197700466-11-21-2023-12-CC-JDMO-CXSVLD-20231121153146

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700466
Report Date: 11/21/2023
Date Signed: 11/21/2023 03:32:07 PM

Document Has Been Signed on 11/21/2023 03:32 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:	TAYLOR FAMILY CHILD CARE		FACILITY NUMBER:	197700466
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS:	DATE:	11/21/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:			TIME COMPLETED:	03:30 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 11/21/2023 at 9:20 A.M., Licensing Program Analyst (LPA) Joselito L. Del Mundo, conducted a Case Management inspection with Licensee, Melissa Taylor. The purpose of the case management inspection was to assess the home for a 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 11/14/2023. During the inspection, two children were present in the facility. The Licensee’s assistant is providing supervision at the time of the inspection. Per licensee, currently residing in the home is the licensee, licensee’s spouse and four minor children (15, 9, 8 and 6). The home is described as follows: This is a two-story home with 3 bedrooms and 3 bathrooms, kitchen, dining area, 2 living rooms, attached garage, laundry area, tool shed, wooden deck, dog run, and backyard (outdoor play area). Per licensee, living room #2 (main care room) will be the main care area. Per licensee, living rooms #1 and #2, dining area, bathroom #1, and backyard (outdoor play area) are utilized for child care activities. The off-limits of the home are 3 upstairs bedrooms, kitchen, upstairs bathroom (#2 and #3), deck, and attached garage. There is a fireplace located in living room #1 and is covered with a glass door. A metal fence is also used to barricade the fireplace to prevent access by children. The home has central heating and air conditioning. Indoor: (On limits) Living room #1: This area was furnished with fireplace, couches, television, and entertainment center. Living room #2 (Main care area): This area was furnished with couches, ceiling fan, tables, chairs, and television. LPA also observed age-appropriate toys, little basketball, little balls, highchairs, drawing board, and other toys for children. Dining area: Furnished with a dining table and chairs, water dispenser, and cabinets for storing food. Per

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

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: TAYLOR FAMILY CHILD CARE	FACILITY NUMBER: 197700466
	VISIT DATE: 11/21/2023

NARRATIVE

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Licensee, this dining area will be utilized by older children during meal and snack time and whenever they do their assignments.
Bathroom 1: Located between the living room #2 (main care area) and attached garage. The bathroom was equipped with a toilet and sink. LPA observed toilet paper, step stool, trash bin with cover, and liquid hand soap. The bathroom was clean and orderly. LPA also observed black ants crawling at the bottom of the toilet. Licensee was advised to clean the bottom of the toilet. 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.

Napping equipment: LPA observed four foldable sleeping cots and one crib.
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Off Limit areas:

LPA did not observe a child safety baby gate barricading the entrance to bedrooms #1 to #3.
Kitchen: All sharp utensils and knives are stored in the upper cabinet of the kitchens. The refrigerator, stove and microwave are clean. The kitchen is free of hazardous items. The Licensee prepares two meals and two snack for the children in care. Per licensee, dinner is provided whenever possible.
Bedroom #1 (Master Bedroom and Bathroom) (Off limits): Located upstairs. Per licensee, the bedroom was furnished with a California king size bed, television, and personal belongings. The bedroom is also equipped with a personal bathroom (bathroom #2) with toilet and sink.
Bedroom #2: (Off limits): Located upstairs. Per licensee, the bedroom was furnished with a twin-size bunk bed and personal belongings.
Bedroom #3: (Off limits): Located upstairs. Per licensee, the bedroom was furnished with a queen size bed and personal belongings.
Bathroom #3: Located in the upstairs hallway. Per licensee, the bathroom was furnished with toilet and sink.
Backyard (Outdoor Play Area): The facility has no body of water on the premises. The back and side yard have covered porch, wooden deck, tool shed, and a dog run. The outdoor space is partly covered with concrete, grass, and mulch. LPA observed a tricycle toy with missing pedal, scooters, and pieces of wood. LPA also observed a cutting tool, bolt, and a screw with a sharp edge.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

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: TAYLOR FAMILY CHILD CARE	FACILITY NUMBER: 197700466
	VISIT DATE: 11/21/2023

NARRATIVE

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Per licensee, she is planning to extend the outdoor play area. The outdoor play area will be undergoing renovations and licensee is planning to put a new playground set. Licensee also provided LPA a copy of the invoice for the repair of the door frames leading to the backyard.

LPA provided a copy of the LIC855 Declaration Form to applicant. The declaration shall state that applicant will not allow all children in care to use the outdoor play area until the area is renovated and clean. Applicant will also ensure that the outdoor play area is always clean for children’s health and safety. Applicant filled out the declaration form and gave it to LPA.

Garage (Off limits): Located off the living room. Per licensee, the garage serves as a storage area for the licensee. It has a workspace and holds item like t-shirt prints.
Electrical outlets: All electrical outlets are covered with a safety plug cover and made inaccessible to children.
Weapons or Firearms: Per Licensee, there are no firearms in the home.
Cleaning compounds and detergents: Per licensee, they are stored in the garage.
The smoke detector and carbon monoxide detector: located in the hallway of the home and are in operable condition (checked at 12:09 P.M.) The home has a pull-down fire alarm system located on the entrance door of the facility.
Fire extinguisher (2-A:10-B:C) There is a fully charged fire extinguisher (2-A:10-B:C) which meets fire marshal standards. The last service date is on January 10, 2023.
First Aid Kit: Stored in the downstairs closet located on the right side of the entrance to the day care.
Medications: Stored in the upper cabinets of the kitchen. Licensee also told LPA that zero medications are currently being provided for the current children in care.

LPA reviewed the Licensee and assistant files. All required forms were within the files at the time of this inspection. Per LPAs review, the Licensee and assistant have a current mandated reporter trainings completed on 01/04/2022 and 01/12/2023; CPR/First Aid trainings were completed last 12/20/2022.

Licensee and assistant have proof of immunization against measles, pertussis, and influenza. Licensee and

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: TAYLOR FAMILY CHILD CARE	FACILITY NUMBER: 197700466
	VISIT DATE: 11/21/2023

NARRATIVE

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assistant have TB skin test on file.

Licensee and other adults living in the home and associated to the facility have 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.

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

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: TAYLOR FAMILY CHILD CARE	FACILITY NUMBER: 197700466
	VISIT DATE: 11/21/2023

NARRATIVE

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

The following citations were issued today:

Based on LPA observation,

1) the outdoor play area is not ready for use by children in care; the play area needs to clean and renovated.

2) the door frames leading to the outdoor play area needs to be repaired.

3) there is no child safety baby gate that barricades the entrance upstairs.

As a result of this inspection, the home does not meet Title 22 Regulations. Capacity increase is pending clearance of the cited deficiencies and final approval from the Licensing Program Manager.

Exit interview conducted, a copy of this report, Notice of Site Visit, and appeal rights were provided with the licensee, Melissa Taylor.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

LIC809 (FAS) - (06/04)

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