. There are no window cords accessible to children.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

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: EDGAR FAMILY CHILD CARE	FACILITY NUMBER: 197492922
	VISIT DATE: 03/07/2023

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Documents Provided and or Discussed: Fire Drill Log, Roster, Postings, Safe Sleep PIN 20-24-CCP. Individual Sleeping Plan (LIC9227) and Emergency Disaster Plan. Licensee stated currently has child care insurance.

Licensee Edgar 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 Kirnon 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.

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 Nicole Edgar,along with her appeal rights and Notice of Site Visit.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Justeene Tamayo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/07/2023 01:20 PM - It Cannot Be Edited

Created By: Justeene Tamayo On 03/07/2023 at 01:07 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: EDGAR FAMILY CHILD CARE	FACILITY NUMBER: 197492922
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(c)

Administration of Child Day Care Licensing

(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. Staff #1 and Staff #2 did not have immunizations in file, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/31/2023
	Plan of Correction
1 2 3 4	Licensee will send proof of completed immunizations: pertussis (tdap), measles (MMR), influenza (FLU) and tuberculosis (TB) to LPA Tamayo no later than 03/31/23

Type B

Section Cited

CCR

102418(g)

Immunizations

(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. Some day care children did not have proof of immunizations in file, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/31/2023
	Plan of Correction
1 2 3 4	Licensee will send proof of completed immunizations to LPA Tamayo no later than 03/31/23.

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:

Mariela Ramon

LICENSING EVALUATOR NAME:

Justeene Tamayo

LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2023

LIC809 (FAS) - (06/04)

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