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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700589
Report Date: 08/08/2024
Date Signed: 08/08/2024 12:52:19 PM

Document Has Been Signed on 08/08/2024 12:52 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:ALLEN FAMILY CHILD CAREFACILITY NUMBER:
197700589
ADMINISTRATOR/
DIRECTOR:		WYVONNEA ALLENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 406-7968
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 4CENSUS: 1DATE:
08/08/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:47 AM
MET WITH:Wyvonnea AllenTIME VISIT/
INSPECTION COMPLETED:
01:10 PM
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On 8/8/2024, Licensing Program Analyst (LPA) Carol Heath conducted an unannounced Annual/Random inspection at Allen Family Child Care. Upon arrival, the LPA met with the licensee, Wyvonnea Allen, who guided the LPA on a facility tour. Family members residing in the home include 2 adult (licensee and licensee’s daughter) and 1 minor child (Grandchild/6 years old) . During this inspection, 1 young children (2 years old) present. Per the licensee, the hours of operation are Monday through Friday, 4:00 a.m. to 9:00 p.m. Incidental Medical Services (IMS) were discussed. Per the licensee, she does not have children who need IMS at this time.
The home is set up as follows:
This is a one-story, four-bedroom, two-bath home with a kitchen/dining room, living room, family room, laundry room, and garage. The home was inspected for safety, comfort, cleanliness, telephone service, central air, and heat and ventilation. The house has central heating and air conditioning. All windows have screens free of cracks, bugs, and debris.
Main Area: Main care is provided in the family room. Children use the bathroom on the right in the hallway. Children can access front yard area.
Living Room: LPA observed age-appropriate toys and furniture for the children in the designated childcare areas. Several plastic storage bins were observed in which games and toys are stored for the children. The mats were observed to be in good condition. A TV plays educational videos for children. The licensee will need to make the TV wire inaccessible to the children.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2024
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: ALLEN FAMILY CHILD CARE
FACILITY NUMBER: 197700589
VISIT DATE: 08/08/2024
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Children's bathroom (#1): The bathroom was toured and inspected, and the sink/toilet is operable. The toilet and faucets are clean and safe. There are no medications or any personal items inside the medication cabinet. All poison and medications are inaccessible to children with child safety latches under the sink cabinet. The bathroom was observed to be free and clear of hazardous items.
Kitchen (Safety Gate): The kitchen was inspected to ensure hazardous and dangerous items were inaccessible to children (Safety latches). Sharp utensils, poisons, and medications are unavailable to children in the kitchen, and child safety latches are on cabinet doors and drawers. Sharp knives are kept in a butcher block in the gated kitchen. During today’s inspection, the licensee did not put the safety gate on, which makes the kitchen accessible to the children.
Front yard: The backyard was inspected; The children use the outside backyard for outside play. The backyard is gated all around. The outdoor play area was observed to be free of hazards and loose and sharp parts. LPA observed a grass and concrete area for active play.
Off-limit: Off-limit areas are all bedrooms, bathroom #2, laundry room,living room, backyard and garage.
Others:
The AC/Heating Unit and Swamp Cooler Unit (off-limited) were observed. The AC/Heating Unit is located on the right side of the home (backyard) and inaccessible to children The swamp cooler unit is also inaccessible to children.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
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: ALLEN FAMILY CHILD CARE
FACILITY NUMBER: 197700589
VISIT DATE: 08/08/2024
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Bodies of water (Off-Limit – Backyard): LPA observed an in ground swimming pool barricaded with a chain link fence at 5 feet 1 inches high. The chain link fence has a master lock and swings away from the swimming pool. The above ground swimming pool is in the off limit areas (barricaded by chain link fence) in the backyard and is currently empty. The fence is designed to prevent climbing, has gates that swing away from the pool. LPA tested the gate and the self-close, and a self-latching device does not work. The licensee agrees to maintain the pool fencing in compliance with licensing requirements to ensure the pool remains inaccessible to children.
Front yard: LPA observed a decorative water fountain does not have water. LPA reminded to make sure no water in the fountain during the raining season.
Electrical outlets: All unused electrical outlets are plugged in and inaccessible to children.
Fire extinguisher (2A10BC): LPA observed a required fire extinguisher (2A10BC) reading in Green, located in the kitchen, and inaccessible to children. It meets standards established by the State Fire Marshall.
Fireplace: In the family room, a fireplace was observed that was properly screened via mirror glass doors. The fireplace is inaccessible to children.
Hanging window blind cords: The cords are inaccessible to children.
Isolation area (Illness): Per the licensee, if the child shows signs of illness, they will be separated from other children.
Medications and cleaning solutions: Detergents and cleaning compounds are in the upper kitchen cabinet, and medications are in the off-limits bedroom.
