197700726-8-7-2023-12-CC-JDMO-CUH27W-20230807170924

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197700726
Report Date: 08/07/2023
Date Signed: 08/07/2023 05:09:42 PM

Document Has Been Signed on 08/07/2023 05:09 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:	JACKSON FAMILY CHILD CARE		FACILITY NUMBER:	197700726
ADMINISTRATOR:	LARHONDA JACKSON		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 291-7050
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93535
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	08/07/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Larhonda Jackson		TIME COMPLETED:	05:00 PM

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On 08/07/2023 at 1:45 P.M., Licensing Program Analyst (LPA) Joselito L. Del Mundo, conducted a Pre-Licensing inspection with applicant Larhonda Jackson to ensure the facility meets basic licensing requirements set forth by Title 22, Health and Safety and statutory requirement. The licensee recently relocated and is requesting to provide care for a Large family childcare home for the capacity of 14 children at this new location. Fire clearance was granted on 07/20/2023. Currently, there is one adult (applicant) and four minor children (17, 12, 5, and 4) living in the home. LPA toured the home indoor and out to ensure it meets FCCH requirements. Licensee is requesting the days and hours of operation will be 23 hours a day, 7 days a week.

The home is described as follows:

This is a two-story home consisting of five bedrooms, five bathrooms, kitchen, kitchen nook, dining area, living room, family room, laundry room, garage, and backyard with an above ground pool. The off-limits areas: All four bedrooms (#2 to # 5), bathrooms (# 2 to #5), kitchen, kitchen nook, garage, laundry room, and parts of the backyard. All the bedrooms, bathrooms, kitchen, kitchen nook, family room, laundry room, garage, other parts of the backyard (off-limits) were inaccessible via a child safety gate. In addition, the sliding door and door leading to the backyard were equipped with exit alarms. On limits: Living room, dining area, bedroom #1 and bathroom #1.

Indoor:

Main area

Living room: The playroom was observed with cubbies for children’s personal belongings and for toys, a carpet, books, kitchen set toy, age-appropriate toys, and learning materials. There is a fireplace in the living room and is covered with metal fence and a glass door. A plastic cubby for toys is also blocking the fireplace.
Dining area: LPA observed child size table with chairs, television, cubbies for arts and crafts, and a water dispense.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: JACKSON FAMILY CHILD CARE	FACILITY NUMBER: 197700726
	VISIT DATE: 08/07/2023

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Pg 2
Bedroom #1: The bedroom was observed with books, bookrack, highchair, crib, rocking chair, drawers, floor highchairs, a small storage box for toys, and a drawer made of mesh for children’s belongings.
Bathroom #1: Located inside bedroom #1. LPA observed a diaper changing table, gloves, diapers for children, step stool, wet wipes, and a trash bin. 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.

Off-limit area

Family Room: LPA observed a carpet and a double-sided fireplace that also connects to the kitchen nook. The fireplace is covered with a mesh screen.
Kitchen and kitchen nook: LPA observed cleaning products under the kitchen sink and secured with a child safety lock. Knives and sharp objects are stored in the upper cabinets of the kitchen with a lock to prevent access to children. The kitchen has a child safety gate to prevents access by children. The refrigerator, dishwasher, stove, etc. are clean. The kitchen was clean and orderly. The kitchen nook has a table and bench for sitting.
Bedroom 1: Furnished with one king size bed, chest, dresser, and personal furnishing.
Bedroom 2: Furnished with one queen size bed, bathroom, and personal furnishing.
Bedroom 3: Furnished with a tv and drawers.
Bedroom 4 (Master bedroom): Furnished with a king size bed, bathroom, fireplace, and other personal belongings.
Bathroom #2: Located in front of the laundry room. LPA observed a toilet and sink. Applicant also store other cleaning compounds inside the bathroom.
Bathroom #3: Located inside bedroom #2. LPA observed the bathroom is clean.
Bathroom #4: Located between bedroom #3 and #4. LPA observed the bathroom is clean.
Bathroom #4: Located inside the master bedroom (bedroom #5). LPA observed the bathroom is clean.
Laundry Area: Located between the family room, kitchen, bathroom #2, and garage. Washer/dryer and storage area. Applicant also store cleaning products on the shelves of the laundry room.
Attached Garage: LPA inspected the attached garage and observed household storage, work out equipment, storage cabinet for toys and other supplies. The door leading to the garage was equipped with a key lock.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: JACKSON FAMILY CHILD CARE	FACILITY NUMBER: 197700726
	VISIT DATE: 08/07/2023

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Pg 3

Backyard: The backyard is divided into on and off-limits area. The backyard has a cement patio and a grassy area. LPA also observed an above ground pool at the backyard (off limits area). The pool is surrounded by a 5’ removable mesh fence that is mounted into the ground. The gate opens away from the pool and is equipped with a self-closing, self-latching mechanism on top of the gate. LPA also observed a fire pit with a cover. The on limits area of the backyard has tables, chairs, slides, toy house, seesaw, climbing structure, water table, rideable toy cars, little basketballs, and a small tunnel made of mesh. Applicant stated that she will remove the heating lamp and the barbeque grill at the backyard.

Napping equipment: LPA observed three cots. Applicant stated that once she get her license, she will bring additional cots in the new day care.
Electrical outlets: All outlets in the home have safety covers.
Weapons or Firearms: Per the licensee, there are no weapons or firearms. LPA did not observe
any weapons or firearms.
Cleaning compounds: were observed in the laundry room and under the kitchen sink. The Applicant will make the items inaccessible to the children in care.
A smoke detector and a carbon monoxide detector were tested and in operable conditions.
Fire extinguisher (2-A:10-B:C). Located in the office area of the applicant. The fire extinguisher service date was 07/12/2023.
Documentation:
Applicant has current CPR, First Aid Training with the expiration dates of 08/25/2025. Applicant completed the Prevented Health and Safety Training last 07/28/2018. Two hours of continuing education on Lead Safety in Child Care was completed on 02/27/2023 and mandated reporter training on 07/11/2023. Applicant has fingerprint clearance and required immunization's on file. Per Applicant, transportation is provided. Per Applicant, three meals and afternoon snack will be provided for children.

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: 08/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023

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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: JACKSON FAMILY CHILD CARE	FACILITY NUMBER: 197700726
	VISIT DATE: 08/07/2023

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Pg 4

Applicant 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 applicant and discussed the Child Care Licensing Safe Sleep webpage atttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant 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.
Lead Poisoning: For more information, go to the California Childhood Lead Poisoning Prevention Branch’s website at www.cdph.ca.gov/programs/clppb,or call them at (510) 620-5600.

Licensee advised visit www.shotsforschool.org for Immunization information.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

LPA reviewed with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

***As a result of this inspection, the home does meet Title 22 Regulations. The applicant is ready for licensure pending the manager's approval.

The exit interview was conducted, and the report was reviewed and provided with the applicant Ms. Larhonda Jackson.

SUPERVISORS NAME: Lady King
LICENSING EVALUATOR NAME: Joselito DelMundo
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2023

LIC809 (FAS) - (06/04)

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