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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700583
Report Date: 07/07/2022
Date Signed: 07/07/2022 11:24:39 AM

Document Has Been Signed on 07/07/2022 11:24 AM - 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:JEAN NOEL FAMILY CHILD CAREFACILITY NUMBER:
197700583
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 2CENSUS: 6DATE:
07/07/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Greitchy Jean Noel TIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) King-Lewis conducted a Prelicensing Inspection with Applicant Greitchy Jean Noel, who guided analyst on a tour of the home. This is a two story 4 bedroom, 3 bathroom home with living room, family room, dinning area, kitchen, laundry room, 3 car attached garage and rear yard. There is no pool or body of water in rear yard. Mrs. Jean Noel stated the day care operation will take place in living room, family room, down stairs hallway bathroom, and the rear yard. The entire upstairs is off limits to day care children.

Family members residing in the home include 2 adults, all adults living/residing in the home are fingerprint cleared and associated. (Applicant and spouse), applicant 3 biological children (2 males 9 & 8 years of age and daughter (6 years of age). Applicant is currently a Resource Parent able to care for 2 children. Resource Family Approval Certificate to Greitchy Jean Noel and Steven Terlonge. Applicant is aware that all children residing in the home, biological and foster placement shall be counted in the capacity. Applicant states no pets resides in the home.

The days/hours of operation will be Monday through Friday from 7:00 AM to 6:30 PM and Saturday as needed.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Lady King
LICENSING EVALUATOR SIGNATURE: DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/07/2022
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: JEAN NOEL FAMILY CHILD CARE
FACILITY NUMBER: 197700583
VISIT DATE: 07/07/2022
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Incidental Medical Services (IMS) policy was discussed, informing applicant when any IMS is provided, a plan for providing IMS must be submitted to the Department prior to providing care to a child that need IMS. The plan shall state the type of IMS the facility will be offering, stating the person providing care has been trained to provide the named IMS. The plan will also provide the steps that will be taken when IMS is provided to a child.

The following information regarding ADA was discuss and the following information 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

Applicant was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within 24 hours of incident by telephone and in writing within 7 day of incident on the form LIC624B per the regulation.

Applicant was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot-line at 1-800-540-4000. Also call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).

Applicant was informed that the presence of adults in the home without Criminal Record Clearance or Exemption will be cited and civil penalty assessed for $100 per day.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Lady King
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
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: JEAN NOEL FAMILY CHILD CARE
FACILITY NUMBER: 197700583
VISIT DATE: 07/07/2022
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The Applicant may find additional information and forms on the DSS website at www.ccld.ca.gov including information on the Live Scan application (LIC 9163). Appointments can be made for Live Scan at 1-800-315-4507
  1. Physical Plant: LPA observed daycare area of the home to be orderly, fireplace screened, central air and heating available, age appropriate toys and play equipment, working smoke detector/carbon monoxide detector. There is a designated area for ill child(ren) as necessary, applicant's spouse weapon/firearms in located in the off limit area of the home locked in cabinet. almo is locked in a separate lock box. Applicant states a cell phone will be available and charge during daycare hours, land line telephone is also available. LPA observe a fully charge 2A10BC fire extinguisher during the inspection. Applicant made poisons, medication and cleaning items inaccessible to children secured with magnet locks or placed on top shelf of hallway closet.

Kitchen: The following are inaccessible: Sharp items, lighter, and cleaning items. LPA observed the refrigerator and freezer to be clean. LPA discuss with applicant food shall be properly stored or refrigerated in container that are labeled with child’s name when supplied by parent.

Bathroom accessible to children: The following are inaccessible: shampoos, mouthwash, medication, perfumes, razor, air freshener, nail polish and polish remover. LPA observed an operable Toilet and faucet.

Outdoor: LPA observed the play area to be clear of garden tools, poisonous plants, and thorn trees, The play area is fenced and gated all around. LPA advised

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Lady King
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
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: JEAN NOEL FAMILY CHILD CARE
FACILITY NUMBER: 197700583
VISIT DATE: 07/07/2022
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applicant supervision is necessary with play rock climbing equipment in yard.

Advisory/Other: LPA observed a first Aid kit with emergency supplies and a thermometer. Applicant’s CPR/First Aid expire 12/27/2023. Preventative Health & Safety completed March, 2022. LPA observed electrical outlets are inaccessible to children. Children will nap on cots. Applicant is aware no day care children shall be allowed in home off limit area at anytime. Infant shall sleep in day care area of home.

Documents Provided and or Discussed: The following were provided to applicant to comply with Title 22 requirements: Fire Drill Log, Roster, Safe Sleep poster, water lead poster, required postings and list of CCL forms required for child file each child in care. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov

Before licensure the following shall be completed:

In person 1st aid CPR training.

Cushioning around outdoor climbing equipment

Posting requirement Parent's Rignts, Emergency and Disaster information Emergency Plan, Earthquake Preparedness Checklist. Lead Information Flyer shall be posted.

An exit interview was conducted, a copy of this report was provided to the applicant.

SUPERVISORS NAME: Mariela Ramon
LICENSING EVALUATOR NAME: Lady King
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022
LIC809 (FAS) - (06/04)
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