Napping: Children will nap in the designated nap areas with adult supervision. LPA observed 6 cots and 1 playpen in the closet.
Overnight Care: According to the licensee, it does not provide overnight care.
Pets: No pets in the facility.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
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: ALLEN FAMILY CHILD CARE
FACILITY NUMBER: 197700589
VISIT DATE: 08/08/2024
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Phone service: There is a working landline or cell phone
Smoke Detectors and Carbon Monoxide: The smoke detectors and carbon monoxide devices tested operable.
The first aid kit is in the key-locked closet and is inaccessible to children. The First Aid Kit was observed to be complete with supplies and a first aid manual.
Transportation: The licensee does provide transportation for children. The licensee has a valid California driver's license, valid vehicle insurance, and vehicle registration.
Weapons or Firearms: Per the licensee, there are No Firearms at the facility at this time. LPA does not observe any firearms.
Documentation:
Child files: LPA reviewed 4 children's records. The records are incomplete and missing forms.
Infant Sleeping Plan (LIC 9227) and Sleeping Log: There is 1 infant enrolled in the facility. The licensee does not have LIC 9227 and Sleeping log in the files. LPA shared the Safe Sleeping Regulation with the licensee.
Influenza Vaccination: The licensee provided a written statement declining the influenza vaccination.
Criminal Record: Per Guardian, all adults who live in this facility obtain a criminal record clearance.
CPR/First Aid: LPA observed that the licensee has current Pediatric CPR and First Aid Training with an expiration date (of 2/2/2026) 1 hour of nutrition training and (8) hours of Preventive Health and Safety Training.
Mandated Reporter Training: The licensee has completed and renewed the online mandated reporter training at www.mandatedreporterca.com on 1/18/2024.
Facility fees: Per the Licensing Information System, annual facility fees were current.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
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: ALLEN FAMILY CHILD CARE
FACILITY NUMBER: 197700589
VISIT DATE: 08/08/2024
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Fire Drill and Disaster Drill: Per the licensee, fire and disaster drills are conducted every 6 months; the last drill was documented and conducted on 07/15/2024.
LPA observed that the licensee post the Facility License, Earthquake Preparedness, and Parents' Rights Poster as required.
The following information was discussed with the licensee:
o A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code sections 1596.848(b) and (c). State law prohibits baby walkers, bouncy seats, exersaucer, and other items that fall into that category.
o Capacity requirements, Roster requirements, Posting requirements, and Documentation requirements for disaster drills (fire and earthquake).
o The licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B
o Licensee was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates on courses and updates/changes to the regulations. Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. The licensee was advised that the inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility's phone number; if the phone number is changed, licensing must be notified.
o Mandatory Forms for the children's files and provider's files.
o Our Quarterly updates come out every 3 months. They are also now in Spanish. Please log in to the CCLD website, or you can email our advocates to have the quarterly updates sent directly to your email. Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
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: ALLEN FAMILY CHILD CARE
FACILITY NUMBER: 197700589
VISIT DATE: 08/08/2024
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o Posting Requirements: Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
o Requirements for fire drills, earthquake drills, and documentation for both.
o The Duty Worker is available for questions Monday through Friday at (661) 202-3318 from 8:00 a.m. - 5:00 p.m.
o The licensee is reminded that 100% supervision is required for children at all times.
o The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also, call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).
o The regulation prohibits the smoking of tobacco in a private residence that is licensed as a family childcare home and in those areas of the family childcare home where children are present (24/7 ban).
· Family Child Care Homes Licensee [or facility representative] was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
· IF THERE IS NO CHILD AT THE FACILITY THAT CURRENTLY NEEDS IMS, USE AS FOLLOWS: Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
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: ALLEN FAMILY CHILD CARE
FACILITY NUMBER: 197700589
VISIT DATE: 08/08/2024
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· Centers and Family Child Care Homes Licensee [or facility representative] was informed of the MyChildCarePlan.org website, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
· Family Child Care Homes During the exit interview, the LICENSEE ****, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
· Family Child Care Homes A notice of site visit was given and must remain posted for 30 days.
· To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-carelicensing/ inspection-process.

No deficiencies are being cited at this time.

An exit interview was conducted, and the report was reviewed with the licensee, Wyvonnea Allen.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024
LIC809 (FAS) - (06/04)
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