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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700628
Report Date: 12/04/2024
Date Signed: 12/04/2024 11:59:31 AM

Document Has Been Signed on 12/04/2024 11:59 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:BLAYLOCK FAMILY CHILD CAREFACILITY NUMBER:
197700628
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
12/04/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:23 AM
MET WITH:Shawntia BlaylockTIME VISIT/
INSPECTION COMPLETED:
12:10 PM
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On December 4, 2024, Licensing Program Analyst (LPA) Kris Diaz, conducted an unannounced Annual/Random Inspection. Licensee, Shawntia Blaylock requested a capacity increase. LPA met with Licensee, who granted access and guided LPA on a tour of the home. People who reside in the home are Licensee and her adult son who are live scanned and have TB skin test on file. The small family childcare home operates Monday-Sunday, 23 hours per day. LPA reminded licensee that someone must be awake when the children are awake. At the time of the visit there were 0 children present. Incidental Medical Services (IMS) were discussed with the licensee. Per licensee, there are no children that need IMS at this time.

This is a two-story home with 4 bedrooms, 3 bathrooms, kitchen, dining room, formal dining area, family room, living room, laundry room, and garage. Children have access to the family room (converted for childcare), the restroom in the childcare area, and the backyard. Off-limit areas of the home are the entire upstairs made inaccessible with a safety gate at the bottom of the stairs, kitchen, living room, dining room, and formal dining area made inaccessible with a safety gate at the childcare area, the laundry room made inaccessible with a keylock, and the garage which is only accessible through the laundry room. Children have access to the kitchen, living room, dining room, and formal dining area when transitioning from the front door to the childcare area. LPA reminded licensee that visual supervision is required at all times during this transition. LPA observed a safety knob on a closet door facing the childcare area. LPA observed a fireplace in the living room which is an off-limits area. Licensee stated the fireplace is being renovated. LPA observed large Christmas decorations in front of the fireplace. LPA reminded licensee to place lock on the fireplace once completed and supervise children walking through the area. LPA observed several cots, and one pack n play for napping. Per licensee, the infants in care are over 12 months old and sleep on cots. LPA observed a space heater near the childcare area accessible to children. LPA advised licensee to make the heater inaccessible to children. LPA did not observe a swimming pool/body of water on the premises. Per licensee, there is no swimming pool, spa, or fountain on the premises.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kristina Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/04/2024
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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