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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700738
Report Date: 12/16/2024
Date Signed: 12/16/2024 11:27:20 AM

Document Has Been Signed on 12/16/2024 11:27 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:COLLINS FAMILY CHILD CAREFACILITY NUMBER:
197700738
ADMINISTRATOR/
DIRECTOR:		JOCELYN COLLINSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 300-0163
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 4CENSUS: 2DATE:
12/16/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:49 AM
MET WITH:Licensee/Jocelyn CollinsTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On 12/10/2024, Licensing Program Analysts (LPAS) Carol Heath and Ana Rodriguez conducted an unannounced annual inspection at Collins Family Child Care. Upon arrival, LPAS Heath was greeted by the licensee, Jocelyn Collins, who provided a facility tour. The home is occupied by two adults (the licensee and her adult daughter) and minor children. 1 young children (7 yrs) and one infant (9 months old) were present during the inspection. According to the licensee, both children are her own children. No childcare children are present at this time. The licensee stated that the facility operates Monday through Friday from 6:00 a.m. to 6:00 p.m. Incidental Medical Services (IMS) were discussed, and the licensee confirmed that no children currently require IMS.
The home is set up as follows: This is a two-story house with five bedrooms, three bathrooms, a living room, a dining room, a kitchen, a laundry room, and a garage. The backyard is also fully barricaded by cement blocks. LPAS did not observe any pools, spas, or bodies of water on the premises. The home was inspected for safety, comfort, cleanliness, phone service, and ventilation. The house has central heating and air conditioning, and all windows have intact screens free of cracks, bugs, or debris.
Main Area: Main care will be provided in the living room and dining room areas. Children will eat in the dining room area. Per the licensee, she will be utilizing a food program. The daycare children will utilize the hallway bathroom on the left-hand side near bedroom #1. The front yard, backyard, entire upstairs (barricaded by safety gate), bedrooms #1-5, bathrooms #2 and 3, laundry room (barricaded by safety gate), and garage(key lock door knob) are off limits to the daycare children.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE: DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: COLLINS FAMILY CHILD CARE
FACILITY NUMBER: 197700738
VISIT DATE: 12/16/2024
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Living Room and Dining Room: LPAS observed age-appropriate toys and furniture in the designated childcare areas. There is a table with eight child-sized chairs and multiple plastic storage bins containing games and toys. The facility also provides books and games for the children. Educational mats were placed on the floor in good condition. An adult-sized couch is present, and a TV shows educational videos to the children.
Children's Bathroom (#1): The bathroom was inspected, and the sink and toilet were operable. The toilet and faucets were clean and safe. The medication cabinet was free of medications or personal items, and all poisons and medications were secured under the sink with child safety latches. The bathroom was clear of any hazardous items.
Kitchen (Safety Gate): The kitchen was inspected and found to be safe. Hazardous items were stored out of children’s reach using child safety latches. Sharp utensils, poisons, and medications were inaccessible to children, and sharp knives were stored in a butcher block. However, the safety gate was not in place during the inspection, which allowed children access to the kitchen.
Backyard (off-limited): The fully gated backyard was inspected for outdoor play. It was free of hazards, loose objects, and sharp items. There is a grass and concrete area designated for active play.
Additional Information:
The AC/Heating unit is located on the right side of the home and is blocked by barrels, making it inaccessible to children. All unused electrical outlets are plugged and inaccessible to children. The licensee, enrolled in the Food Program, provides breakfast, lunch, snacks, and sometimes dinner.
A 2A10BC fire extinguisher in the kitchen and reading in the green meets State Fire Marshall standards and is inaccessible to children. There is no fireplace, and all window blind cords are out of children's reach. If a child shows signs of illness, they will be located near the front door area.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
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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: COLLINS FAMILY CHILD CARE
FACILITY NUMBER: 197700738
VISIT DATE: 12/16/2024
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Cleaning compounds are stored in an upper kitchen cabinet, and medications are kept in an off-limits bedroom, both inaccessible to children. Children nap in designated areas with adult supervision, and 6 cots were observed in a closet. The licensee does not offer overnight care. Two dogs and 3 puppies live in the home but do not interact with the children. The house has a working phone line.
Smoke detectors and carbon monoxide devices were tested and found to be operable. A First Aid kit with supplies and a manual is kept in the kitchen, out of children's reach. The licensee does not provides transportation. The licensee confirmed that there were no firearms at the facility, and none were observed during the inspection.
Documentation Review:
Child Files: LPAS reviewed 4 children's records. While some forms were incomplete, all necessary licensing documents were observed in the files.
Infant Sleeping Plan (LIC 9227) and Sleeping Log: 1 infant (licensee’s child). The licensee did not have LIC 9227 forms and sleeping logs for her own babe. LPAS shared information about Safe Sleep Regulations with the licensee.
Personnel File: No assistant at this time.
Criminal Record: According to the Guardian, all adults living and working in the facility have criminal record clearance.
CPR/First Aid: LPAS verified that the licensee holds current Pediatric CPR and First Aid certifications, which expire on 08/2026. The licensee also completed one hour of nutrition training and eight hours of Preventive Health and Safety Training.
Mandated Reporter Training: The licensee completed the online mandated reporter training at www.mandatedreporterca.com, which expires on 1/2024.
Facility Fees: According to the Licensing Information System, the annual facility fees are current.
Fire/Disaster Drill: The licensee conducts fire drill every months, with the last drill documented on 12/9/2024. If earthquake drill were not observed, it will be noted.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
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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: COLLINS FAMILY CHILD CARE
FACILITY NUMBER: 197700738
VISIT DATE: 12/16/2024
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Required Postings: LPAS observed that the licensee doeshave the Facility License, Emergency Disaster Plan displayed as required. LPAs provided Earthquake Preparedness and Parents' Rights Poster to the Licensee.
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 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 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).
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Carol Heath
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
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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: COLLINS FAMILY CHILD CARE
FACILITY NUMBER: 197700738
VISIT DATE: 12/16/2024
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ü LPAS discussed the safe sleep regulations with licensee [or facility representative] 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. LPAS also informed licensee [or facility representative] 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.
ü 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.
ü 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: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
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: COLLINS FAMILY CHILD CARE
FACILITY NUMBER: 197700738
VISIT DATE: 12/16/2024
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ü 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.
ü Family Child Care Homes During the exit interview, the LICENSEE ****, confirmed that there are no Registered Sex Offenders living in the facility and LPAS completed the RSO profile in FAS.
ü Family Child Care Homes A notice of site visit was given and must remain posted for 30 days.
ü 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.

Deficiencies cited: (See LIC 809D). The following Type B deficiencies are being cited in accordance with Title 22 of the California Code of Regulations and/or Health & Safety codes

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

DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/16/2024 11:27 AM - It Cannot Be Edited


Created By: Carol Heath On 12/16/2024 at 11:00 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: COLLINS FAMILY CHILD CARE
FACILITY NUMBER: 197700738

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/16/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. During today's inspection, the licensee was unable to provide updated Mantdate Reporter Training. The training expired on 1/2024, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/23/2024
Plan of Correction
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The licensee agreed to complete her Mandated Reporter Training and email her certification by 12/23/2024.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claretta Yates
LICENSING EVALUATOR NAME:Carol Heath
LICENSING EVALUATOR SIGNATURE:
DATE: 12/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/16/2024


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